Immediate-Use Steam “Flash” Sterilization? Not So Fast!

Every day, acute care and ambulatory surgery centers face challenges on how to lower healthcare-associated infections. In the operating room, a large part of this effort involves the proper cleaning and sterilization of surgical devices and equipment. But with limited numbers of instruments, tight turnaround schedules, and decreasing budgets, many facilities are performing immediate-use steam sterilization (aka “flash” sterilization) in an effort to sterilize items quickly to avoid buying additional surgical instruments. The fact is, rather than save money and time, immediate-use steam sterilization has been implicated in increasing a patient’s risk for infection, which may lead to lawsuits and loss of accreditation for a facility.

Originally, this type of sterilization was intended for use only in an emergency, such as when a one-of-a-kind instrument was contaminated or dropped from the sterile field. Unfortunately, it has now become common place and used too frequently due to time and budget constraints. Because items do not recieve the complete traditional sterilization processing, professional groups and accreditation agencies believe that IUSS should not be  a routine practice, but rather used only in select clinical situations, and in a controlled manner.

“The reason that it’s not looked upon as a good solution is because oftentimes in the tight timeframe that we use, there are chances that corners may be cut; that during that rushed process to get the instrument turned around there could be processes and protocols that are missed completely, or at least not fully complied with. Immediate-use steam sterilization is denoted as a process that is used only in emergencies and only if the devices that are to be sterilized are compatible with that process.” – Natalie Lind, CRCST, CHL, FCS, IAHCSMM Education Director.

In this day and age, healthcare facilities are under great pressure to prevent surgical site infections. It seems obvious that items that do not receive full sterilization cycles are likely to be the source of infections. Surgical Technicians and Central Service professionals must become aware of the issues surrounding this form of sterilization, and the standards, regulations and best practices regarding its use. It is vital that immediate-use steam sterilization be utilized in accordance with professional guidelines; facility policies and procedures; as well as in strict compliance with validated written instructions provided by device manufacturers, sterilization equipment manufacturers, and container or textile manufacturers. This is especially critical for short sterilization cycles, as it takes time for steam to penetrate a sterilizer load and achieve an acceptable sterility assurance level.

In an effort to promote best practices regarding the use of IUSS, a multi-agency position paper was released January 2011 by the International Association of Healthcare Central Service Materiel Management (IAHCSMM), the Association for the Advancement of Medical Instrumentation (AAMI), the Association of peri-Operative Registered Nurses (AORN), the Association for Professionals in Infection Prevention and Control (APIC), the ASC Quality Collaboration,  and the Accreditation Association for Ambulatory Health Care (AAAHC) .  In addition, the Centers for Disease Control and Prevention (CDC) has recommendations, and The Joint Commission has standards regarding proper use and protocols for IUSS that must be followed and closely documented.

Envision, Inc. and IAHCSMM are proud to present a NEW 11 minute staff training program entitled “Protocols for Immediate-Use Steam Sterilization,”  part of the Of Critical Importance staff education series for Central Service and Operating Room professionals who process surgical instruments and devices.  For a preview of the program in it’s entirety, visit www.EnvisionInc.net.