CMS replaces flash sterilization with IUSS
The Centers for Medicare & Medicaid Services (CMS) has replaced the term “flash sterilization” with “immediate use steam sterilization” (IUSS) in surgical settings. The change in terminology, which applies to Medicare-participating hospitals, critical access hospitals, and ambulatory surgical centers that are subject to Conditions of Participation or Conditions of Coverage,…
Best sterile processing managers anticipate, collaborate, stay up to date
With more than 36 years of experience in sterile processing, I have seen many changes occur, and I know what it takes to be an effective sterile processing (SP) manager. The goal of an effective SP manager is to determine where the department is now, where you want it to…
A risk analysis of the steam sterilization process can improve patient safety
The steam sterilization process is complex and includes a number of important steps: decontamination, preparation and packaging, sterilization, quality control, sterile storage, and product distribution. The effectiveness of this process cannot be determined by inspection or testing of each product, and because sterility assurance is a probability function, it must…
Learning from Leaning: Case cart readiness improves after barriers are removed
Bristol Hospital had a supply problem. Instruments were often missing from case carts, so nurses had to scramble to find the items on the morning of a scheduled procedure. Staff wondered whether the problem was caused by shortages, but a Lean process revealed an entirely different scenario and forged a…
Improving instrument readiness cuts case delays, boosts surgeon satisfaction
Surgical case delays have been found to last an average of nearly 17 minutes. Not only do such delays make surgeons dissatisfied, they also reduce case volume and related revenues, and they may lead to additional time under anesthesia for patients. The root causes of instrument-based delays are seldom simple,…
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…
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