Archive July 2017 XVIII, No. 7

Flash Forward

The unexpected benefits of abstaining from immediate-use steam sterilization.

Megan Lamoreux

Megan Lamoreux, RN, BSN, CNOR


immediate-use steam sterilization IMMEDIATE BENEFITS? Although using immediate-use steam sterilization can return instruments to the sterile field quickly, it can also increase infection risk.

Flash sterilization goes by many names: flashing, short-cycle steam sterilization, immediate-use steam sterilization (IUSS). Regardless of what you call it, it means the same thing: subjecting unwrapped instruments to an abbreviated steam sterilization cycle with no drying or packaging, and then using the instruments promptly after the cycle is complete rather than storing them for later use.

"Flash," which arose out of the abbreviated time of exposure of the unwrapped device, has fallen out of favor. It now goes by IUSS. And it's generally frowned upon, especially if you're doing so on a routine basis to compensate for an insufficient instrument inventory or to keep up with fast turnovers. There are concerns that shortcuts are inevitable: not taking instruments completely apart, poor placement of instruments so that steam can't penetrate all parts and not validating that parameters have been met.

Nursing groups and accreditors want us to use IUSS as little as possible — only in emergency situations, when there is insufficient time to sterilize an item by the preferred packaging method of wrap or container — with a goal of total abstinence. Our surgical, infection control and central sterile teams have spent the past few years working toward that same goal of zero. We're not there yet, but our monthly IUSS rate has dipped considerably: from an average of 6 times per month in 2014, to 2.5 in 2015 to 1.25 in 2016 — including a few IUSS-free months. What's more, we've addressed some of our toughest reprocessing challenges along the way. Here's how we did it.

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