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Good morning
Just wondering if anyone has set up an area in the operating theatre for a
benchtop ‘flash’ steriliser? This would be used if reprocessing was
performed offsite (outsourced). It would only be used for a dropped or
suspected compromised sterility RMD that is of limited supply. Not routinely
used.I have heard some conflicting opinions on what is required.
I believe from reading AS/NZS 4187:2014 that a designated area must include
an area for cleaning, drying and the sterility would not be compromised when
it is removed from the benchtop ‘flash’ steriliser. This would not be an
endoscopy reprocessing room as has been suggested (but I will accept another
opinion)!I am uncertain on what the air handling system should be eg HEPA filtration
and the same as recommended for sterilisation areas.AS/NZS 4187:2014 continues to put challenges in our path…….it is all
down to interpretation of the whole document and not just little sections!I would value some advice from a colleague who has installed a benchtop
‘flash’ steriliser in the operating theatre.Thank you
Joe
INFECTION CONTROL REVIEW PTY LTD
Joe-Anne Bendall Consulting
ABN 98630512284
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Hi Joe
I will confess to not having placed a flash sterilizer in an OT for many, many years (have removed them all!), but if one was required one of the main factors to consider is how the ‘flashed’ instruments get transported from the steriliser into the OT.
If you use a container system of some sort, the instruments inside will be protected from the environment and handling once sterilised, and so the transport from the steriliser to the OR is not as compromised (although it is very difficult to validate this consistently). The other option is ‘open’ trays or racks that are carried from the steriliser to the OR. This would mean that you need to safeguard the instruments from environmental and handling contamination for the whole passage from the steriliser to the OR. That is fraught with difficulties (opening doors, scrubbed staff walking through ancillary areas), Almost impossible to validate a process like that and is one of the reasons we stopped doing flash sterilisation in OT.
I know this is probably not helpful to you here, but I personally would do everything in my power NOT to support a flash sterilization process, as I believe they compromise the sterility of critical instruments, and cannot be easily validated. More instrument availability would be what I would look at exploring to try and reduce the likelihood of needing a process like this..
Isn’t this forum great for getting opinions of others? That’s mine. 🙂
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Good morning
Just wondering if anyone has set up an area in the operating theatre for a benchtop ‘flash’ steriliser? This would be used if reprocessing was performed offsite (outsourced). It would only be used for a dropped or suspected compromised sterility RMD that is of limited supply. Not routinely used.
I have heard some conflicting opinions on what is required.
I believe from reading AS/NZS 4187:2014 that a designated area must include an area for cleaning, drying and the sterility would not be compromised when it is removed from the benchtop ‘flash’ steriliser. This would not be an endoscopy reprocessing room as has been suggested (but I will accept another opinion)!
I am uncertain on what the air handling system should be eg HEPA filtration and the same as recommended for sterilisation areas.
AS/NZS 4187:2014 continues to put challenges in our path……………….it is all down to interpretation of the whole document and not just little sections!
I would value some advice from a colleague who has installed a benchtop ‘flash’ steriliser in the operating theatre.
Thank you
JoeINFECTION CONTROL REVIEW PTY LTD
Joe-Anne Bendall Consulting
ABN 98630512284Joe.bendall@bigpond.com
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Hi Joe
I think you will find few people are installing flash sterilisers in theatres as most people have had the task of removing them from theatre. Elimination of flash sterilisation has been recommended in AS/NZS4187 since at least 2003.
AS/NZS4187 indicates that insufficient instruments is not an excuse for flash sterilisation so the most important thing would be to try and have a good supply of sterile critical items which I know is not easy but best practice.
So if outsourcing processing you may need to order back up sets as well as the one to be used. Maybe try and have a supply of critical single use RMDs if available.
The problems in the past with flash sterilisers were:
* Inappropriate use for cannulated items (most flash sterilisers that I have seen in the past were downward displacement and not vacuum assisted to save time.)
* Burn risk to staff
* Inadequately maintained
* Costly as validation required even for occasional use
* Facility air conditioning and area not correct where they were situated
* Potential for contamination during removal of items from steriliser
* Potential for contamination during transport
* Potential for contamination when cooling down very hot items with sterile water in theatre
To comply with work flow the flash would have to have access on a “dirty” site where the instrument would be cleaned, and then removed on a clean side. Again you are right the dirty and clean side would have set requirements.
To date there have been few outsourcing options but as there are some on the horizon and facilities choose to go this way this may become a bigger problem in the future and lead to more discussion for the standards writers.
Best wishes
Sylvia
Sylvia Morris
Sterilising and Reusable Medical Device Reprocessing State Coordinator
Infection Control Service
Health Regulation and Protection
Department for Health and Wellbeing/Government of South Australia
Level 3 Citi Centre 11 Hindmarsh Square Adelaide SA 5000HCW infection prevention: http://www.sahealth.sa.gov.au/infectionprevention
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Good morning
Just wondering if anyone has set up an area in the operating theatre for a benchtop ‘flash’ steriliser? This would be used if reprocessing was performed offsite (outsourced). It would only be used for a dropped or suspected compromised sterility RMD that is of limited supply. Not routinely used.
I have heard some conflicting opinions on what is required.
I believe from reading AS/NZS 4187:2014 that a designated area must include an area for cleaning, drying and the sterility would not be compromised when it is removed from the benchtop ‘flash’ steriliser. This would not be an endoscopy reprocessing room as has been suggested (but I will accept another opinion)!
I am uncertain on what the air handling system should be eg HEPA filtration and the same as recommended for sterilisation areas.
AS/NZS 4187:2014 continues to put challenges in our path……………….it is all down to interpretation of the whole document and not just little sections!
I would value some advice from a colleague who has installed a benchtop ‘flash’ steriliser in the operating theatre.
Thank you
JoeINFECTION CONTROL REVIEW PTY LTD
Joe-Anne Bendall Consulting
ABN 98630512284Joe.bendall@bigpond.com
[Infection Control Review Logo – small2]MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
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