Answers to some of the questions asked at several recent annual meetings, notably AORN, APIC (Association for Professionals in Infection Control and Epidemiology), and IAHCSMM (International Association of Healthcare Central Service Materiel Management), are offered by sterilization expert Martha Young. Also included are questions from seminars and webinars she has…

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The circulating nurse was cleaning up after surgery in an ambulatory surgery center (ASC) when she noticed the internal chemical indicator (a Class 5 integrating indicator) had not reached its appropriate endpoint response, which is a pass. That meant an unprocessed instrument tray had been used on the patient. Her…

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Checklists are a common safety strategy in the OR. Why not have a checklist for the sterile processing department (SPD)? A “cockpit checklist” has helped reduce defects in instrument sets at Virginia Mason Medical Center in Seattle, Washington, by serving as the final quality assurance audit before a set enters…

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I have heard the following statement from OR personnel: “We use rigid sterilization containers and run a 270-275ºF (132-135ºC) prevacuum steam sterilization process in our OR. So we no longer use IUSS.” Is that an IUSS cycle? IUSS, or immediate-use steam sterilization, was formerly known as flash sterilization. This article…

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Narrow-lumened instruments and endoscopes are one of your biggest reprocessing challenges. They have the highest risk of being improperly processed, notes Michelle J. Alfa, PhD, FCCM, a researcher in health care-associated infections. If the lumens and channels of endoscopes are not cleaned properly, high-level disinfection or sterilization may not be…

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It’s one thing to have a policy on managing loaner instrument sets. But how do you put teeth in your policy so these sets can be reprocessed in time to provide safe care and comply with professional guidelines and regulatory requirements? Readers have asked how to get administrative support for…

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When its instrument repair contract was up for review last year, the University of Virginia (UVA) Medical Center decided to look at the bigger picture. Rather than evaluating vendors solely on price, it looked for a company that was willing to partner in meeting its goals. The evaluation of 6…

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Here is some advice from experts on a program to ensure clean, functioning instruments.   Take a proactive approach Sharp, well maintained instruments are critical to patient safety, surgeon satisfaction, and smooth OR case flow. Kerrison rongeurs, for example, “should punch cleanly, not rip, tear, or pull,” says Rick Schultz,…

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Earnest Peachy, a perioperative tech, and Shandlee Woodward, a student nurse intern, are removing a trash bag from the scanner. Safety checklists are not the only concept the operating room has gleaned from aviation. Ten years ago, the 26-room OR suite at the Ohio State University (OSU) Medical Center in…

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Missing instruments and supplies can be one of the OR's biggest frustrations. Chasing down instruments or retrieving items during a case wastes time, irritates surgeons, and prolongs the patient's time under anesthesia. At Exempla Good Samaritan Medical Center in Lafayette, Colorado, chronic problems had eaten away at morale. "We wanted…

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