It's OK to flash instruments under certain circumstances, says The Joint Commission, which yesterday updated its position on using steam to sterilize. You can flash as long as it's part of a "complete and effective process of sterilization." This means, for example, that you must adequately clean instruments before sterilizing them and cover instruments before you transport them back to the OR after they've been sterilized. Surveyors will shift their focus from what method or cycle of sterilization you use to your entire sterilization process.

"Based on discussions with experts in the field, professional organizations, and government organizations, The Joint Commission has decided to refocus its survey efforts on all of the critical processes included in sterilization," reads the position statement. "If a complete and effective process of sterilization is used, it will be considered an effective sterilization method. Surveyors will review the critical steps of disinfection and sterilization to determine if the process is appropriate."

However, the statement says surveyors will be on the lookout for overuse. For example, a high percentage of steam sterilization using less than a full sterilization cycle or exclusively steam sterilizing certain types of instruments.

The position statement also defines steam sterilization as sterilizing unwrapped instruments using steam for 3 minutes, at 270 degrees F and at 27 to 28 lbs. of pressure.

Dan O'Connor

A sensor technology similar to that of a Breathalyzer test can track the frequency of healthcare workers' hand-washings in real time, according to researchers at the University of Florida.

The trademarked technology, called HyGreen, is designed to help facility leaders monitor their staff members' hand hygiene compliance without having to police scrub sinks and hand sanitizer dispensers with clipboards in hand.

The HyGreen system consists of 3 components: wall-mounted sensors placed next to soap and hand sanitizer dispensers, electronic ID badge holders for every healthcare worker and monitors placed at every patient's bed. After washing up, workers pass their hands under the sensors, which "sniff" soap or sanitizer fumes on their hands and trigger green LED lights on their ID badges. The sensors also transmit the date, time and location of each hand-washing event to a database with which supervisors can monitor compliance.

Then, when a worker enters a patient's room, the monitor by the bed detects whether her badge's green light is on. If it's not, the badge will vibrate, reminding the employee that she needs to wash her hands before coming into contact with the patient.

The system, which was unveiled at the Association for Professionals in Infection Control and Epidemiology's annual meeting last week, is designed to be a "non-invasive" measurement tool for healthcare facilities, says Loretta Fauerbach, director of infection control for Shands at the University of Florida, where the system is being evaluated in a hospital setting. "It allows for nonbiased measurement and is unobtrusive," she says. Medical device manufacturer Xhale, Inc. is marketing the system.

Irene Tsikitas

Despite an increasing prevalence of healthcare-associated infections, hospitals are cutting staff and resources devoted to infection prevention, according to a survey conducted by the Association for Professionals in Infection Control and Epidemiology.

The nationwide survey of nearly 2,000 infection prevention specialists reports that 41% of respondents saw their facilities cut infection prevention budgets in the 18 months before March 2009.

This survey follows reports that hospitals are cutting staff as a result of the recession. Nearly 40% of the hospitals that made such cuts have experienced layoffs, reduced hours or hiring freezes in the infection prevention departments. One-fourth of respondents said they have reduced surveillance activities to detect, track and monitor nosocomial infections.

Cutting infection prevention budgets is a short-sighted move, says APIC chief executive Kathy Warye in a published report. "It confirms that many health-care leaders still don't understand that preventing infections costs pennies on the dollar compared to the cost of treating infections when they occur," she says.

The mean cost of a healthcare-associated infection is $13,773 per patient. A surgical site infection adds $10,443 to $25,546 to the cost of treating a patient, according to a recent report from the Centers for Disease Control and Prevention.

Kent Steinriede

The corneal swelling from cataract surgery can jeopardize a patient's cornea transplant, according to research published in the June issue of the journal Ophthalmology.

In reviewing the cases of 1,090 patients who had undergone cornea transplants, researchers discovered that a swelling of the cornea caused by cataract surgery resulted in implant failure for 27% of patients. In comparison, patients whose corneal edema was caused by Fuchs' dystrophy, a disorder that affects the cornea's endothelial layer, had only a 7% failure rate.

Glaucoma also appeared to significantly increase transplant failure rates, with 29% of patients who underwent surgical interventions, 20% of patients who treated the condition with medications and 58% of patients who used both methods suffering unsuccessful transplants. Meanwhile, implants in patients without glaucoma failed only 11% of the time.

The study did not show a significant correlation between transplant failure and patients' ages, genders, incidents of diabetes and smoking histories. All patients included in the study were considered to have a moderate risk for transplant failure, note the researchers.

Alan Sugar, MD, FACS, a professor in the department of ophthalmology and visual sciences at the University of Michigan in Ann Arbor and the study's lead author, believes his research will help predict the outcomes of the approximately 40,000 corneal transplants that the American Academy of Ophthalmology says are performed each year.

Daniel Cook