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4 Sterile Processing Updates

Publish Date: April 28, 2021


Erin Kyle
Erin Kyle, DNP, RN, CNOR, NEA-BC

Being informed about the latest changes in evidence-based guidelines, practice standards, and regulatory requirements can support perioperative teams in providing quality sterile processing practices that can reduce patients’ risk of surgical site infection, according to AORN Guidelines for Perioperative Practice Editor-in-Chief Erin Kyle, DNP, RN, CNOR, NEA-BC.

She says maintaining up-to-date knowledge of sterile processing best practices can help any periop professional involved in sterile processing to feel confident explaining the evidence-based reasons for their actions during a survey. 

Updating Sterile Processing Practices

Here are four sterile processing topics from AORN guidelines Kyle says teams can implement to improve patient safety and assure compliance with survey.

  1. Include sterile processing personnel in pre-purchase evaluation of surgical instruments and other medical devices.

    From the Guideline for Care and Cleaning Surgical Instruments

    Sterile processing personnel can bring important insights for purchasing considerations, Kyle says. For example, purchasing requires knowledge about the functional space and supplies that should be present in the decontamination area, the facility’s water management program, responsibilities and procedures associated with loaned instrumentation, and use of decontamination equipment and accessories.

  2. Take a closer look at how the cleanliness of the practice environment effects sterile processing.

    From the Guideline for Environmental Cleaning

    Environmental cleaning recommendations can be applied to all areas of the perioperative practice environment, including areaes where sterile processing occurs, Kyle explains. “Consider how the frequency of and methods for terminal cleaning in sterile processing areas can decrease the risk of personnel unknowingly transmitting infectious pathogens to instruments and equipment.”

    She also stresses the importance of evaluating environmental cleaning effectiveness in all areas. This should include a clear understanding of how room decontamination systems, such as UV light emitting systems and hydrogen peroxide systems, are used as an adjunct to manual environmental cleaning.

  3. Know the correct protocols for explanted medical devices.

    From the Guideline for Specimen Management

    “Teams often ask if it’s okay to give the explanted medical device back to the patient,” Kyle notes. That’s why it’s important for perioperative teams to know what should be considered when developing and implementing an explant policy and procedure. For example, team members should know when it is permissible to return explants to a patient versus when they should be returned to the manufacturer or retained by the organization for risk management concerns.

  4. Recognize the key role sterile processing personnel play in inspecting and evaluating electrosurgical accessories for damage, insulation defects and malfunctions.

    From the Guideline for Electrosurgical Safety

    Sterile processing personnel should be competent and confident when using an active electrode insulation integrity tester before packaging for sterilization, Kyle says.

Related Evidence to Know About

Reading up on the evidence featured in these guidelines that supports these practices for sterile processing are equally important to be familiar with, Kyle says.

For example, several articles cited in the environmental and instrument cleaning guidelines discuss using cleaning verification as part of quality programs to give personnel who are performing cleaning real-time feedback for improvements.

Water quality monitoring research cited in the care and cleaning surgical instruments guideline is another area where new evidence has emerged. Kyle says it’s important to understand the effects of municipal water utility services interruptions because health care facility water systems are susceptible to biofilm proliferation and subsequent bacterial contamination following these interruptions.

Water quality that does not meet the requirements specified in the detergent or the cleaning equipment manufacturers’ instructions for use can adversely affect the efficacy of cleaning chemistries and can contain waterborne bacteria, including Legionella and Pseudomonas species, Kyle explains. “Sterile processing professionals play an important role in routine water quality evaluation to detect water quality issues that can impede decontamination and sterilization processes.”

Related Resources

Learn more from Kyle and Susan Klacik, BS, CRCST, ACE, FCSS, about 2021 Updates on Sterilization Best Practices during their education session on Sunday, Aug. 8 from 9:45–10:45 am at Global Surgical Conference & Expo in Orlando, Fla.

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