IE910292A1 - A process for preparing a medical pack - Google Patents

Abstract

This invention relates to a process for preparing a medical pack which includes a number of surgical linens for surgical operations and procedures. The process comprises of sorting through soiled surgical linens to remove foreign objects, separating the linens into different categories, laundering each category separately, inspecting the linens and rejecting any which are inadequately cleaned or have defects, folding of the linen in a manner which will not break the sterile barrier, and assembling a pack containing said linens for the aforesaid surgical operations and procedures. The inspection of the laundered linens preferably includes the step of back lighting each to detect defects. The process of sterilisation is preferably carried out by a steam and vacuum drying process, which includes a 'telltale' tape to indicate when sterilisation has occurred.

Description

A process for preparing a medical pack This invention relates to a process for preparing a medical pack which includes a number of surgical linens for surgical operations and procedures .

The term surgical linens as used in this specif ication includes surgical gowns and the numerous different types of surgical drapes used, for example large/medium drapes, wound drapes, dressing drapes, Mayo Stand covers and the like. While referred to as linens they may be of any suitable material and are typically either pure cotton or a polyester/cotton blend.

It is known to provide a medical pack containing various surgical linens for use in hospitals and the like in surgical operations and procedures. After the packs are used by the hospital the linens are returned for laundering prior to their use in new packs. The packs have a shelf life of typically 12 months and if not used in that time, to ensure sterility, the linens in the packs have to be re-laundered irrespective of whether they have been used or not.

A difficulty arises in that different operations will have different linen requirements, and in many cases some of the linens contained in a pack will not be used in a specific operation. These extra linens may sometimes be used in a subsequent operation, but if not used within the shelf life of the pack they are returned for re-laundering. This obviously leads to increased expense for the hospital. Further, a nurse - 2 has to spend time selecting the various linens required for a particular operation.

Another problem is that when soiled linens are returned for laundering they often contain foreign objects such as paper towels, lint, syringes, and surgical instruments for example. These foreign objects have to be removed prior to laundering. Syringes and surgical instruments such as scalpels pose a health threat to those sorting the linens and great care must be taken to avoid being cut and infected by, for example a scalpel or a needle of a syringe.

Another problem that arises during laundering of the linens is that there is a tendency for longer drapes to become entangled with shorter drapes and gowns and this can adversely effect the washing of the linens. Also after washing, time is wasted in having to disentangle the various linens prior to further processing the linens.

It is an object of the present invention to overcome these problems .

According to the invention there is provided a process for preparing a medical pack which includes a number of re-usable surgical linens, comprising the steps of; (a) sorting through soiled surgical linens to remove foreign objects, (b) separating the surgical linens into surgical gowns and surgical drapes and delivering the gowns and drapes into separate wash bags, (c) laundering the gowns and drapes separately, ? z·’ ri' irtt . ,« < 'j 1/ / £ 7 (d) inspecting laundered linens and rejecting any linens inadequately cleaned or having defects, rejected linens being returned for re-laundering and repair as necessary, (e) folding the linens in a manner which allows the linens to be unfolded for use without breaking the sterile barrier afforded by the linens in use, (f) assembling a medical pack containing a number of the linens, the pack being assembled such that it contains the correct amount and type of linens appropriate for a particular surgical operation or procedure, and (g) sterilising the medical pack.

In a preferred embodiment inspection of the laundered linens includes the step of back lighting each of the linens to detect defects.

In another embodiment the sterilising is carried out by steaming the pack at a temperature of 134°C for 3¼ minutes followed by vacuum drying at a temperature of 7 5°C for ten minutes .

In a preferred embodiment the process includes the step of inserting a tell-tale tape centrally in the pack when assembling the pack, the tape being of a type which changes colour when subjected to the sterilising process.

In a further embodiment the process includes the step of checking the soiled linens with a metal detector prior to sorting the soiled linens.

Preferably the metal detector gives visual indication of any metal objects entrained in the linens. -910292 ‘ Typically the linens are delivered through the metal detector on a conveyor, the conveyor being adapted to stop in response to detection of metal objects.

In another aspect the invention provides a medical pack whenever produced by the process as described above.

