2.1 ORGANISATION OF PACKING AREA

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1 2.1 ORGANISATION OF PACKING AREA An organised packing area ensures a clean, safe working area that reduces the risk of equipment damage/loss and unsafe work practices. OPERATING PROCEDURE Wrapping and packaging of items shall be performed on clean designated work benches/area The bench space is to be kept uncluttered Be responsible for your own workspace and restock equipment as required Utilise manuals, cards or computer for clear identification of instruments and trays. If the information or equipment required is missing report this to the Senior Dental Assistant If unsure what the item is or where it goes, ask for help, as this may be an integral part of the equipment 2010

2 2.2 ASSEMBLY OF INSTRUMENT TRAYS AND HOLLOW- WARE Consistent patterns/protocols for assembling trays of instruments and other equipment prior to wrapping and sterilizing enables efficiency and completeness of kit/trays. Check that equipment / instruments are clean, dry, rust and stain free. The use of a magnifying lamp is recommended Remove all damaged instruments, metallic/plastic hollow-ware and report to the Senior DA Prepare equipment for sterilization: o Check multi-part equipment / instruments are assembled and functioning and are disassembled or loosely assembled for sterilization as per manufacturers instructions e.g. composite and amalgam applicator o Hinged or ratchet instruments must be opened and unlocked o Sharp items shall be protected with a tip protector or enclosed in a cassette Follow a predetermined tray list or packing order Select the appropriate size tray or packaging material to assemble instruments giving consideration to size, mass and contents of tray When packaging hollowware sets: o Opening are to face in the same direction, o Hollowware should not be able to move, and o If hollowware is nestled insert separators Individual packs do not include combinations of hollowware, instruments, gauze dressings, drapes or tubing Where instrument reprocessing occurs offsite, manufacturer s instructions for the disassembly, cleaning and sterilization of instruments shall be provided to the sterilizing facility by District Oral Health Services REPORTING All damaged and incomplete trays/kits are reported to the Senior DA/Supervisor NB The density and size of tray/pack is determined at each oral health facility during the annual sterilization performance qualification (PQ) 2010;ADA Guidelines for infection control 2012

3 2.3 WRAPPING / PACKAGING / LABELLING To provide a protective barrier against sources of potential contamination. Wrapping/packaging methods shall facilitate aseptic removal of contents Refer to SOP 2.4 Dedicated Area Sterile Goods Refer to SOP 3.2 Loading and Recording of Items for Steam Sterilization Refer to SOP 4.2 Stock Rotation Refer to SOP 5.5 Internal and External Chemical Indicators Refer to OH Fact Sheet Validation of Benchtop sterilizer Ensure wrapping/sealing is accurate If tape is removed or repositioned or pouch is resealed and packaging material protective barrier has been compromised, then these items must be rewrapped/pouched in new materials Wrapped items Prior to use the wrapping material is to be checked to ensure that it is not damaged or expired The type of material, wrapping method and packaging is facility specific The wrapping method shall be envelope fold or square fold technique. Wrapping methods are part of the validation process Flexible packaging materials eg. laminated pouches/rolls Check for damage and expiry date prior to use Choose correct size of pouch for contents as per validated process, refer to OH fact sheet Validation of Benchtop Sterilisers Pouches shall only be filled up to ¾ of the overall space, allowing approximately 5 cm from the seal area Sharps or pointed items shall be protected by using tip protectors following manufacturer s instructions. Hollowware (bowls) openings are against non-laminate surface e.g. paper Labelling of packs All packs, bags, pouches and wrapped items must be labelled. Labelling shall include name of item if items are not visible through packing material Use a non-toxic, water resistant, felt tipped marking pen made specifically for steam sterilization If rubber stamps are used, the ink shall be non-toxic and water resistant and made specifically for steam sterilization When using a non-toxic, water resistant, felt tipped marking pen made specifically for steam sterilization, write on the outer parameter (edge) of the flexible packaging material When labelling items consider easy visual identification for stock rotation, ease of access, minimise handling and compromising sterility of items To occur prior to the sterilizing process utilising: o Batch labels (piggyback) o Pre-printed tape o Write on tape Labelling shall be clear and precise for easy identification and recall if required All packs shall have a batch label on them. Details on the batch label gun shall be checked and updated for each sterilizer cycle. The minimum information required on each label shall include; o Date of sterilization o Sterilizer number or site location number o Sterilizer cycle number In the event that a facility runs out of labels or the batch gun malfunctions, sterilization must not continue until replacements can be sought i.e. arrange for a replacement gun/labels to be sent from another facility 2010; ADA Guidelines for infection control 2012

