Since sterilization of surgical instruments is a key component of patient safety and infection prevention, ambulatory surgery centers must take extra caution and ensure sterilization is performed in an efficient and effective manner. Joan Blanchard, MSS, BSN, RN, CNOR, CIC, who serves as the Association of periOperative Registered Nurses' liaison to the CDC Healthcare Infection Control Practices Advisory Committee, shares four key considerations regarding sterilization of surgical instruments.
1. Research industry-accepted guidelines. Various organizations follow the Association for the Advancement of Medical Instrumentation's published guidelines for effective sterilization of surgical instruments. AAMI is an alliance that includes members of associations such as the Centers for Disease Control and Prevention, AORN and vendors. ASCs should look to these resources for further guidance on recommended practices for steam sterilization.
"AAMI publishes a comprehensive guide to steam sterilization and sterility assurance, which members have input into and represents the professionals' consensus," Ms. Blanchard says. "AORN uses the guideline as a basis for the Recommended Practices for Sterilization in the Perioperative Practice Setting. Organizations use different means of getting the information to their members as changes in the guidelines are updated.
ASCs can purchase the guidelines directly from AAMI. Recommended Practices can also be purchased from AORN.
2. Validating containers for flash sterilization. Although AAMI, AORN and other organizations recommend keeping flash sterilization of surgical instruments to a minimum, it may be used when there is insufficient time to process by the preferred wrapped or container method. In those situations, Ms. Blanchard says ASCs should ensure that the rigid container used is designed and intended for flash sterilization cycles and is validated by the manufacturer.
"Containers have to be validated for flash sterilization cycles because they are different from the ones used for full cycle sterilization," she says. "The manufacturer of the rigid flash container does the testing and validation of those containers to ensure they are indeed appropriate for the autoclave cycle to be used in the healthcare facility."
3. Log sterilization cycles. Sterilization logs accomplish a number of tasks. Logs are a formal process for documenting sterilization cycles and allow ASCs to present evidence of that documentation to accreditation organizations. Logs also allow ASCs to maintain accountability among staff members for proper sterilization and helps maintain sterilization equipment in an efficient manner.
"ASCs have to log their sterilization cycles and continuously gather information, including dates, items that were sterilized and the reason for flash sterilization," Ms. Blanchard says. "Keeping these logs is important to monitor any problems with the sterilizers and also serves as a means for accountability in case, for example, a staff member does not bring the cycle up to the right temperature."
4. Be mindful of the storage area. ASCs must ensure they are storing sterile supplies in a clean environment for storage. Ms. Blanchard says ASCs must also ensure there is an appropriate amount of air exchanges, correct temperature and humidity levels are reached to ensure supplies remain sterile in their storage environments.
"Storage area cleanliness, air exchanges, temperatures and levels of humidity are all factors that should be controlled on a daily basis," Ms. Blanchard says. "The guidelines for air exchanges, temperatures and levels of humidity were established by the Facility Guidelines Institute, an organization consisting of healthcare engineers who test for those specific parameters."
Learn more about AORN.
1. Research industry-accepted guidelines. Various organizations follow the Association for the Advancement of Medical Instrumentation's published guidelines for effective sterilization of surgical instruments. AAMI is an alliance that includes members of associations such as the Centers for Disease Control and Prevention, AORN and vendors. ASCs should look to these resources for further guidance on recommended practices for steam sterilization.
"AAMI publishes a comprehensive guide to steam sterilization and sterility assurance, which members have input into and represents the professionals' consensus," Ms. Blanchard says. "AORN uses the guideline as a basis for the Recommended Practices for Sterilization in the Perioperative Practice Setting. Organizations use different means of getting the information to their members as changes in the guidelines are updated.
ASCs can purchase the guidelines directly from AAMI. Recommended Practices can also be purchased from AORN.
2. Validating containers for flash sterilization. Although AAMI, AORN and other organizations recommend keeping flash sterilization of surgical instruments to a minimum, it may be used when there is insufficient time to process by the preferred wrapped or container method. In those situations, Ms. Blanchard says ASCs should ensure that the rigid container used is designed and intended for flash sterilization cycles and is validated by the manufacturer.
"Containers have to be validated for flash sterilization cycles because they are different from the ones used for full cycle sterilization," she says. "The manufacturer of the rigid flash container does the testing and validation of those containers to ensure they are indeed appropriate for the autoclave cycle to be used in the healthcare facility."
3. Log sterilization cycles. Sterilization logs accomplish a number of tasks. Logs are a formal process for documenting sterilization cycles and allow ASCs to present evidence of that documentation to accreditation organizations. Logs also allow ASCs to maintain accountability among staff members for proper sterilization and helps maintain sterilization equipment in an efficient manner.
"ASCs have to log their sterilization cycles and continuously gather information, including dates, items that were sterilized and the reason for flash sterilization," Ms. Blanchard says. "Keeping these logs is important to monitor any problems with the sterilizers and also serves as a means for accountability in case, for example, a staff member does not bring the cycle up to the right temperature."
4. Be mindful of the storage area. ASCs must ensure they are storing sterile supplies in a clean environment for storage. Ms. Blanchard says ASCs must also ensure there is an appropriate amount of air exchanges, correct temperature and humidity levels are reached to ensure supplies remain sterile in their storage environments.
"Storage area cleanliness, air exchanges, temperatures and levels of humidity are all factors that should be controlled on a daily basis," Ms. Blanchard says. "The guidelines for air exchanges, temperatures and levels of humidity were established by the Facility Guidelines Institute, an organization consisting of healthcare engineers who test for those specific parameters."
Learn more about AORN.