Ask the Editors
We are thinking about switching our practice to using cassettes as containers for our instruments; what factors should we consider as we discuss this major step?
The procedural shift away from seeing ungloved health care personnel use small scrub brushes to routinely clean contaminated instruments at sinks has been dramatic. As more data have accumulated concerning the potential for personnel to be accidentally stuck with sharp, contaminated instruments, the use of cassettes in hospitals, dental, hygiene, and assisting schools, practices, and other health care facilities has increased significantly over the years. A central, precautionary reason for this is the long standing infection control recommendation that contaminated instruments should be handled carefully, and as little as possible, in order to minimize the occurrence of accidental sharps exposures. Depending on how instruments and packages are handled and subsequently loaded into a sterilizer, there is a potential for personnel to be accidentally stuck with a sharp instrument. Using this concept as a starting point for discussion, the following should be included when discussing incorporation of cassettes into a practice setting:
1. a cassette system can substantially reduce direct handling of contaminated instruments before sterilization;
2. different cassette sizes are available, whereby they can hold complete sets of instruments for single procedures; this eliminates the need to prepare and process multiple packages;
3. when loaded properly, it is very difficult to overload the cassette; instrument rails or racks inside the cassette are designed to hold a certain number of instruments;
4. damage to instruments during processing in a cassette can be reduced from that noted with use of bags or pouches, because the items are held more securely in place; and
5. perforated cassettes are preferable over completely solid containers, as the latter may not allow steam or chemical vapor to reach the contents for sterilization to occur.