6 Common Misconceptions About Surgery Center Sterilization

Jan Davidson, RN, MSN, the new AORN perioperative education specialist who has a focus on ambulatory surgery centers, discusses six common misconceptions about proper sterilization in ASCs.


1. Automated washer decontaminators and sterilizers are required for reprocessing instruments. While AORN recommends mechanical cleaning of instruments using automated washer decontaminators/disinfectors and washer sterilizers as a preferred method, Ms. Davidson says it is acceptable for ASCs to manually clean instruments as long this is done is a way that provides proper decontamination.

In fact, there are some delicate instruments, such as those used for eye cases, and all power equipment which require manual cleaning because they cannot be submerged in water.


"The person who is manually cleaning the equipment just needs to be aware that splashing infectious material or injury from sharp objects can occur," Ms. Davidson says.


2. Terminal cleaning of operating rooms is not necessary on a daily basis. Ms. Davidson says many ASCs do not perform terminal cleaning and disinfection of the perioperative environment each 24-hour period during a regular work week. AORN recommends this practice because it decreases the number of pathogens, dust and and debris created by daily activity.


3. Alcohol-based hand sanitizers are effective for cleaning hands under all circumstances. "While alcohol-based hand sanitizers are an excellent antiseptic agent (they kill both gram positive and gram negative bacteria), they do not penetrate organic material such as blood," Davidson says. "They are also not effective in killing bacterial spores like Clostridium difficile."


4. ASCs do not need to adhere to the same standards as a hospital. Ms. Davidson says ambulatory surgery should not equate to a lesser standard of care than a hospital, so ASCs should still adhere to the same practice and standards as a hospital. She says the challenge facing ASCs, where case volume drives revenue, is avoiding mistakes made by prioritizing number of cases over quality care.


"I think the healthcare professional feels the need to cut corners to have faster turnover," she says. "The person that suffers from that is the patient."


She says all of AORN's recommended practices can be adapted to the ASC setting, and that AORN will work with surgery centers to do so.


5. It is not necessary to implement an infection control program which follows nationally recognized guidelines. Many ASCs do not understand the Conditions for Coverage requirement stating they need to be able to produce documentation showing they have implemented nationally recognized infection control guidelines such as those set forth by the CDC, the Healthcare Infection Control Practices Advisory Committee (HICPAC) and AORN, Ms. Davidson says.


"It would be ideal if they use the guidelines from all of them," she says. "If the ASC cannot produce documentation showing that it's elected to follow nationally recognized guidelines for use in their infection control program, then they'll be cited with a deficiency."


6. Closed containers used for sterilization are interchangeable. There are several different types of rigid closed containers ASCs now use for sterilization, Ms. Davidson says. Some containers are designed for immediate use sterilization (formerly known as flashing) while others are designed for full cycle sterilization. The two are not interchangeable.


"It's important that the healthcare personnel know which kind of closed container they have and that they are used according to the manufacturer's direction," she says. "The manufacturer should actually validate the container for mmediate-use sterilization." If the manufacturer does not validate the container for immediate use you should not assume it is appropriate for immediate-use sterilization.


Learn more about AORN.


Read more from AORN:


- AORN Releases Learning Module to Assess Knowledge of Retained Surgical Items Prevention


- Sharps Injuries Still High Despite Legislation and Improved Technology


- AORN Urges Safety During Six Phases of Medication Administration Process

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