The invention will be more clearly understood by the following description of some embodiments thereof, given by way of example only, with reference to the accompanying drawings, in which: Fig. 1 is a block diagram of a process for preparing a medical pack according to one embodiment of the invention, Fig. 2 is a block diagram of a laundering portion of the process, Fig. 3 is a perspective view of a surgical drape included in a medical pack produced by the process, Fig. 4 is a side view of the drape shown in Fig. 3, Fig. 5 and Fig. 6 show consecutive steps of a folding sequence for the drape of Fig. 3, Fig. 6, 7 is an end view of the drape illustrated in Fig. Fig. 8 is a perspective view of another drape forming portion of the medical pack, Figs . 9 to 15 inclusive show sequential steps for folding the drape shown in Fig. 8, Fig. 16 is an end perspective view of the drape of Fig. fully folded, Fig. 17 is a perspective view of a stack of swabs forming portion of the medical pack, Fig. 18 is a perspective view of a paper bag forming portion of the medical pack, Fig. 19 is a perspective view of dressing drapes forming portion of the medical pack, Figs. 20 to 27 inclusive are various views showing sequentially different steps in the assembly of the medical pack, Figs. 28 to 30 are plan views illustrating sequentially the opening of the medical pack for use, and Fig. 31 is a block diagram illustrating another process for forming medical packs according to another embodiment of the invention.

Referring to the drawings and initially to Fig. 1 and Fig. 2 which schematically illustrate a process for preparing a medical pack according to the invention. Bags of soiled surgical linens including various types of drapes and gowns are received from a hospital. Sorting 10 through soiled linens is carried out to remove any foreign objects such as paper tissues, surgical instruments, bandages and the like which are frequently entrained in the linens. Sorted linens are separated and delivered into wash bags, the gowns and drapes being put in separate bags as shown in Fig. 2. These bags are then delivered for laundering 12. Each of the bags of linens is sized to contain a single load for a washing machine. It will be noted from Fig. 2 that the linens are separated into four streams for washing, namely: gowns 80; large/medium drapes 82; dressing drapes/eye drapes 83; wound drapes/Mayo Stand covers 84. The gowns undergo washing 85 and tumble drying 86 before being delivered to inspection 14. Each of the other streams of drapes undergo washing 87 followed by spin drying 88 to partially dry the drapes followed by calendering 89 and then delivery for inspection 14 .

After laundering 12 the linens are subjected to careful inspection 14 to ensure that the linens have been adequately cleaned. It is necessary to ensure that all stains are removed from the linens and also that there are no particles of paper, lint or the like adhering to the linens which would cause a sterility problem. Further, any defective linens, for example, having tears or loose threads will not pass inspection. To show up defects the linens are back lit by placing them against a light source which will shine through any defects. Linens rejected at 15 are returned for further laundering and defective linens are delivered for repair 16 prior to re-laundering.

Linens which pass inspection 14 are delivered to a folding station 20 where they are folded in a manner which allows the linens to be subsequently unfolded for use without breaking the sterile barrier afforded by the linens in use, as will be described later.

