1 / 44

Immediate-Use Steam Sterilization

Immediate-Use Steam Sterilization. Continuing Education Contact Hours. Participants must complete the entire presentation/seminar to achieve successful completion and receive contact hour credit. Partial credit will not be given.

meadow
Download Presentation

Immediate-Use Steam Sterilization

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Immediate-Use Steam Sterilization

  2. Continuing Education Contact Hours • Participants must complete the entire presentation/seminar to achieve successful completion and receive contact hour credit. Partial credit will notbe given. • All of the presenters are employees of STERIS Corporation and receive no direct compensation other than their normal salaries for participation in this activity. • STERIS Corporation is an approved provider of continuing nursing education by the California Board of Registered Nursing, provider number CEP 11681 for 1 contact hour along with IAHCSMM and CBSPD. • STERIS Corporation is providing the speakers and contact hours for this activity. However, products referred to or seen during this presentation do not constitute a commercial support by the speakers.

  3. Learning Objectives • Discuss appropriate handling of instruments sterilized for immediate-use steam sterilization • Describe recommended monitoring and record keeping

  4. Immediate-Use Steam Sterilization • Intended for emergency use only • Immediate patient use • To process single items

  5. Large Trays and Multiple Trays not Recommended • Heat up time • Total cycle time • Instrument cooling time • Risk of contamination during transfer

  6. Cycles for Immediate-Use Steam Sterilization • Gravity commonly known as “flash” cycle • Dynamic Air Removal (Prevacuum) • Express

  7. Phases of Immediate-Use Steam Sterilization • Conditioning phase • Sterilization phase • Exhaust phase

  8. Gravity Cycle • Inefficient passive process • Uses gravity in conditioning and exhaust • Steam displaces air in the chamber by gravity • Dry time not necessary

  9. Gravity Exposure Parameters • Non-Porous Cycle • All metal items only • Non-lumen items •Minimum Exposure Time • 3 Minutes at 270° F (132° C)

  10. Gravity Exposure Parameters • Porous Cycle • Mixed materials • Lumen/cannulated items •Minimum Exposure Time • 10 Minutes at 270° F (132° C)

  11. Prevacuum Cycle • More efficient method of air removal from the chamber • Uses mechanical process of four steam injections and vacuum pulses in conditioning phase • Added when more complex devices manufactured

  12. Prevacuum Exposure Parameters • Porous and non-porous • Mixed material items • Lumen/cannulated item •Minimum Exposure Time • 4 Minutes at 270° F (132° C) • 3 Minutes at 275° F (134° C)

  13. Gravity vs. Prevacuum Gravity Prevacuum

  14. (Association for the Advancement of Medical Instrumentation) • Addresses safe and effective immediate-use steam sterilization processes • Always follow manufacturer’s instructions for use • Work practices include proper decontamination • Immediate transfer using aseptic technique • ANSI/AAMI ST79:2010

  15. (Association of periOperative Nurses) • Use of closed sterilization container or tray • Used only when there is insufficient time to process by the preferred wrapped or container method • Should not substitute for insufficient instrument inventory • AORN Perioperative Standards and Recommended Practices, 2010

  16. Appropriate Work Practices • Scenario #1: Dr. Kool has his specialty instruments that he brings in from his office for every procedure. What is the first thing that you do with his instrumentation?

  17. Scenario #2 • Dr. Kool’s gold-plated microscissors took a dive off the sterile field, tips down. Because there is only one pair of these gold-plated microscissors, what is your next step? The sterile processing department is on the third floor and you are on the first floor.

