AORN Outlines How Perioperative Nurses Can Catch Sterility Packaging Failures

DENVER, CO, UNITED STATES, October 7, 2026 /EINPresswire.com/ — AORN, the Association of periOperative Registered Nurses, has shared new guidance for perioperative nurses on identifying compromised sterile packaging before surgical instruments reach the patient. Packaging issues remain among the most common causes of sterility failures in the operating room, according to Joint Commission Ambulatory Surveyor Beth Hogan, MSN, RN, CASC, CNOR, CGRN, CNAMB. Perioperative nurses serve as a critical checkpoint, catching a compromised package at the point of use before it reaches the sterile field.

Exterior Package Inspection Signals Sterility Risk

Nurses should inspect sterile packaging exteriors before opening for signs of compromise, including:

Tears, holes, or punctures in the packaging.

Wet spots or moisture.

Broken or missing tamper-evident seals.

Loose, unsealed, or wrinkled wraps.

Uneven or incomplete peel pack seals.

Dust, residue, or unidentified stains.

Missing or expired sterilization labels.

Missing load documentation, including initials, date, or load number.

Opening Technique Affects Package Sterility

Intact packaging can still be compromised during handling. Overstretching a peel pack seal, touching sterile areas of the packaging, and opening packages too quickly or forcefully all raise contamination risk.

Internal Package Contents Require Verification

Nurses should confirm that the internal chemical indicator is present and has changed to the correct color for the sterilization method used. An item with a missing or unchanged indicator should not be used. Additional internal signs of compromise include:

Moisture or condensation inside sterile trays.

Corrosion or rust.

Debris, lint, dust, hair, fibers, or insects.

Excess oil or lubricant residue.

Unusual odors.

Chipped or cracked instruments.

OR and SPD Communication Strengthens Packaging Safety

Hogan identifies standardized handoff tools, tray discrepancy sheets, load review processes, and color-coded tags, such as “Do Not Use — Investigation Needed” labels, as tools that help staff flag packaging concerns quickly. Clear escalation pathways help staff know when to involve leadership or infection prevention. Routine huddles, held before shifts and after incidents, support consistent communication and real-time learning. Hogan points to a “just culture” as essential to helping staff report sterility concerns without fear of blame.

For more perioperative safety guidance, visit AORN’s website.

About AORN

The Association of periOperative Registered Nurses (AORN) represents the interests of more than 200,000 perioperative nurses by providing evidence-based resources, continuing education, and advocacy to advance surgical care. AORN is committed to empowering nurses to transform patient experiences before, during, and after surgery.

Christian Czerwinsk
AORN
cczerwinski@aorn.org
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