4 2.4 LOADING AND USING A BATCH LABEL GUN Ensure the use of batch label guns facilitate accurate labelling of items for sterilization and for the purpose of instrument tracking. Where possible one batch label gun should be dedicated to each sterilizer. Upper adjustable print display - Setting the date and the sterilizer number Place the gun in your hand using the handle grip Have the adjustable print display facing you Identify the location of the date, and sterilizer number or site location number on the adjustable print display To adjust date or sterilizer number or site location number on the print display, o Use the knob to slide the white marker guide to the field that requires changing o Rotate the side knob until the required number appears in the viewing area o Date must appear as DD(space)MM(space)YY starting from the far left o The sterilizer number or site location number must be positioned to the far right Perform a final visual check to ensure the correct date, month, year and sterilizer number are visible Slide the upper knob fully into place to ensure that it is locked into position and display is fully visible Lower print band - Setting the sterilizer cycle number Lower adjustable print display shows the sequential cycle number Check what the last sterilizer cycle number used was and follow number sequence for anticipated sterilizer cycle number to be allocated Slide and rotate the knob until the anticipated sterilizer cycle number appears in the lower adjustable print display Slide the lower knob fully into place to ensure that it is locked into position and display is fully visible How to apply a Batch Label Squeeze and release the handle lever Direct the gun towards a test surface (e.g. scrap of paper) and apply by dragging the rollers across the surface towards you The label shall adhere fully to the surface and the information shall align in the correct fields Check the details on the batch label are correct

5 Reloading the batch label gun with labels Remove the empty roll cartridge by grasping the plastic core and gently pulling out of the label role holder Pull back the sliding mechanisms that are located on each side of the gun at the side of the gun. The base plate will release and drop open underneath Place the gun down on a solid surface with the base plate in a fully open position with the adjustable print display in an upright position Take the replacement roll of labels, pull approximately 15 cms of length away from the roll. Ensure the labels are facing up Feed the length of labels through the middle section of the gun until the labels appear through the bottom of the gun Align the edge of the roll to the rear of the gun, and push firmly down, until the roll snaps into place WARNING: Ensure your fingers are clear of the separation point at the rear of the gun to avoid pinching injuries The hard plastic core of the roll should fit into place over the roll holders of the gun Tug lightly on the roll to ensure the roll does not easily dislodge Turn the gun over and pull approximately 15 cms of the labels over the roller DO NOT feed the labels between the black rubber roller and the small white roller Push the base plate forward and then down to close an audible click should be heard Take hold of the length of labels and tilt the underside of the gun towards you Identify the slot to feed the length of labels through, which is towards the handle Feed the labels through the slot until they appear along the handle lever Gently pull the labels where they appear at the handle lever, to tighten Note that the labels should appear flat to the base Squeeze and release the handle lever once and remove the label Repeat this process until the labels produced by the gun are aligned in their correct fields Check that fields are correct - date, sterilizer number or site location number and cycle number o If not, recheck the adjustable print display and reload if necessary Note: Label details shall be checked every time a label is applied to an item Batch label guns shall be serviced every 12 months If the base plate is opened during operation, re-check that fields are correctly aligned 2010; ADA Guidelines for infection control 2012

6 2.5 RESTOCKING CONSUMABLE MATERIALS Efficiencies in work practice. Refer to SOP 2.1 Organisation of Packing Area Refer to SOP 4.2 Stock Rotation Each day check and replenish consumables in the reprocessing area Know where the bulk storage is located Storage containers / shelves that hold stock are required to be cleaned at regular intervals. Check your environmental cleaning plan for frequency Cardboard boxes are not to be used, refer SOP 4.1 Follow stock rotation process when removing required stock from a shelf Ensure wrapping and packaging materials have not reached their expiry date A process shall be in place to identify stock, stock numbers and expiry dates for removing expired stock and reordering purposes Reference: AS/NZS 4815