The new era of flash sterilization

AORN Journal,  July, 2007  by Arlene Carlo

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DOCUMENTING

Records document that the sterilization process is being monitored as it occurs and provide evidence that cycle parameters have been met. Record-keeping is necessary to document essential information such as the reason for flash sterilization. These might include

* test cycle;

* dropped instrument;

* insufficient quantity or type of instruments, which will help justify the need to purchase additional instruments;

* loaner instruments that arrived too near the start time of a scheduled procedure for terminal sterilization; (8) and

* emergent or unplanned procedure. In addition,

* the cycle run (ie, date, time, load number);

* load contents (eg, individual instrument, instrument set);

* CI and BI results;

* patient identification; and

* sterilizer operator identification should be documented. The information typically is recorded in a flash sterilization log (Figure 1).

[FIGURE 1 OMITTED]

Flash sterilization records allow for traceability of every load of instruments or set that was used for patients, provide an audit trail, and are necessary if there is a recall of items sterilized or if flash sterilization records are subpoenaed for a lawsuit. Routine audit of the flash sterilization records provides a good picture of how often flash sterilization is being performed and why, as well as the volume and types of instruments and instrument sets being flash sterilized. Having this information helps determine where to focus reduction efforts. The department with responsibility for the facility's processing policies and procedures, typically sterile processing or central material services, should be responsible for auditing the flash sterilization process. Perioperative managers can use the results of the audit for budgetary justification to purchase additional instruments and sets to reduce flash sterilization.

A flash sterilization usage form can be used to record essential information on a monthly basis (Figure 2). The perioperative manager can summarize the findings and make recommendations to improve the process and periodically submit a report to the infection control department and other appropriate committees and department managers. Managers should consider establishing a quality improvement team consisting of perioperative, sterile processing, and infection control personnel to review current flash sterilization practices and establish process improvement initiatives that will help ensure safe, proper application and use of the flash sterilization process.

[FIGURE 2 OMITTED]

CONCLUSION

Flash sterilization is a critical aspect of the health care delivery system, which directly affects patient safety, quality of patient care, and the facility's financial bottom line. The serious consequences of SSIs that result from improperly sterilized instruments and current national demands for patient safety highlight the need for added vigilance in the practice of flash sterilization today.

Ultimately, the goal is to have no SSIs that can be attributed to flash sterilization. To help ensure the best outcomes (ie, the patient receives sterile instruments), it is critical to