The benefits of sealed sterilization containers for surgical instruments have been documented extensively in the medical literature. However, not all containerized solutions use the same technology. ONE TRAY's FDA-cleared, rigid sterilization containers are intended to be used to hold temperature tolerant medical devices, surgical supplies, single instruments, multiple instruments or an instrument to be used immediately following sterilization. ONE TRAY® containers have been validated to maintain the sterility of the contents for up to 48 hours. This includes sterilization of lumens 3 mm in diameter or larger with lengths of up to 400 mm.
Becker's ASC Review recently spoke with two experts responsible for implementing ONE TRAY®’s innovative sterilization technology at their institutions:
- Warren Perry, BSN, RN, RNFA, CNOR, Director of Surgical Services at Community Memorial Hospital in Hamilton, N.Y.
- Eric Netroe, Administrative Program Coordinator for sterile processing at a hospital in the Midwest
Changing the game means changing mindsets
ONE TRAY's patented design takes advantage of the thermodynamic behavior of steam to efficiently attain sterility within the sealed container. The number, relative size and positioning of the filtered vent configuration creates a flow pattern that assures the expeditious and complete dispersal of saturated steam throughout the container. Retained moisture accumulates in a designed collection area, while a raised deck plate eliminates contact between instrumentation and the collection area.
"When I first learned about ONE TRAY, my biggest concern was the allowed retained moisture," Mr. Netroe said. "That broke a foundational belief I had regarding retained moisture within sterile trays. After the ONE TRAY rep and I had multiple conversations about the proven science, my opinion shifted. ONE TRAY's residual moisture is sterile. I went from wondering how this could be safe for patients to wondering how I hadn’t heard about or implemented this technology before."
Once Mr. Netroe's hospital implemented ONE TRAY, the sterile processing department team was able to pay more attention to decontamination and inspection processes. Time was saved, as well, since surgical teams didn't have to wait for trays to dry and cool. According to Mr. Netroe, "ONE TRAY has been a game changer for our day-to-day operations. In the five years that I’ve been an SPD manager, we've never had an infection or adverse event linked to ONE TRAY."
Sealed sterilization containers minimize OR delays, while maximizing patient safety
Mr. Perry was first introduced to ONE TRAY when he worked at a hospital in Florida as a staff nurse. When Community Memorial Hospital started to experience significant delays in the operating room due to holes in wrapped instrument trays, he immediately thought of ONE TRAY as a potential solution.
"Although we are a small critical access hospital, we have a significant joint replacement program. Each year, we perform around 700 joint replacement procedures. We have a small inventory of instruments and we don’t have significant budget to purchase additional tools,” Mr. Perry said. "The OR delays were leading to turnover issues which led us to using immediate use steam sterilization for certain trays. On our journey of discovery to eliminate Immediate use steam sterilization, we reached out to ONE TRAY."
The sterile processing team was on board with implementing ONE TRAY, but hospital administrators had questions about the return on investment. A sterilization wrap shortage was the catalyst that convinced Community Memorial Hospital to move forward with ONE TRAY.
"We knew that we’d have significant delays and would most likely have to cancel surgical cases," Mr. Perry said. "That motivated us to bring ONE TRAY to the attention of administration again, so we could highlight the benefits from a patient safety perspective, as well as an efficiency perspective."
Community Memorial Hospital planned to use ONE TRAY proactively for as many instruments as possible, but the organization also expected to leverage the solution reactively for cases where wrapped vendor trays still had to be used. If a wrapped vendor tray had a hole in it, the instruments could be reprocessed using ONE TRAY in about one hour, compared to the two hours required with dry time in our previously used autoclave cycle.
"To wash, wrap and autoclave instruments and then leave them to cool to room temperature before transport can take upwards of two hours, maybe longer," Mr. Perry said. "I worked closely with the finance team, and we calculated that an average OR minute cost $23. Making the argument for ONE TRAY® with that data was powerful. At $23 a minute, an hour saved in the OR adds up to over $1,300. If that happens a couple of times a week, the return on investment becomes clear."
Community Memorial Hospital ordered 75 ONE TRAY containers and they were delivered within just a couple of days. To date, the results of the program have been universally positive.
"Now that surgeons see the reduction in OR delays due to compromised wraps, they are happy," Mr. Perry said. "Before ONE TRAY, those delays happened several times a week. There are no more situations where scrub techs pick up a tray that had a hole in its wrapper and mistakenly put it down on the sterile field. When that happens, you have to tear the entire field down. We’ve also eliminated immediate use steam sterilization."
In addition, the ONE TRAY system generates less waste. Although Community Memorial Hospital doesn't track waste volumes formally, Mr. Perry has observed that there used to be two to three bags of trash after every case, and now it’s just one.
Most importantly, patient safety has been maintained. As Mr. Perry explained, "For all of us in healthcare, the primary concern is the patient's well-being. It's our responsibility to eliminate as many variables and prevent as many infections as possible. We’ve had no change in our [surgical site infection] rates after adopting ONE TRAY. In fact, everyone loves the technology so much that I just ordered 15 more containers."
One Tray surrounds its innovative technology with client education and support
The ONE TRAY team is committed to educating and supporting partner organizations during every step of the journey to containerized sterilization. "Barbara Ann Harmer, ONE TRAY's Vice President of clinical services, has been amazing for clinician-to-clinician discussions. That dialogue gave me the ammunition needed to have intelligent conversations with other stakeholders in my organization," Mr. Perry said. "I could also sleep well at night, knowing that this technology is the best thing for the organization and patients."
Mr. Netroe also interacted extensively with the ONE TRAY team to become an expert on the technology. He has used that information to educate surveyors from The Joint Commission and other accreditation bodies about ONE TRAY's approach to sterilization. Mr. Netroe has also closely examined the design of the ONE TRAY. "The way ONE TRAY constructed the gasket and filter in their container to allow for the sterilization of medical devices, is genius compared to competitors," he said.
Hospitals and health systems are recognizing that ONE TRAY can support patient safety, while maintaining operational efficiency and safeguarding financial viability. According to Mr. Perry, "Orthopedic surgery represents the largest portion of the revenues generated by our hospital. It just makes sense to protect our patients and to protect the business. We saw that we could ensure the fiscal health of the organization by making a small investment in ONE TRAY."
Mr. Netroe is also a fan. "When I first came across ONE TRAY, I was a staunch opponent, but now I feel like it's the ultimate tool for SPD managers to have in their arsenal. It's the biggest game changer in sterile processing that I’ve seen over the last 10 years."
ONE TRAY® provides a solution that allows facilities to meet demands head on by processing loaner, consignment, and high turn hospital instrumentation in a fraction of the time it takes sterile wrap or other rigid containers. American Made and backed by our Lifetime Warranty, ONE TRAY® is committed to patient safety and providing years of effective and reliable service. Partner this with EZ-TRAX™ and MAXIMIZE reprocessing of orthopedic sets with the ability to take 6-8 trays down to 2-3. This saves approximately 3 hours in reprocessing per case resulting in approximately 75% reduction in cost and labor to process TJA instrumentation. No need to process unnecessary vendor trays costing your facility time and money. Increase cases per day, do MORE surgeries in LESS trays and mitigate cancellations and delays with ONE TRAY® and EZ-TRAX™.