In June, The Joint Commission announced changes to its criteria for evaluating flash sterilization processes at surgical centers and hospitals. The Joint Commission is focusing its survey efforts on the following core areas to assess the appropriateness and integrity of the sterilization process:
» Cleaning and decontamination
» Sterilization
» Storage or return of instruments to the sterile field
Under The Joint Commission’s new guidelines, surgical facilities will be forced to demonstrate documented, regimented sterilization practices that are dependent upon adequate supplies of instruments. This is important because flash sterilization is often used to sterilize instruments quickly, due to insufficient instrument inventories and increased procedure volume.
While “flashing” has become a routine practice, it was originally designed to quickly sterilize a one-of-a-kind device that was dropped or contaminated in the operating room. As a result of excessive use, flash sterilization has come under increasing scrutiny from the Joint Commission, the Association of periOperative Registered Nurses (AORN) and the Centers for Disease Control and Prevention (CDC) for being overused, potentially raising the risk to patient safety.
What can facilities do to ensure they are prepared and sufficiently equipped to meet the Joint Commission’s new measures?
Work with a knowledgeable surgical instrument supplier that can help with streamlining and ordering additional instrument sets to ensure the facility has time to provide proper cleaning and sterilization.
Consider metal sterilization trays instead of plastic trays. The metal trays eliminate wet packs and radiate heat and evaporating any moisture. Plastic absorbs heat and does not diffuse the moisture.
Utilize flash sterilization and closed sterilization containers to assure proper transport and sterilization of your instruments.
To view The Joint Commission’s update in its entirety, visit http://www.jointcommission.org/Library/WhatsNew/steam_sterilization.htm.
Decontamination and Sterilization Tips
The following best practices are also recommended for decontamination and sterilization of surgical instruments:
Use Flash Sterilization Appropriately
Flash sterilization should be used only when there is insufficient time to process by the preferred wrapped or container method. Flash sterilization should not be used as a substitute for insufficient instrument inventory.
Weigh the Cost of Instruments Versus Patient Safety
Although instrument sets can be a significant cost for facilities, the cost pales in comparison to the detriment associated with declining patient safety and contamination. Not only does this put the patient at risk, but also the facility’s reputation, not to mention running the risk of lawsuits and losing Joint Commission accreditation.
Establish Guidelines
Define the rules for flash sterilization by your facility and establish appropriate guidelines for everyone to follow. A flash sterilization log must be used.
If You Are Going to Use Flash — Do it Right
Used closed sterilization containers or the Flash-Guard system, so instruments are protected from contamination from autoclave to point of use.
Build More Efficient Instrument Sets
Keep an inventory of your instruments and determine those that are most frequently used. Streamlined instrument sets should be built to only include those instruments. Fewer instruments in the sets allow for faster processing. With streamlined sets, money isn’t wasted on instruments that are rarely used. Find an instrument vendor who can help you.
Dedicate Someone for Reprocessing Instruments
Ensure all instruments are sterilized through reprocessing by dedicating someone to this responsibility. Patient safety is an important measure for all facilities and reprocessing instruments is a key part of ensuring a sterile and safe environment.
Seek Outside Support
If your budget or systems cannot keep up with demands, seek outside help. There are several companies which provide outsourced sterilization services and even companies who can provide sterile instruments on a just-in-time and charge-by-use basis.
Robert Edelstein is president of Millennium Surgical Corp. He can be reached by mail at Millennium Surgical Corp., 822 Montgomery Ave., No. 205, Narberth, PA 19072; by phone at (800) 600-0428 or e-mail Robert directly at redelstein@millenniumsurgical.com.