Lessons on Flashing
There's a time and a place for rapid-cycle steam sterilization.
Dan O'Connor, Editor-in-Chief
Immediate-use steam sterilization (née flashing) is about as rare as a lunar eclipse at some outpatient surgical centers. Take the Sharp Chula Vista (Calif.) Outpatient Surgery Center, for example. This year, they've flashed 6 times — or once every 333 or so procedures. That was high compared to last year, when they flashed all of 4 times. "And those times when we had to do it, everybody felt bad about it," says Manager Mindy Hoffman, RN, CNOR. "If we flashed, you can bet it was a true emergency" — like an odd drill bit that came in from a loaner ortho set or a retractor wing nut that fell to the floor while someone was trying to tighten it.
Such infrequent flashing wasn't always the case at the 12-year-old surgery center. In the early years, routine flashing was the norm. Each eye surgeon had a single set of instruments — that's right, there weren't any backup sets — that techs flashed after each case. "We were flashing all day long," says Ms. Hoffman.
Soon after an infection prevention consultant advised the center that it's neither safe nor wise to run rapid cycles to cover up for an inadequate instrument inventory, Ms. Hoffman went to her superiors with a plan of action. From now on, she told them, every time we have to flash a set of instruments, we'll invest in a backup set for it. They agreed. "It was a chunk of change, but they said do what you need to do to get to where you need to be." And so before long, the facility had invested in 6 new sets of eye instruments for its cataract surgeons. "Now that we have enough backup instruments, we hardly ever flash," says Ms. Hoffman.
Ms. Hoffman's simple flash-avoidance policy: Have enough instrument sets for your daily caseload or schedule cases to allow for enough time between cases for full-cycle reprocessing. "We as a staff pride ourselves on not flashing," she says.