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AORN Blog - The Periop Life

5 Multidisciplinary Team Sterilization Practices

July 14, 2021

Surgical instruments are increasingly complex, surgical schedules are tight, and resource shortages such as blue wrap are all placing tougher demands on sterile processing to ensure surgical instruments are safe and available for every surgery.

To address these complexities and challenges, sterilization best practices have been updated in several regulatory requirements and guidelines this year, including AORN’s guidelines for Care and Cleaning Surgical Instruments and Electrosurgical Safety, and in revisions to AAMI documents for healthcare medical device processing.

“OR and sterile processing professionals can’t navigate these changes separately, it takes communication and collaboration to implement changes and also be nimble in improving practices when challenges develop,” says Susan Klacik, BS, CRCST, ACE, FCS, AAMIf. Klacik is the International Association of Healthcare Central Service Materiel Management (IAHCSMM) Representative to the Association of the Advancement of Medical Instrumentation (AAMI) and serves on AORN’s Guidance Advisory Board that oversees guideline development.

Sterilization Updates to Implement as a Team

Here’s an overview of Klacik’s five most significant sterilization changes that multidisciplinary teams need to address for safe and effective implementation.

  1. Rethink point-of-use instrument prep as treatment, not cleaning.
    AORN and AAMI now use the term “point-of-use treatment” to describe the gross soil removal and moistening of instruments that OR staff complete prior to transporting used instruments to sterile processing. “This process must include careful packing for transport, removal of disposables, and documentation, if required. Also remember to put heavy instruments under light instruments to ensure long-term instrument integrity and availability,” Klacik adds.

  2. Build in time for cleaning verification.
    Any lumened instrument should be verified as clean with a borescope. This relatively recent recommended step takes additional time prior to transporting sterile instruments back to the OR, Klacik acknowledges. “So many instruments are complex and require much more time to process. We want to make sure instruments are ready for surgery and we need to collaborate with OR scheduling to ensure this can happen.”

  3. Inspect instruments prior to use.
    Despite busy surgical schedules, time for instrument inspection in the OR prior to use is an essential step to ensure patient safety, Klacik says. “If nurses in the OR are seeing problems with equipment during inspection, this needs to be communicated immediately to sterile processing—having an open communication channel for such issues leads to more rapid response and resolution.”

  4. Immediate Use Steam Sterilization (IUSS) requires time, too.
    When IUSS is required in the OR, nurses must follow the same sterilization steps as those practiced in sterile processing. That’s why all OR nurses need to be aware of manufacturer instructions for use and sterile processing practices, she adds. “Practice updates and manufacturer updates are happening frequently so communication needs to be fluid between the OR and sterile processing to keep everyone up to date.”

  5. Learn together.
    Regular multidisciplinary team education can prevent knowledge deficits from slipping through the cracks, Klacik stresses. “The OR and Sterile Processing teams that learn together, huddle together, and troubleshoot together do consistently better in surveys and in daily efforts to ensure there are safe surgical instruments ready for every procedure.”

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