IAHCSMM Sterile Storage and Distribution 1 — Questions and Answers

Question 1: The recommended temperature range for sterile storage areas is:

32 to 40 degrees F (0 to 4 degrees C) - refrigerator temperature
64 to 75 degrees F (18 to 24 degrees C) - room temperature range (Correct answer)
80 to 90 degrees F (27 to 32 degrees C) - warm room temperature
Temperature does not matter for sterile storage

Correct answer: 64 to 75 degrees F (18 to 24 degrees C) - room temperature range

Sterile storage areas should be maintained at 64 to 75 degrees F (18 to 24 degrees C) with controlled humidity to prevent condensation that could compromise packaging integrity.

AAMI ST79 and general sterile storage guidelines recommend maintaining sterile storage areas at 64 to 75 degrees F (18 to 24 degrees C) with relative humidity between 30 and 60 percent. Excessive heat can degrade packaging materials over time. High humidity and temperature fluctuations can cause condensation on packages, compromising sterile barrier integrity - moisture allows wicking of microorganisms through porous packaging materials. Climate-controlled storage protects sterile item integrity and extends shelf life.

Question 2: The first in, first out (FIFO) principle in sterile storage means:

Sterilize new items before old ones
Oldest sterilized items are used or distributed first so that items are not stored indefinitely (Correct answer)
Items closest to the front of shelves are thrown away first
The first technician in each shift handles all storage tasks

Correct answer: Oldest sterilized items are used or distributed first so that items are not stored indefinitely

FIFO means the oldest sterilized items are used first, ensuring that no item remains in storage indefinitely while newer stock accumulates in front of it.

FIFO stock rotation in sterile storage ensures that items sterilized earlier are used before more recently sterilized items. This practice: prevents packaging materials from degrading over extended storage periods, supports event-related sterility maintenance by minimizing unnecessary storage time, identifies and removes items with expired facility-determined storage dates, and improves inventory management. Practically, FIFO means placing newly sterilized items behind existing stock, so staff retrieve from the front.

Question 3: Which condition would warrant removing a sterile packaged item from service BEFORE use?

The package has been stored for more than 72 hours
The packaging has a visible tear, moisture wetness, or seal breach (Correct answer)
The external process indicator has completed its color change
The item is from the same sterilizer load as the last used item

Correct answer: The packaging has a visible tear, moisture wetness, or seal breach

A visible tear, moisture exposure, or seal breach compromises the sterile barrier and means the item must be removed from service and reprocessed, regardless of when it was sterilized.

Event-related sterility requires inspection of each packaged item before use. Items must be removed from service if: packaging is torn or punctured, seals are open or incomplete, packaging is wet or shows moisture damage (moisture wicking allows microbial entry), the item has been dropped on the floor, or the package shows signs of insect or pest contact. The length of storage time alone is not grounds for removal unless it exceeds the facility validated hang-time policy. A completed external process indicator is expected and normal - it confirms the item was processed.

Question 4: What is the purpose of closed shelving in sterile storage areas?

To allow technicians to easily see all stored items
To protect sterile packages from dust, moisture, and potential physical damage from open environments (Correct answer)
To reduce shelf costs in the CS department
To comply with OSHA hazardous materials storage requirements

Correct answer: To protect sterile packages from dust, moisture, and potential physical damage from open environments

Closed or covered shelving protects sterile packages from dust accumulation, moisture exposure, and physical damage that could compromise packaging integrity.

AAMI ST79 recommends that sterile items be stored in a clean, controlled environment, with closed or covered shelving preferred to protect packages from dust, which can carry microorganisms, and from physical damage. Open wire shelving is acceptable if the area is clean and well-controlled, but the bottom shelf should be at least 8 to 10 inches off the floor to prevent floor cleaning splash contamination. Items should never be stored on the floor, near sinks, or near air vents that could carry dust or moisture.

Question 5: When distributing sterile sets to the operating room, a CS technician should:

Unwrap all packages before transport to save time in the OR
Inspect each package for integrity at point of use before handing it to the OR staff (Correct answer)
Transport packages in open bins without covers
Sign out items as used regardless of whether the surgery is performed

Correct answer: Inspect each package for integrity at point of use before handing it to the OR staff

At distribution and point of use, CS staff should perform a final package integrity inspection - checking for tears, moisture, open seals, and indicator status - before the item is accepted by OR staff.

A final package integrity check at point of delivery or use is the last opportunity to identify compromised sterile packaging before an instrument contacts a patient. CS technicians delivering to the OR, and OR staff receiving items, should both be trained to inspect for: seal integrity, package tears or punctures, moisture or wetness, chemical indicator completion, and appropriate labeling (load number, sterilizer ID, expiration and hang-time). Any item failing inspection must be returned to CS for reprocessing.

Question 6: What is the minimum height above the floor that sterile supplies should be stored on shelving?

2 inches
8 to 10 inches (Correct answer)
18 inches
24 inches

Correct answer: 8 to 10 inches

Sterile supplies should be stored at least 8 to 10 inches off the floor to prevent contamination from floor cleaning splashes, moisture, and physical damage.

AAMI ST79 and general sterile storage guidelines specify that sterile supplies be stored a minimum of 8 to 10 inches off the floor. This clearance prevents: splash contamination during floor mopping or cleaning, moisture wicking from condensation that may accumulate near floor level, and physical damage from foot traffic or equipment. Similarly, items should not be stored within 18 inches of ceiling sprinkler heads (per NFPA fire codes) and should maintain clearance from walls and pipes.

IAHCSMM Sterile Storage and Distribution 1

The recommended temperature range for sterile storage areas is: