Outpatient Surgery Magazine

tainers' surfaces smooth and without damage? Is the outside free of tape and debris? Do the containers close easily and properly? 4. The sterilizer. Test the sterilizer daily for 3 things: time, temperature and pressure. Keep good documentation for every load and every cycle. Are you plac- ing the appropriate biological indicator into the sterilizer, and putting it in its proper place according to the manufac- turer's IFU? Surveyors will review your sterilization logs. They'll ask about physi- cal, chemical and biological indicators. 5. Storage. This is a significant issue for ASCs, where space is often limited. Here are the most important things to keep in mind: • Don't store equipment near high-walkway-traf- fic areas where passersby could contaminate them. • Don't store equipment near air ducts where cold air will blow on it and cause condensation to form on its surfaces. • After sterilization, don't touch the instruments until they've cooled to room temperature. (Heat will wick moisture from your fingers and contaminate the sets.) Surveyors will ask how you confirm instru- ments have cooled. Using a temperature gun is a good option. It's not acceptable to let instruments cool in the OR. • Storage locations should have adequate lighting. • The bottom shelf of a storage unit must be 8 inches to 10 inches off the floor, so the floor can be properly cleaned. Cover the bottom shelf with plas- tic lining to prevent water from splashing up when mopping the floor. All shelves should be 2 inches from any outside wall. Top shelves should be at least 18 inches from any ceiling fixture to keep sprinkler heads clear in case of a fire. • Don't crush, bend, compress or puncture any stored device. Even though manufacturers tell users to not stack products that are in blue wrap trays, many facilities do it due to a of a lack of storage space. This could compromise sterility and is never acceptable. A U G U S T 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 7 5 • DAILY CHECKUP Test the sterilizer daily for 3 things: time, temperature and pressure. Mr. Marrs (bob@beyondclean.net), the vice presi- dent of organizational development at Beyond Clean, has worked in surgery for 20 years as a certified surgical technologist, central sterile techni- cian, case cart coordinator, and sterile processing supervisor, manager and director. 6. Instrument inventory. Purchase adequate instrument inventories. Many facilities don't have an adequate rotation of instruments to meet the demands of the surgical schedule. When someone from the OR states, "We need these things back ASAP to use them on another patient," it places ster- ile processing professionals in a conundrum. They can't follow IFUs to the letter and also get the instru- ments back to the OR in time. This is when corners get cut, and when facilities resort to immediate-use steam sterilization (IUSS). Inadequate inventory of instruments is no longer an acceptable reason to use IUSS. And it perpetuates a vicious cycle. You don't have enough instruments, yet the expectation that they'll be cleaned, inspect- ed and stored properly remains. When they aren't, surgeons get frustrated and, of course, surveyors hand out citations during inspections. Always follow manufacturers' instructions for use and best practices when caring for your instru- ment inventory to ensure every patient receives the same standard of care: properly cleaned, disinfec- ted, inspected, assembled, sterilized and working instruments. OSM

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