  18. During Decontamination •Protect yourself • Use enzymatic cleaners and detergents • Rinse instruments thoroughly

  19. Decontamination of Instruments • Refer to manufacturer instructions • Manual or mechanical • Appropriate brushes

  20. Preparation for Sterilization • Inspect instruments • Position for proper air removal • Flush lumens vs. non-flushed lumens

  21. Appropriate Containers • Rigid containers approved for immediate-use steam sterilization • Follow manufacturer’s instructions for use • Perforated or mesh bottom trays

  22. Sterilizer to Point-of-Use Transfer • Excellent aseptic technique • Path of transport • Strict traffic control

  23. Quality Assurance Monitoring • Physical Monitoring • Chemical indicators • Biological indicators

  24. Physical Monitoring • Real time assessment of sterilization cycle • Check before and after each cycle • Provides earliest detection of malfunction • Legal documents

  25. Chemical Monitoring • Chemical indicators do not verify sterilization • Indicates exposure to the sterilizing process • Minimum recommendation of one chemical indicator per tray • Chemical indicators not considered porous

  26. Chemical Monitoring Six Classes of Chemical Indicators (Defined by AAMI, based on specificity) Class 1 – Process Indicators Class 2 – Indicators for use in specific tests (Bowie-Dick) Class 3 – Single parameter indicators Class 4 – Multi-parameter indicators Class 5 – Integrating indicators Class 6 – Emulating indicators

  27. Residual Air Removal Test Class 2 Indicator: Bowie-Dick Test • Checks air removal system/air leaks • Performed on prevacuum cycles only

  28. Class 5 Integrator • Front moving chemical indicator • Monitors all critical variables of sterilization • Correlated to BI • Monitors more of the sterilization cycle than a BI

  29. Class 6 Emulator • Responds to all critical variables • Performance correlated to the sterilization cycle • Monitors more of sterilization cycle

  30. Biological Monitoring • Test BI • Control BI • Positive BI • Procedure

  31. What About Implants? • FDA: • … a device that is placed into a surgically or naturally formed cavity of the human body… intended to remain for a period of one year or more is an implantable device. “ ”

  32. AAMI and AORN Agree and State: “ Flash sterilization of IMPLANTABLE devices is not recommended: however, if it is unavoidable, full traceability to the patient shall be maintained. AAMI ST79:2010 ”

  33. Releasing Implants with BI If the implants are released from quarantine before the outcome of the BI monitor is known: •Documentation of premature release of implants must be kept •Exception form for premature release of implantable devices/ trays must be completed

  34. Example Documentation form for premature release of implantable devices AAMI ST79:2010

  35. Example Exception form for premature release of implantable devices. AAMI ST79:2010

  36. Immediate-Use Steam Sterilization Documentation • Epidemiological tracking • Traceability of sterilization cycle to patient • Ongoing assessment of items flash sterilized

  37. Documentation • Recommended documentation for each cycle • Patient’s name • Contents of the sterilization load • Type of sterilization cycle used • Cycle parameters • Staff person’s signature

  38. Example of Immediate-Use Steam Sterilization Log

  39. Action Plan • Appropriate work practices are utilized • Audit plan to monitor practice • Yearly education review

  40. Evaluation and Registration • Thank you for attending this CE activity. • Please complete and submit the evaluation form. • For more information on the CE credentialed programs offered, go to http://university.steris.com

  41. References • Comprehensive guide to steam sterilization and sterility assurance in health care facilities; Association for the Advancement of Medical Instrumentation, ANSI/AAMI ST79:2010 Arlington, VA. • Standards Recommended Practices and Guidelines; Recommended Practices for Sterilization in the Perioperative Practice Setting, Association of Perioperative Registered Nurses (AORN) (Denver, CO: AORN, 2010). • Central Service Technical Manual, 7th Edition, IAHCSMM (International Association of Healthcare Central Service Materiel Management), 2007.

  42. Express Cycle • Metal instruments ONLY (non-porous) • NO LUMENS, no mixed materials • NO complex medical devices • Single wrap – reusable or disposable • Wrapper protects sterile goods during transfer • Transfer aseptically • Wear sterile gloves to transfer • No shelf life

  43. Express Cycle Parameters • Preset by manufacturer • 5 Minutes conditioning time • 4 Minutes at 270° F (132° C) • 3 Minutes dry time • Total cycle time = 12 minutes

More Related