STERILIZATION PRACTICES – ISSUE NO. 6

Latest JCAHO Statement Leaves Sterile Professionals Unsure : Last week, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) issued an update on their position regarding sterilization of surgical instruments. The first bullet point of that statement deals with flash sterilization. Only a couple of years ago, JCAHO took a strongly negative position on flash sterilization, setting as a goal to severely limit its use. While the vast majority of healthcare professionals supported JCAHO's position, many also struggled to comply fully with its implementation. In its latest statement, JCAHO may be trying to soften their position, but they appear to be taking a 180 degree turn and actually endorsing widespread adoption of the practice: "Flash sterilization is the most common term used to describe certain types of steam sterilization that do not utilize a full (also known as terminal) cycle. Originally, this term meant sterilizing unwrapped instruments using steam for 3 minutes, at 270 F. at 27 to 28 lbs of pressure. Over the last several decades, a number of improvements have been made to this process, such as longer exposure of the instruments to steam, the use of special trays and packs to hold and protect the instruments, and the routine use of biological indicators." While products have been developed over the decades to improve the efficacy of flash sterilization, AAMI, AORN and other standards writing bodies are clear: Flashing should be limited to emergency use only and only for devices that are going to be immediately used (AAMI ST79: Introduction Flash Sterilization, AORN Recommended Practices 2008, Recommendation IV). JCAHO's newest statement seems to go too far now in the other direction, creating confusion for sterile professionals and the people they serve.