Nurses' packaging preferences headlined HealthPack

As expected, HealthPack 2012 provided compelling end-user feedback with its Voice of the Customer survey and its lively nurses panel. This year’s survey results, organized by Jennifer Neid Benolken and Jennifer Blocher and presented by Blocher, reiterated many of the ongoing preferences nurses have expressed at past HealthPack events, such as for double-barrier packaging. And in the live panel moderated by Benolken, nurses expressed their opening concerns, which included avoiding tears and reducing waste. Benolken serves as senior packaging engineer for St. Jude Medical’s Cardiovascular Division, and Blocher is medical device applications specialist for Sealed Air Corp.’s Medical Applications Division.

The survey results included responses from nurses around the world.

Double barrier packaging continues to be preferred by nurses, reported Blocher. Seventy-three percent of U.S. respondents prefer double barrier, as compared with 63% of European respondents. “They believe that it offers more protection to maintain sterility,” Blocher said. “But for those who prefer single barrier, the majority do so because it is easier to access.”

When asked whether a product would be discarded should a circulating nurse drop its package, 48% of U.S. respondents said that they would, immediately. Only 10% of European respondents said that they would. Many other respondents outside these regions reported that they would inspect it first.

Other responses honed in on packaging preferences. Eighty-six percent of U.S. respondents say that clear packaging is important, compared with 77% of European respondents.

Instructions for use provided via Web sites or CDs were considered to be least helpful, Blocher reported, quoting one respondent: “By the time I need instructions, I am already in the OR.”

Printed expiration or use-by dates were coveted by all regions. Sterilization indicators were heavily favored by nurses in regions other than the United States or Europe.

The survey also looked at sustainability. “Recycling bins are not in the OR suite, if they even exist at all,” reported Blocher. As a result, about 64% of U.S. respondents and 68% of European respondents reported discarding noncontaminated trays in the trash; 80% of U.S. respondents and 72% of European respondents reported putting noncontaminated pouches into the trash. 
“The nurses wished they had better options, but it is not easy,” said Blocher.

During a packaging focus group that was broadcast live to the HealthPack audience, nurses opened packaging samples and expressed the importance of maintaining product sterility during package opening. They also spoke frankly about their reactions to specific packages during a live Q&A before the audience.

“We need one inch of area around the sterile area. If the content touches the seal area during opening, it is contaminated,” expressed one of the nurses as she reviewed a specific package.

Audience members inquired as to whether such a statement represented official policy. PMP News found these statements in the online Encyclopedia of Surgery: “Edges of sterile areas or fields (generally the outer inch) are not considered sterile,” and “When in doubt about sterility, discard the potentially contaminated item and begin again.” (Read more at http://www.surgeryencyclopedia.com/A-Ce/Aseptic-Technique.html#ixzz1p2kg...).

Nurses reported being frustrated repeatedly by package tears. “We can see up to three to four packages a day with tears, and then go for a week without throwing a package away from a tear,” said a nurse responding to an audience question.

“A tear is always a sterility issue, unless you have room to peel it open with your unsterile fingers,” reported another nurse. “In that instance, it is nice to have double packaging.”

And, “if you accidentally open a double packaging, you might put it back on the shelf. But in the majority of cases we would throw it away. When in doubt, throw it out,” reported one nurse.

And the “easier a package is to open, the least stressful the environment is,” said one nurse when asked by an audience member whether a larger package would be preferred for opening ease, despite straining inventory space.

Product information printed clearly on the package is key for safe product use. However, nurses did not appear to recognize some of the commonly used symbols for single use or expiration date. Instead, they look for cues in printed text. “We need to know that the product is sterile, its lot number and expiration date, as well as product diameter and size. Color coding can be helpful,” said one nurse.

Nurse complaints are being heard by hospital inventory teams, reported these nurses. “If you fill out enough forms [on discarded, unused product], management stops ordering that product,” said one nurse.

"If staff complains, we often get sales reps involved, and we may stop order the product,” said one nurse.

The costs associated with discarded products are often passed along to patients, one nurse reported.

Nurses will return for HealthPack 2013 for a packaging focus group and a live panel. The next Voice of the Customer survey, however, will be presented at HealthPack 2014.

For next year’s HealthPack, Blocher will work with Clemson University to survey HealthPack attendees and members of IoPP's Medical Device Packaging Technical Committee regarding their interpretations of ISO 11607.

Stay tuned to www.pmpnews.com for more HealthPack news. And be sure to add two new dates for upcoming HealthPack events: HealthPack Europe will be held October 8-9, 2012, in Dublin, Ireland; HealthPack 2013 will be held March 12-14, 2013, in Louisville, KY. For more details, visit www.healthpack.net.