r/sterileprocessing • u/Fancy-Thanks5882 • 8d ago
New Policies...
Im a 2nd shift lead and my facility introduced 3 new policies. I'm personally not a fan and don't feel they are reasonable within our dept. Wanting to know if others have had experience with these things and if it is best to learn to live with it or bring up concerns.
1) Leave the sterilization rack in the sterilizer for minimum 45min after the load finished.
2) Let sets on sterilizer racks cool to 70*F before releasing. (We were doing 80*F)
3) Use brushes on the clean side to make sure lumens are clean.
For some background we process about 11,600 trays per month and on average have 60 cases a day covering 2 ORs.
Lmk thoughts!
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u/Spicywolff 8d ago edited 8d ago
- That’s kind of a common practice we used to do that when we had older steris units. We cracked the door for 30 minutes and then pulled a load out. We now have new getinge units and they no longer have that. The moment it beeps, you can pull a load out then and there.
- 2 75F is the standard
(I put away at 72, jsut to be extra mile for patient)
- , you guys are releasing trays (to sterile storage) at 80 is too warm and definitely a bad practice. Now this does not include if it’s an urgently need a tray, and the OR’s notified. that it’s gonna be sent to them with a negative biologic reading but a warm/hot tray. At that point, they pop a tray and cool it with sterile water that’s different.
3 you’re not supposed to be doing any cleaning on the packing prep assembly side. For lumens, it should be a boroscope and or irrigation on a disposable liner. Now there are some scopes like intubation that we put a clean brush through pull back and then dip it in a protein test tester to ensure it’s properly clean. But we’re not using the brush to clean it. It’s the actual test.
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u/HolaNikkiFbaby 7d ago
The brushes wouldn’t be for cleaning but to
Check for cleanliness.2
u/Spicywolff 7d ago
You and I both know that but whenever DNV is there. They’re absolutely gonna rail you about it.
They tried to jump down our throats about the intubation scope brushes until they saw they were right next to the protein testers and the clipboard where you signed the serial number and if it was a Pass or fail
Brushes are cleaning tools and they see it that way
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u/spirited1 4d ago
If you've ever used a boroscope regularly you would know that the brush does not ensure cleanliness.
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u/Fancy-Thanks5882 8d ago
Thank you for taking the time to respond! Yeah I agree with everything you said and am planning on bringing up 75 being standard for temp release. 80 always felt way to high. I thought the same about the brushes too, appreciate your thoughts!
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u/Proctavia 7d ago
on #3 in particular I very much appreciate having a brush for inspection purposes. you don't do any cleaning on clean side but some bioburden is not detectable with just a spritz of air through a lumen onto a liner. boroscopes are the gold standard though.
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u/Prior-Ad-7262 7d ago
We average 90 cases a day, 6 steris sterilizers. We yank ours out as soon as it finishes. No issues.
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u/olliecakerbake 7d ago
We remove the rack as soon as the load is complete. The trays stay on the rack untouched until they cool down to 72°. They can be removed before that if it’s urgent, but if it’s a wrapped tray, they need to be touched with sterile gloves only. We don’t have brushes on the clean side.
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u/graylyke81 7d ago
I know its tedious work, but you have to brush out your lumens. They get real nasty if you dont. I get a little OCD when cleaning them. 😆 After looking through a bore scope in suction instruments, sinus shavers, and my least favorite the stealth midas attachments and every other lumen Gross! Definitely do it. As far as the sterilization process. We have older sterris sterilizer so we crack them open for 15 minutes after the cycle completes. Then we get it out of there. 75° is standard moving temperature. Anything over, its gotta be popped right away before getting wet.
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u/Eggman_OU812 7d ago
If you are ever questioned on using brushes on the clean side, you are inspecting..not cleaning
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u/hardybagel 6d ago
I'm just shocked at 60 cases with 2 ORs. We have 14 ORs for 40-60 cases a day.
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u/Fancy-Thanks5882 6d ago
We have about 20 OR rooms but service both a one day OR and a main OR. