Why the Fuss Over Flashing?
Re: "What's Wrong With Flashing Cataract Instruments?" (July, page 54). I read your article with great interest because it matches my feeling that flashing is a good process. Here at our critical access hospital, we, too, do meticulous cleaning and flash in an enclosed FlashPak. We do eyes once a month and rent two trays of cataract instruments from an outsourcing company. We flash those instruments to have adequate turnover time. When the Joint Commission recently surveyed us, we received a "requirement for improvement" based on the accreditor's review of our flash log, which listed 12 flash loads for "eye instruments." We need to respond to the Joint Commission within 45 days with our plan. Without a standard from some organization that recommends the flashing, we may be forced to either procure more trays or stop providing cataract services. We're probably going to have to increase those two trays to eight trays to meet Joint Commission and AORN standards.

Phyllis Crall, RN
Manager of Surgery
Bucyrus Community Hospital
Bucyrus, Ohio
[email protected]

In Praise of Paula
I'm a director of nursing in an outpatient endoscopy unit. I just wanted to say how much I look forward to reading Paula Watkins' "Behind Closed Doors" columns. When the journal comes in the mail, it's the first article I look at. Keep up the good work. Paula's humorous and candid view is refreshing.

Sharon Iden, RN
Director of Nursing
Carroll County Digestive Disease Center
Westminster, Md.
[email protected]

Re: "Things That Make You Go Whoops" (July, page 88). We've all been there if we've been in nursing for any time. It's great to see it put into words so humorously.

Sandra Sagerian, RN, DABCM
Doctors Outpatient Surgicenter
Pasadena, Texas
[email protected]

A 30-percent Discount?
Re: "Strengthen Every Link in Your Supply Chain" (July, page 64). Today I was waiting in between cases and had an opportunity to read this article. I am an RN and a distributor of surgical products and have been for 30 years. I have never been more offended.

The author's claim that hospitals or surgery centers should demand a minimum of 30 percent discount and free freight simply shows that she doesn't know what she's talking about. There isn't that kind of margin in this business. Suggesting that a rep or distributor should be banned if they won't cooperate is ludicrous. By printing her words, you are giving them credibility. Nothing could be farther from the truth. From all of us out there that do a good solid job for a reasonable price, you owe us an apology.

Cynthia Baldauf, RN
President
Unique Surgical Products
Pittsboro, Ind.
[email protected]

Melody Mena replies: I'm glad that there are competitive and reputable distributors like you, but I'm here to tell you that this isn't always the case. Vendors that don't contract under GPO pricing or ship through distributors create tremendous pressures for surgery centers. Interestingly, most of these vendors are bringing in implants and high-dollar items that are not reimbursed by insurance companies and can quickly put a case at a surgery center in the red. Communicating ground rules up front helps to alleviate misunderstandings and control costs. As I said in the article, developing close working relationships and communication with vendors, distributors and GPOs is paramount to all surgery centers.