News: Nurses Headline HealthPack 2008




Nurses's opinions were considered during Rollprint Packaging Products' design of its Duet chevron header pouch.

Helping nurses to be more efficient in the operating room could be the key to better health­care. At least in the OR. Nurses’ efficiency, however, may depend on how fast they can open medical packaging.

“In today’s healthcare environment, we are trying to do more with less,” explained Mary Jo Steiert, president of the Association of periOperative Registered Nurses (AORN), to a packed room at HealthPack 2008 in San Antonio, TX. “Supplies are important. We are doing things faster, but we have a number of supplies to open.”

Steiert pointed to a number of trends that are affecting nursing. “Demand is rising for healthcare services and procedures, yet there is a shortage of nurses, given the shortage of nursing facilities.”

There is also a drive toward risk management. After the Institutes of Medicine’s report on medical errors, “Mistakes are a concern,” she said. “We are focusing on keeping things safe for patients and healthcare workers.” Minimizing hospital-acquired infections is also a goal. The Center for Medicare and Medicaid Services will cease reimbursement in October 2008 for certain infections that could be attributed to hospital care, such as catheter-associated urinary tract infections and infections caused by objects left in patients during surgery.

As a result, the pressure is on nurses. “We need packages that help make procedures safer,” reported Steiert.

Packaging has been a source of frustration for some nurses, she explained. “We often wonder who designed [a particular] package. I wish they were present to see how difficult it is to use it.”

To offer nurse feedback on packaging, AORN members participated in a survey organized by the Medical Device Packaging Technical Committee (MDPTC) of the Institute of Packaging Professionals (IoPP). Jennifer Neid, packaging chair of the IoPP MDPTC Education Task Group and a certified packaging professional with Tolas Healthcare Packaging, an Oracle Packaging Co., led the effort. Surveys were completed by 151 nurses, the majority of whom have more than 20 years’ nursing experience. Their most preferred package is the formed rigid tray with a lid, and the least favored is the single pouch. Double-barrier packages are preferred by nurses, Neid told the HealthPack audience. “Ease of transfer to the sterile field is important,” nurses agreed.

In presenting survey results, Neid shared verbatim responses to several questions. “When one struggles to open a package, contamination is possible,” wrote one nurse. “Labeling should be clear and large,” wrote another.

“It is best, if possible, to see package contents,” expressed one nurse. Another said that it “is hard to remove an item snapped into a tray with a double glove.” And some nurses have rejected packages for “holes or foreign matter.”

In ranking packaging qualities, nurses listed “easy-to-read labeling” first, then “speed of opening package,” and finally “manufacturer’s instructions printed on packaging.”

Tensions can run high in operating rooms, especially when doctors pressure nurses to expedite package opening and label reading. Consequently, nurses “need big enough print [to read] while the doctor is yelling at you to open it first and read it later.”

Rollprint Packaging Products (Addision, IL), a HealthPack exhibitor, had already sought nurse input on package design. The company convened a focus group with OR nurses and doctors and used their feedback to develop a new-generation, peelable chevron header pouch called Duet. Focus group participants said that it was often difficult to figure out how to open sterile medical packages. Structural indicators on the package weren’t always present, and having only one opening option could be frustrating.

Duet’s new hybrid design combines elements from both header bags and chevron pouches, Rollprint reports. It utilizes the header-bag concept with a strip of Tyvek heat sealed to a polyester/extrusion-coated sealant to create one side of the structure. Next, the Tyvek/film combination is three-side-sealed to a layer of polyester/poly, with the top Tyvek area left unsealed so that the medical product can be loaded. At the bottom, the polyester/extrusion-coated layer extends slightly beyond the polyester/poly film side creating access tabs at both corners where a dual chevron opening feature has been created.

According to Rollprint, the dual chevron at the outer edge of the structure makes it easier for operating room personnel to open and remove challenging three-dimensional products—such as trays, tubing and various kits—without flaps potentially compromising the aseptic presentation. In addition, the ability of the Duet pouch to facilitate aseptic presentation could eliminate the need for a central supply room (CSR) wrap found over many procedural kits and trays.

HealthPack 2008 was organized in cooperation with IoPP and sponsored by Pharmaceutical & Medical Packaging News, Sealed Air, DuPont, Eastman, and Mocon. HealthPack 2009 will take place March 3–5, 2009, in Memphis, TN. For more details, visit


No votes yet