APIC-DFW Community Standards of Practice SIG

The Impact of Temperature and Humidity on the Integrity of Sterile Supplies

Summary

February 14, 2019

14:00 – 15:00

The APIC-DFW Community Standards of Practice (CSOP) Special Interest Group (SIG) held a meeting on February 14, 2019 to discuss common practices around compromised sterile supplies after exposure to extreme environmental conditions. The meeting was open to current infection prevention and public health practitioners, both members and non-members of APIC-DFW. Currently, state regulations and national guidelines require rooms storing sterile supplies to:

·         be under positive pressure relative to adjacent rooms,

·         have a minimum of 4 air changes per hour (ACH),

·         maintain temperatures between 72ºF and 78ºF, and

·         have a maximum of 70% relative humidity (RH).

These regulations and guidelines are provided by the Texas Department of State Health Services (DSHS), the Association for the Advancement of Medical Instrumentation (AAMI), the American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE), and the Centers for Disease Control and Prevention (CDC).

Prior to the meeting, a voluntary survey was administered concerning current practices for sterile supply storage and experience with a compromised supply incident. The results were used to help guide the meeting’s conversation. Seventeen facilities were represented in the survey responses, with 88.2% being acute care hospitals. All respondents that gave a quantifiable value said they store sterile supplies between 60ºF and 80ºF with a relative humidity between 20% and 70%. 82.4% of respondents stated their facility has centralized monitoring of temperature and humidity where sterile supplies are stored. 64.7% of respondents stated their facility has experienced a HVAC incident that resulted in temperature and humidity levels outside of regulation limits, with 41.2% stating their facility’s sterile supply storage areas were affected.

Participants working for a facility that experienced an event were asked to share information regarding the incident, mitigation steps, and the outcome. Representatives from two facilities, who are entities of different health systems, shared about their events. Both incidences occurred within the same week and were a result of power outages for several hours. One of the facilities reported that they sequestered all supplies that were in affected areas and, once the environmental conditions returned to normal, the areas were terminally cleaned and restocked with new supplies. The other facility did not remove all sterile supply, but described a risk assessment tool that was developed and used to remove compromised supplies.

Participants felt that further guidance was needed on how to respond when these events occur. The APIC-DFW CSOP SIG will be meeting again to further discuss this topic.