of IUSS. And each year, to ensure that our IUSS rate doesn't creep
back up, the OR budget includes a line item to purchase new instru-
ments. To know which instruments to buy, review your sterilization
logs monthly to figure your IUSS rate. Divide the number of instru-
ment sets that you flashed by the number of procedures in each of
your specialties. We found we needed to buy more retina, cataract
and tonsillectomy sets.
2
Standardize your instrument trays. Instead of stocking trays
customized for this surgeon and that surgeon, we created basic
instrument sets and also streamlined our trays, removing those
instruments that only a few surgeons need. Let's say Dr. Smith is
scheduled to do 20 cataract cases at your facility today. Trouble is,
you only have 3 trays that he can use because he uses 5 forceps while
other doctors use only 3 and he prefers to use his $5,000 diamond
knife for every procedure. No doubt you'll be forced to flash through-
out the day. But when you standardize your trays, you'll have 20 trays
instead of 3 available for Dr. Smith. You can add other individually
wrapped instruments to a tray for special situations, but it's better to
1 1 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 6
We only use immediate-use steam sterilization under the follow-
ing conditions:
• When one-of-kind instruments have been contaminated
and they need to be replaced to the sterile field immediately.
• When a specific instrument is needed for
an emergency procedure.
• When there is no other sterilization alternative.
— Editha Esquieres, RN, MHA, CNOR
NEVER SAY NEVER
Exceptions to Our No-Flashing Rule
