title: A Shipping Container-Based Sterile Processing Unit for Low Resources Settings.
abstract: Deficiencies in the sterile processing of medical instruments contribute to poor outcomes for patients, such as surgical site infections, longer hospital stays, and deaths. In low resources settings, such as some rural and semi-rural areas and secondary and tertiary cities of developing countries, deficiencies in sterile processing are accentuated due to the lack of access to sterilization equipment, improperly maintained and malfunctioning equipment, lack of power to operate equipment, poor protocols, and inadequate quality control over inventory. Inspired by our sterile processing fieldwork at a district hospital in Sierra Leone in 2013, we built an autonomous, shipping-container-based sterile processing unit to address these deficiencies. The sterile processing unit, dubbed "the sterile box," is a full suite capable of handling instruments from the moment they leave the operating room to the point they are sterile and ready to be reused for the next surgery. The sterile processing unit is self-sufficient in power and water and features an intake for contaminated instruments, decontamination, sterilization via non-electric steam sterilizers, and secure inventory storage. To validate efficacy, we ran tests of decontamination and sterilization performance. Results of 61 trials validate convincingly that our sterile processing unit achieves satisfactory outcomes for decontamination and sterilization and as such holds promise to support healthcare facilities in low resources settings.
authors.affiliation: Association Soleil-Vapeur, Evreux, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Boubour
authors.affiliation: Jones Graduate School of Business, Rice University, Houston, Texas, United States of America.
authors.forename: Katherine
authors.initials: K
authors.lastname: Jenson
authors.affiliation: Brown School of Engineering, Department of Mechanical Engineering, Rice University, Houston, Texas, United States of America.
authors.forename: Hannah
authors.initials: H
authors.lastname: Richter
authors.affiliation: Brown School of Engineering, Department of Chemical Engineering, Rice University, Houston, Texas, United States of America.
authors.forename: Josiah
authors.initials: J
authors.lastname: Yarbrough
authors.affiliation: Brown School of Engineering, Department of Bioengineering and Rice 360 Institute of Global Health, Rice University, Houston, Texas, United States of America.
authors.forename: Z Maria
authors.initials: ZM
authors.lastname: Oden
authors.affiliation: Jones Graduate School of Business and Rice 360 Institute of Global Health, Rice University, Houston, Texas, United States of America.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Schuler
mesh_terms: D003666:Decontamination / Q000379:methods*; D004866:Equipment Contamination / Q000517:prevention & control; D006801:Humans; D008420:Manufactured Materials; D009873:Operating Rooms / Q000379:methods; D012807:Sierra Leone; D013227:Steam; D013242:Sterilization / Q000379:methods*; D013245:Sterilization, Reproductive / Q000379:methods*
chemical_list: D013227:Steam