000			03336nam a22005057a 4500
008			180220s20182018 xxu||||| |||| 00| 0 eng d
022			_a0009-921X
024			_a10.1007/s11999.0000000000000185 [doi]
040			_aOvid MEDLINE(R)
099			_a29432266
245			_aLooking for Holes in Sterile Wrapping: How Accurate Are We?.
251			_aClinical Orthopaedics & Related Research. 476(5):1076-1080, 2018 05.
252			_aClin Orthop. 476(5):1076-1080, 2018 05.
253			_aClinical orthopaedics and related research
260			_c2018
260			_fFY2018
266			_d2018-02-20
520			_aBACKGROUND: Defects in sterile surgical wrapping are identified by the presence of holes through which light can be seen. However, it is unknown how reliably the human eye can detect these defects.
520			_aCONCLUSIONS: Defects <= 2 mm were not reliably detected with respect to lighting, time, or level of experience. Future research is warranted to determine defect sizes that are clinically meaningful.
520			_aLEVEL OF EVIDENCE: Level II, diagnostic study.
520			_aMETHODS: Thirty participants (10 surgical technicians, 13 operating room nurses, seven orthopaedic surgery residents) inspected sterile sheets for perforations under ambient operating room (OR) lighting and then again with a standard powered OR lamp in addition to ambient lighting. There were no additional criteria for eligibility other than willingness to participate. Each sheet contained one of nine defect sizes with four sheets allocated to each defect size. Ten wraps were controls with no defects. Participants were allowed as much time as necessary for inspection.
520			_aQUESTIONS/PURPOSES: The purpose of this study was to determine (1) how often holes in sterile packaging of various sizes could be detected; and (2) whether differences in lighting, experience level of the observer, or time spent inspecting the packaging were associated with improved likelihood of detection of holes in sterile packaging.
520			_aRESULTS: Holes >= 2.5 mm were detected more often than holes <= 2 mm (87% [832 of 960] versus 7% [82 of 1200]; odds ratio, 88.6 [95% confidence interval, 66.2-118.6]; p < 0.001). There was no difference in detection accuracy between OR lamp and ambient lightning nor experience level. There was no correlation between inspection time and detection accuracy.
546			_aEnglish
650			_a*Equipment Contamination/pc [Prevention & Control]
650			_a*Lighting
650			_a*Product Packaging
650			_a*Sterilization/mt [Methods]
650			_a*Surgical Equipment
650			_a*Visual Perception
650			_aHumans
650			_aInternship and Residency
650			_aNursing Staff, Hospital
650			_aObserver Variation
650			_aOperating Room Technicians
650			_aOperating Rooms
650			_aOrthopedic Surgeons/ed [Education]
651			_aMedStar Harbor Hospital
656			_aDepartment of Medicine
657			_aJournal Article
700			_aRichardson, Mark W
790			_aBush CM, DiPasquale TG, Mayassi HA, Muccino PM, Opalacz BM, Rashidifard CH, Richardson MW
856			_uhttps://dx.doi.org/10.1007/s11999.0000000000000185 _zhttps://dx.doi.org/10.1007/s11999.0000000000000185
942			_cART _dArticle
999			_c3066 _d3066