Double-barrier packaging still ideal, nurses report at HealthPack

Nurses prefer double-barrier packaging, consisting of a sealed tray within either another tray or a pouch, learned attendees at HealthPack 2013 in Louisville, KY. Such preferences along with feedback on package recycling and usability were shared during HealthPack’s annual Voice of the Customer survey and live nurses panel. This year’s survey results were gathered by Jennifer Foreman and Jennifer Neid Benolken and presented by Foreman on March 13, marking the survey’s fifth year. Later in the day Benolken moderated a live nurses panel during which nurses opened medical device packaging and shared their perspectives, which centered around opening ease and time. Foreman serves as medical device applications project coordinator for Sealed Air Corp.’s Medical Applications Division, and Benolken is technical communications manager for Smiths Medical. The survey results included responses from nurses around the world.

As in previous surveys, double barrier packaging continues to be preferred by nurses, Foreman told the audience. Seventy-three percent of respondents said that they “have more confidence” in products in double-barrier packaging, she said. During Benolken’s panel, nurses said that “double sterile barrier packaging is easier to pass, and it is safer.”

But all survey respondents (100%) reported that single-barrier packaging is “quicker to access,” and opening time and ease were key concerns during the subsequent panel.

Clear packaging is also ideal, with 86% of U.S. survey respondents and 79% of E.U. respondents preferring clear packaging. 
Sixty-eight percent of U.S. survey respondents and 62% of those from the E.U. examine seals for clean peels or defects. And one nurse on the panel said that she looked for “creases that compromise packaging” as well as for “holes and slices.”

All respondents (100%) look for and read “use before dates,” and 90% in the United States prefer labels that state warnings pertaining to latex allergies. During the panel, one nurse stated that she had “issues with finding expiration dates, lot numbers, and sizes” on labels. “It should be common practice to put it in the same format and location,” she added.

In an ancillary survey on International Symbols, Foreman found that 23% do not know what the hourglass symbol (for use-by date) means, and 50% do not know what the factory symbol (for manufacturer) means. During the panel, nurses reported having no formal training on reading symbols.

Nurses largely do not like instructions for use to be provided on CDs, Foreman explained. “They often are already in the operating room with no access to computers,” she said.

Recycling continues to be of interest to nurses, but only 41% of U.S. respondents and 31% of E.U. respondents report having recycling programs at their hospitals or clinics. And only 27% of U.S. respondents and 32% of E.U. respondents say they recycle. Seventy-four percent of U.S. respondents and 68% of E.U. respondents report putting noncontaminated trays in the trash.

One of the panel nurses said that her employer, Jewish Hospital in Louisville, was the first green hospital in Kentucky, “so we recycle,” she said. Her other two panelists said they do not recycle.

Opening ease was an important point made during the panel. “When nurses need extra time to figure out how to open a package, it is an issue,” explained one nurse.

Panel nurses also said that packaging features—or a lack of them—frequently lead to opening struggles. “I hate packages that don’t have a lot of room to grab for peeling open the seal,” said one nurse. “You fumble and struggle with packages that are too hard to open or peel open too easily.”

Opening cues would be appreciated. “If I can identify them, I don’t have a problem with corner peels,” said one nurse. “I look for the little tabs and open slowly, but if you do it too fast, you lose it,” explained another panelist.

“It is important what ends up near the opening feature, and it is often hard to hold something up without a good grip,” said a panelist.

Nurses also struggle with “something that sticks out or doesn’t come out right,” said one nurse. “You often don’t have an extra pair of hands to help.” And: “Someone isn’t always available to pick it out.”

Flipping or dumping devices into the sterile field, therefore, seemed to be a common practice among the panel nurses, as they demonstrated package opening. “Training helps you know what to dump,” said one nurse. “Everyone is taught to have a sterile conscience,” added another panelist.---Daphne Allen