Are you correctly using rigid sterilization containers for IUSS?
Although immediate-use steam sterilization (IUSS) is a safe method to sterilize emergently contaminated instruments, inappropriate use may lead to an increased risk for surgical site infection, according to a study in the American Journal of Infection Control. This study stated the only acceptable indicator for use of IUSS based on…
Sterile processing questions and answers
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…
Unprocessed tray incident prompts investigation, leads to process improvements
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…
A 'cockpit checklist' reduces defects in instrument sets
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…
Have you taken steps to avoid the abuse of IUSS?
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…
Lumens and endoscopes: Meeting cleaning basics
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…
How to add more teeth to your loaner set policy
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…
Evaluating surgical instrument repair options
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…
Tips on making the most of instrument repair
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,…
Scanner detects lost OR instruments
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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