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cessing. Finally, the intraoperative staff begins the cleaning of instru- ments by making sure all instruments are free from blood, tissue, and bone during each operative procedure, as well as spraying all with an enzymatic foam to help decrease bioburden and biofilm from develop- ing before transport to the Sterile Processing Department (SPD). The IUSS rate is now between 1% to 2% and has consistently been below 3% in 2017. "That might sound high, but for the volume of surgery our hospital does, we're very proud," says Ms. Haberkorn. • Perfect trays. Another key role in the prevention of SSIs is the "March to Zero" collaboration with the SPD to provide sterile trays with zero defects every time for every surgical case. To ensure suc- cess with this initiative, all SPD techs are certified and presently attending CIS (certified instrument specialist) training for a deeper understanding of how to clean instruments. • Chlorhexidine baths. All surgical patients receive a take-home bath kit and instructions to take a total-body bath or shower before their procedures, but "we didn't know if patients were complying," says Ms. Haberkorn. So on the morning of surgery in the pre-op area, S E P T E M B E R 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 7 5 Community Hospital curbed SSIs in part by taking a deep dive into its immediate-use steam sterilization (IUSS) practices. After studying its most frequently "flashed" items, the hospital decided to purchase additional instrumentation, which not only reduced occurrences of IUSS but also lightened the turnaround burden of its central sterile department. In addition, the central sterile staff now reviews the surgical schedule in 2-week segments to ID potential issues that might cause an uptick in IUSS use. Terri C. Armstrong, BSN, RN, CGRN, surgical services manager, says the hospital has seen significant reductions in its IUSS rate since making these process changes. — Bill Donahue