{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:04:47Z","timestamp":1784743487344,"version":"3.55.0"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"9-10","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The storage of reusable medical devices (RMDs) is the final reprocessing phase and the step that directly precedes point-of-care delivery. Reusable medical devices, including surgical tools necessitating sterilization and semicritical devices such as endoscopes, undergo high-level disinfection. The rigorous reprocessing protocols and subsequent storage of RMDs are crucial in preserving their sterility and asepsis. This ensures they are available, clean, and safe for patient use, thereby significantly reducing the risk of surgical site infection. The stringent requirements for RMD storage are a testament to the critical role it plays in patient safety, making it a demanding task for health care organizations (HCOs) to comply with. These challenges are further amplified in austere environments. This integrative review aims to identify optimal storage practices, emphasize the critical importance of RMD storage in the Military Health System, and derive implications for policies and future considerations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>The authors performed an integrative review and comprehensive literature search in PubMed\/MEDLINE, CINAHL, and Embase using the keywords \u201cinstrument storage,\u201d \u201csurgical instruments,\u201d \u201csterile storage,\u201d \u201csterile wrap,\u201d and \u201cflexible endoscope storage.\u201d Articles were limited to English from 1980 to 2024. Additionally, the authors reviewed international guidelines to support RMD storage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The integrative review of 42 articles and 14 guidelines and articles identified 6 central themes supporting RMD storage, which include facility design, environmental considerations, sterile storage packaging systems, considerations for event-related sterile storage, point-of-care delivery, and endoscope storage best practices. The abundance of evidence-based recommendations and guidelines complicates adherence to optimal practices in HCOs, presenting significant challenges in austere environments. Integrating RMD storage considerations into training, exercises, and operations help promote a culture of RMD stewardship to ensure safe surgical and procedural care within the Military Health System.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Although surgical teams\u2019 capabilities are crucial in delivering effective care in a dynamic environment, the management and storage of RMDs are equally essential. Numerous organizations have outlined rigorous guidelines for HCOs to comply with, which can be intensified in austere conditions. Ultimately, a commitment to integrating the literature and developing the groundwork for clinical practice guidelines can improve the safe storage of RMDs in both standard and austere environments.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaf023","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T10:30:15Z","timestamp":1737973815000},"page":"e1818-e1826","source":"Crossref","is-referenced-by-count":3,"title":["Best Practices for Storage of Reusable Medical Devices in the Military Health System"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4031-0447","authenticated-orcid":false,"given":"Matthew G","family":"Blake","sequence":"first","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Gracia","sequence":"additional","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Uregen","sequence":"additional","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Brown","sequence":"additional","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Romito","sequence":"additional","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Stucky","sequence":"additional","affiliation":[{"name":"Center for Nursing Science and Clinical Inquiry (CNSCI), Landstuhl Regional Medical Center , Rheinland-Pfalz 66849,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Atwood","sequence":"additional","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"2025092416174795700_R1","article-title":"Military Health System: our strategy","author":"Defense Health Agency."},{"issue":"2S Suppl 1","key":"2025092416174795700_R2","doi-asserted-by":"publisher","first-page":"S145","DOI":"10.1097\/TA.0000000000004379","article-title":"Refocusing the Military Health System to support Role 4 definitive care in future large-scale combat operations","volume":"97","author":"Remondelli","year":"2024","journal-title":"J Trauma Acute Care Surg"},{"key":"2025092416174795700_R3","volume-title":"Sterile Processing Technical Manual","author":"Healthcare Sterile Processing Association","year":"2023","edition":"9th"},{"key":"2025092416174795700_R4","article-title":"What are reusable medical devices? 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