A number of the linens are assembled into a medical pack at a packing station 22. It will be noted that each pack is assembled such that it contains the correct amount and type of linens appropriate for a particular surgical operation or procedure. In addition to the linens the medical packs will contain various other items such as swabs, cotton wool balls, hand towels and the like as appropriate for the particular surgical procedure. By way of example a number of different types of medical pack are itemised below: Itemised Pack List THORACOTOMY PACK (Inner Wrap - 1 Large Drape) Medium Drapes Mayo Stand Covers Wound Drapes X-Strip Swabs 30cm x 30cm x 12ply Peanut Dissectors Cotton Wool Balls (Large) Paper Bag and Safety Pin STANDARD ABDOMINAL PACK (Inner Wrap - Large Drape) Medium Drapes Dressing Drapes Mayo Stand Cover Wound Drapes X-Strip Swabs 30 X 30 without tapes 1 Surgical Sheet 90 X 90 1 Surgical Sheet 50 X 50 5 Cotton Wool Balls Large Paper Bag and Pin MINOR PROCEDURE PACK (Inner Wrap - Medium Drape) Minor Surgery Drape Dressing Drapes Surgical Sheet 90cm x 90cm 1 Surgical Sheet 50cm x 50cm 5 Cotton Wool Balls Large X-Strip Swabs 10cm x 10cm x 32ply 1 Paper Bag and Pin SMALL MINOR SURGERY PACK (Inner Wrap -1 Medium Drape) Minor Surgery Drape Surgical Sheet 50cm x 50cm Plain Swabs 10 x 10 x 32ply white 5 Cotton Wool Balls (large) PERINEAL PACK (Inner Wrap - 1 Large Drape) Perineal Drape Leggings Dressing Drapes X-Strip Swabs 22.5cm x 22.5cm x 12ply 1 Surgical Sheet 50cm x 50cm 5 Cotton Wool Balls (Large) Paper Bag and Safety Pin GOWN PACK (Inner Wrap - 2 Sheet 90 x 90 crepe paper) Gowns (Large) Gown (Medium) Hand Towels (paper) CYSTOSCOPY AND HAEMORRHOIDECTOMY PACK (Inner Wrap - 1 Medium Drape) Minor Surgery Drape Dressing Drapes Leggings X-Strip Swabs 10cm x 10cm x 32 ply9 1 0 29 2 1 CAESAREAN SECTION PACK (Inner Wrap - 1 large Drape) Laparotomy Drape Medium Drapes Dressing Drapes Mayo Stand Cover Wound Drapes X-Strip Swabs with tapes 45cm x 45cm x 12ply 1 Surgical Sheet 90cm x 90cm 1 Paper Bag and Safety Pin DELIVERY PACK (Inner Wrap - 1 Medium Drape) Surgical Sheet 90cm x 90cm Dressing Drapes Cotton Wool Balls (Large) Maternity Pads D. AND C., A.R.M. AND STITCH PACK (Inner Wrap - 1 Medium Drape) Dressing Drapes White Swabs 7.5cm x 7.5cm x 8 ply 20 Cotton Wool Balls - Large 1 Maternity Pad Surgical Sheet 50cm x 50cm HIP PACK (Inner Wrap - 1 Large Drape) Medium Drapes Mayo Stand Cover X-Strip Swabs 30cm x 30cm x 12ply 10 Cotton Wool Balls (Large) Wound Drapes Ι Paper Bag and Safety Pin •οKNEE PACK (Inner Wrap - 1 Large Drape) Medium Drapes Dressing Drapes X-Strip Swabs 10cm x 10cm x 32ply 10 Cotton Wool Balls (Large) NOSE AND THROAT PACK (Inner Wrap - 1 Medium Drape) Medium Drape Dressing Drapes Cotton Wool Balls (Large) EYE PACK (Inner Wrap - 1 Medium Drape) Surgical Sheet 90 x 90 3 Dressing Drapes 1 Eye Drape X-Strip Swabs 10 x 10 x 8ply 10 X-Strip Swabs 5 x 5 x 32ply 10 Vitreous Sponges MINOR OPHTHALMIC PACK (Inner Wrap- 1 Medium Drape) Dressing Drape 1 Eye Drape X-Strip Swabs 10 x 10 x 8ply 10 X-Strip Swabs 5 x 5 x 32ply 10 Vitreous Sponges Surgical Sheet 90 x 90 / ο / A number of assembled medical packs are delivered into a sterilisation chamber 24 in which the medical packs are sterilised by steaming the pack at a temperature of about 134°C for 3¼ minutes followed by vacuum drying the packs at a temperature of 75°C for about ten minutes.

Referring now in particular to Figs. 3 to 7 there is illustrated a Mayo Stand cover 25 used in some of the packs. The folding sequence for the Mayo Stand cover 25 is shown in Fig. 3, Fig. 5 and Fig. 6. Fold lines are indicated in broken outline .

Referring now in particular to Figs. 8 to 16 there is illustrated sequentially the folding of a medium drape 30. Fold lines are indicated in broken outline. As shown in Figs. 8 to 11 the drape 30 is first accordion folded. The drape 30 is then repeatedly doubled over on itself as shown in Figs. 11 to 14 to form the compact folded drape 30 illustrated in Fig. 15 .

It will be appreciated that the method of folding the Mayo Stand cover 2 5 and medium drape 30 allows them to be subsequently unfolded for use without breaking the sterile barrier afforded by the linens in use.

Fig. 17 shows a bundle of swabs 40. Fig. 18 shows a paper bag and pin included in some of the packs. Fig. 19 shows various sized dressing drapes 41 used for the packs.

Referring now to Figs. 20 to 27 assembly of a medical pack will be described. An outer wrapping sheet 50 formed by a large drape is folded over on itself and laid on a flat surface. A drape 30 partially folded as in Fig. 11 is centrally placed on the wrapping sheet 50 as shown in Fig. 20. A number of fully folded drapes 30, folded surgical sheets 55, swabs 40, dressing drapes 41 and the like are all assembled centrally on the partially folded drape 30 to form a compact bundle 56 of the linens and the other pack accessories. Different combinations of the various items for the pack will be assembled as required such that the medical pack contains the correct amount and type of linens and other accessories for a particular surgical operation or procedure as appropriate. The partially folded drape 30 has its outer ends 57 folded inwardly then each end 57 of the partially folded drape 30 is folded up over the assembled bundle 56 as shown in Fig. 21 to neatly bind the various items together. Then the wrapping sheet 50 is folded around the bundle 56 totally enclosing the bundle 56 as shown in the sequence of Figs. 22 to 27. It will be noted from Figs. 23 and 24 that the wrapping sheet 50 is folded such that a folded edge 60 of the wrapping sheet 50 is retained between the two free edges 61, 62 of the wrapping sheet 50. Further a peripheral portion of each of the free edges 61, 62 of the wrapping sheet 50 is folded back on itself. Then each end 65, 66 of the wrapping sheet 50 are folded inwardly and over a top of the enclosed bundle 56 as shown in Figs. 26 and 27. The wrapped bundle 56 may then be inserted into an outer bag the mouth of which is folded shut and taped. A number of the bags are then sterilized as previously described. The tape used to close the outer bag has markings thereon which change colour when steamed to give indication that sterilisation has been carried out. It will also be noted that during assembly of the packs a strip of the tape is located in the centre of the bundle 56 of linens so that when the pack is subsequently opened prior to use in an operation there is visual indication that during the sterilisation process steam has penetrated right through the pack ensuring all the linens have been sterilised. Figs. 28 to 30 illustrate sequentially how the wrapping sheet 50 is opened up in use.

