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Sterilization

What conditions are necessary for storage of sterile supplies? 

How heavy can instrument sets be for sterilization?  

What is the best way to transport flashed items to point of use and prevent contamination?  

Should instruments with sharp points and edges (eg, towel clips) be sterilized in the open or closed position? 

How many Immediate Use Steam Sterilization (IUSS) cycles (flash sterilization) are acceptable in a month? 

Can the pack be used if it is only wet on the inside? 

What are the reasons for wet packs? 

How can we prevent wet packs? 


  

What conditions are necessary for storage of sterile supplies? 

Answer:

Sterile items should be stored under environmentally controlled conditions, which means a temperature of approximately 75° F (24° C), a maximum relative humidity of 70%, a positive air flow pressure in relation to adjacent areas, and a minimum of four air exchanges per hour. To comply with fire code regulations and reduce the risk of contamination, sterile supplies should be stored at least 8 to 10 inches from the floor, at least 18 inches from the ceiling, and at least 2 inches from outside walls. Fire codes specify minimum distances below the ceiling to ensure the effectiveness of sprinkler systems. 

Resource

Recommended practices for sterilization. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:513-540.

 

Updated January 28, 2013
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How heavy can instrument sets be for sterilization?

Answer:

AORN and the Association for the Advancement of Medical Instrumentation (AAMI) recommend that instrument sets and trays prepared for sterilization not exceed 25 pounds. This weight limit includes the combined weight of the pan and the instruments. Sets exceeding 25 pounds present an increased risk of ergonomic injury to personnel handling the sets and result in wet loads unless the sterilization drying time is extended.

Resource

Recommended practices for sterilization. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:513-540.

 

Updated January 28, 2013 

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What is the best way to transport "flashed" items to point of use and prevent contamination? 

Answer:

AORN recommends the use of rigid sterilization containers designed and intended for specific sterilization modes (ie, Immediate Use Steam Sterilization (IUSS), flash sterilization, abbreviated, short, rapid) if items must be sterilized using sterilization modes other than conventional processing. AORN and the Association for the Advancement of Medical Instrumentation (AAMI) state that items should be delivered to the point of use and sterile field in a manner that maintains sterility.

Resource

Recommended practices for sterilization. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:513-540.

  

Updated January 28, 2013
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Should instruments with sharp points and edges (eg, towel clips) be sterilized in the open or closed position?

Answer:

All hinged instruments should be sterilized in the open position, unless the manufacturers What manufacturer the sterilizer, the instrument, or the container? instructions advise against this practice. If hinged instruments are on stringers, racks, or instrument pegs, the instruments should be kept open and unlocked. The rationale behind the practice is to expose all surfaces to the sterilant.
To manage sharp points and edges, loose-fitting tip protectors for sharp and delicate instruments should be used if they have been validated for use with the method of sterilization and according to manufacturer's instructions. 

Resource

Recommended practices for cleaning and care of surgical instruments and powered equipment. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:485-504.

   

Updated January 28, 2013
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How many Immediate Use Steam Sterilization (IUSS) cycles (flash sterilization) are acceptable in a month?

Answer:

IUSS (flash) rates may be calculated by dividing the number of IUSS (flash) cycles per month by the number of procedures per month. Health care organizations may benefit from benchmarking IUSS (flash) rates against themselves as part of quality improvement initiatives for decreasing IUSS utilization. 

 

Resource

Denholm, BG. Calculating flash sterilization rates. [Clinical Issues]. AORN Journal. 2011;93(2):296-297.

 

Updated January 28, 2013
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Can the pack be used it if is only wet on the inside? 

Answer:

There is no definitive evidence to support that moisture inside a closed container is sterile; therefore, the pack is considered contaminated and should not be used. Often, moisture can act as a wicking agent and may cause pathogens to come in contact with the items in the pack.

Resources

Recommended practices for sterilization. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:513-540.

Spry C. Understanding current steam sterilization recommendations and guidelines. AORN J. 2008;88(4):537-550.

 

Updated January 28, 2013

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What are the reasons for wet packs?

Answer:

Several variables contribute to wet packs:
•poor steam quality;
•sterilizer cycle and drying times;
•tray configuration and design;
•type of load (eg, heavy instrument sets, sets with excess density);
•type of wrap used as a packaging system for sterilization; and
•location of the pack in the sterilizer.

Resources

Recommended practices for selection and use of packaging systems for sterilization. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:505-512.

Spry C. Understanding current steam sterilization recommendations and guidelines. AORN J. 2008;88(4):537-550.  

 

Updated January 28, 2013

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How can we prevent wet packs?

Answer:

The occurrence of wet packs can be minimized by the following actions:
• Precondition the load by placing instruments inside the steam sterilizer with the door closed for 10 to 15 minutes before starting the cycle.
•Place a towel between the bottom of trays with wire mesh bottoms and between layers of instruments (unless contraindicated by the instrument and container manufacturer).
•Divide sets if they are excessively heavy or dense.
•Do not enclose peel pouches in instrument sets.
•Do not overload the sterilizer.
•Inspect steam line drains for clogs.
•Instrument sets that weigh more than 25 lbs are difficult to dry without a lengthy dry time.

Document and track wet packs according to the facility policy to identify any problems that may exist with the sterilizer and take steps to correct problems.

Resources

Recommended practices for selection and use of packaging systems for sterilization. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:505-512.

Recommended practices for sterilization. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:513-540.

Spry C. Understanding current steam sterilization recommendations and guidelines. AORN J. 2008;88(4):537-550.

 

Updated January 28, 2013
Back to top 

 

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