HEALTHCARE
PURCHASING EWSN SELF-STUDY SERIES
May 2021 The self-study lesson on this central service topic was developed by STERIS. The lessons are admin- istered by Endeavor Healthcare Media.
Earn CEUs After careful study of the lesson, complete the examination at the end of this section. Mail the completed test and scoring fee to Healthcare Purchasing News for grading. We will notify you if you have a passing score of 70 percent or higher, and you will receive a certifi cate of completion within 30 days. Previous lessons are available at
www.hpnonline.com.
Certifi cation The CBSPD (Certification Board for Sterile Processing and Distribution) has pre-approved this in-service for one (1) contact hour for a period of fi ve (5) years from the date of original publication. Successful
completion of the lesson and post-test must be documented by facility management and those records maintained by the individual until recertifi cation is required. DO NOT SEND LESSON OR TEST TO CBSPD. For additional information regarding certifi cation, contact CBSPD - 148 Main Street, Suite C-1, Lebanon, NJ 08833 • www.
sterileprocessing.org.
IAHCSMM (International Association of Health- care Central Service Materiel Management)
has pre-approved this in-service for 1.0 Continuing Education Credits for a period of three years, until April 2, 2024. The approval number for this lesson is STERIS-HPN 210204. For more information, direct any questions to Healthcare Purchasing News (941) 259-0832.
LEARNING OBJECTIVES
1. Describe the difference between immediate use steam sterilization and Short Cycle steam sterilization
2. List the steps of Short Cycle validation
3. Defi ne quality control needs and reporting
Sponsored by: by Arthur Henderson
Unmasking Short Cycle sterilization
D
uring my 30-plus years in operat- ing rooms and sterile processing departments, I believed that choos- ing the appropriate steam sterilization cycle was a simple task. Terminal steam sterilization is performed on wrapped or containerized instruments if you intend to store these critical medical devices for future use. Immediate-use steam steriliza- tion (IUSS) allows us to use abbreviated cycles for devices that are to be quickly used for a specifi c case. However, the introduction of Short
Cycles used for ophthalmic device ster- ilization has challenged the simplicity of this thought process. These Short Cycles use terminal sterilization packaging but have shortened drying times, and the packaged instruments are typically used immediately, though they may be stored. So, should these new cycles be classifi ed as a terminal sterilization process, an immediate-use process, or as something else? Let’s see if we can make sense of this.
What is a Short Cycle? Most healthcare facilities are familiar with terminal sterilization and IUSS. However, the newer Short ycle defi es previous cat egories. It’s a type of terminal sterilization process, but it is unlike the traditional pro- cesses used in larger healthcare facilities. Terminal steam sterilization uses steam to sterilize medical devices held within containers, pouches, and wrapped trays. The devices are dry at the end of the process, which allows them to be placed into storage. That dry condition is very important, since any residual moisture creates an opportunity for microorganisms to contaminate the pack. It also creates an
Parameter / Condition Terminal Cycle Exposure time Dry time
Moisture Retention Storage
26 May 2021 • HEALTHCARE PURCHASING NEWS •
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Full Full Dry
May be stored
opportunity for devices to be exposed to the corrosive properties of water, which can damage them and shorten their use- ful life.
In contrast, IUSS uses steam to sterilize medical devices held within containers validated specifically for this process. Devices are typically wet at the end of the sterilization cycle and are used immediately for a specific procedure. How do IUSS cycles differ from terminal sterilization cycles? Simply stated, they have shorter steam exposure times, drying times, or both.
After completing an IUSS cycle, it’s important that the devices cool before they are used. Hot instruments can injure staff and patient tissues.
A Short Cycle is a term used by oph- thalmic associations and ambulatory care facilities to describe a steam sterilization cycle that uses a shorter drying time than standard terminal sterilization cycles but achieves the same sterilization conditions as terminal sterilization cycles. However, items must be packaged in the same manner as if undergoing terminal steam sterilization, and they must be dry at the completion of the sterilization cycle. Short Cycles are not included in the standards and guidelines of the Asso- ciation for the Advancement of Medical Instrumentation (AAMI) or the Associa- tion of peri-Operative Registered Nurses . Instead, this is a cycle specifi c to ophthalmic instrumentation and is defi ned by the enters for edicare and edicaid Services S. S defi nes Short Cycles as “a sterilization cycle for a wrapped/contained load that meets the device manufacturer’s instructions for
Table 1: Comparison of terminal, IUSS and Short steam sterilization cycles. IUSS Cycle
May be shortened 0-1 minute Wet
No Storage
Short Cycle Full
Shortened Dry
May be stored
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