Gown packs are provided containing a number of surgical gowns (not shown). Each gown is turned inside out prior to folding.

A paper hand towel is provided with each gown. The folded gowns with their associated hand towel are wrapped in crepe paper in similar fashion to the wrapping of the wrapping sheet 50 about the bundle 56 of linens to form the medical pack described with reference to Figs. 20 to 27. A number of the wrapped gowns are inserted into an outer bag which is taped shut.

Referring now to Fig. 31 there is illustrated schematically an alternative process for preparing the medical packs. This is largely similar to the process described previously with reference to Fig. 1 and like steps are assigned the same reference numerals. In this case prior to sorting 10 the linens are delivered through a metal detector 70. This will detect any metal objects such as surgical instruments, needles and the like which are entrained with the soiled linens. Detected metal objects can be carefully removed to avoid injury to persons sorting the linens.

Ideally, the linens are delivered through the metal detector 70 on a conveyor. Preferably a viewing screen is provided for easy location and identification of metal objects within the drapes and gowns.

It will be appreciated that as the packs are prepared with the correct amount and type of linens appropriate for a particular surgical operation or procedure the wastage of having extra linens which are not used before the expiry date is eliminated thus saving the costs of having to re-launder unused linens and improving the overall efficiency of the process. Of further advantage to hospitals is the fact that the specific linen requirement for each operation is assembled in a particular pack which is simply selected and opened out ready for use prior to the operation. Thus nursing staff do not have to waste time assembling the required linens for each particular operation. θ λ * « ν ί .9 2 Further by separating the soiled linens into a number of different streams for washing an improvement in the overall efficiency and quality of washing can be achieved.

By delivering the soiled linens through a metal detector prior 5 to sorting any metal objects entrained in the linens can quickly and easily be detected and carefully removed from the linens .

The invention is not limited to the embodiments hereinbefore described which may be varied in detail.

Claims (10)

1. A process for preparing a medical pack which includes a number of surgical linens, comprising the steps of; (a) sorting through soiled surgical linens to remove foreign objects, (b) separating the surgical linens into surgical gowns and surgical drapes and delivering the gowns and drapes into separate wash bags, (c) laundering the gowns and drapes separately, (d) inspecting laundered linens and rejecting any linens inadequately cleaned or having defects, rejected linens being returned for re-laundering and repair as necessary, (e) folding the linens in a manner which allows the linens to be subsequently unfolded for use without breaking the sterile barrier afforded by the linens in use, (f) assembling a medical pack containing a number of the folded linens, the pack being assembled such that it contains the correct amount and type of linens appropriate for a particular surgical operation or procedure, and (g) sterilising the medical pack.

2. . A process as claimed in claim 1 wherein inspection of the laundered linens includes the step of back lighting each of the linens to detect defects.

3. A process as claimed in any preceding claim wherein the sterilising is carried out by steaming the medical pack at a temperature of 134°C for 3¾ minutes followed by vacuum drying at a temperature of 75°C for ten minutes.

4. A process as claimed in any preceding claim including the step of inserting a tell-tale tape centrally in the pack when assembling the pack, the tape being of a type which changes colour when subjected to the sterilising process.

5. A process as claimed any preceding claim, wherein the process includes the step of checking the soiled linens with a metal detector prior to sorting the soiled linens.

6. A process as claimed in claim 4 wherein the metal detector gives visual indication of any metal objects entrained in the drapes and gowns.

7. A process as claimed in claim 4 or claim 5 wherein the drapes and gowns are delivered through the metal detector on a conveyor, the conveyor being adapted to stop in response to detection of metal objects.

8. A process substantially as hereinbefore described with reference to the accompanying drawings.

9. A medical pack whenever produced by the process as claimed in any preceding claim.

10. A medical pack substantially as hereinbefore described with reference to the accompanying drawings .