The CDC finished updating its latest version of the Guidelines for Disinfection and Sterilization in Healthcare Facilities in November.\u00a0 The new publication represents the first comprehensive overhaul of this document since the 1980\u2019s.\u00a0 At a hefty 158 pages, this isn\u2019t exactly light reading.\u00a0 However, it is definitely written with an emphasis on clarity.\u00a0 The terminology is simple enough for an entry level hospital technician to easily grasp.\u00a0 This booklet will make a valuable addition to the library of any employee responsible for following proper disinfection protocols.\u00a0 It is available for download at the CDC website in Adobe format.\u00a0\u00a0 Of special interest is the section on flash sterilization issues.<\/p>\n
This controversial decontamination technique has been the source of much discussion in the past and that certainly hasn\u2019t changed.\u00a0 Flash processing is the quick and \u201cdirty\u201d version of steam processing medical instruments.\u00a0 This method is used when there is no time to run a full length autoclave cycle and there are no spare instruments available.\u00a0 In the middle of a life or death surgery, doctors must make the call on how to clean an item that falls on the floor or otherwise becomes contaminated.\u00a0 If there is no replacement, they may choose to simply have it run through a fast cycle and put it back to work.<\/p>\n
The CDC publication states \u201ccorrectly performed flash sterilization is an effective process for the sterilization of critical medical devices\u201d(p60).\u00a0 The problem is that proper procedures are\u00a0sometimes ignored.\u00a0 In the rush to get instruments back to the operating room, mistakes can be injurious or fatal. The risk of surgical site infection skyrockets if any steps in this complex procedure are skipped.\u00a0 Burns have also been known to occur when items are not cooled to a safe temperature before use.<\/p>\n
Because instruments are cleaned in open trays or pans, they can quickly become re-contaminated with microbes.\u00a0\u00a0 This can happen even on the short trip from the sterilizer back to the OR.\u00a0 For this reason, some hospitals are now choosing protective packaging that allows steam penetration but still provides a shield against airborne bacteria.\u00a0\u00a0 Other facilities locate the sterilization room as close to operating theaters as possible to reduce transit time.<\/p>\n
Since the run time for a flash cycle is only 3 minutes or so, the risk of some organisms being left alive is higher than with regular processing.\u00a0 To find out if a particular load was indeed sterile, a bio indicator test must be run.\u00a0 These usually take 24-48 hours to deliver results.\u00a0 Obviously, by this time the surgery is over and any damage has already been done.\u00a0 Even with newer tests that can be read within an hour, the problem still persists.\u00a0 Records must be kept for each load so that personnel can follow up.\u00a0\u00a0Patients who were accidentally exposed\u00a0to inadequately sterilized instruments require close monitoring and additional antibiotics.<\/p>\n
This method should never be used simply for the sake of convenience.\u00a0 Maintaining sufficient inventory of all instruments is one way to avoid circumstances in which flash processing is necessary.\u00a0 This type of sterilization should only be done by employees who fully understand the consequences of a mistake.\u00a0 As always, proper training is the best protection against errors.\u00a0 Having the right information makes all the difference.<\/p>\n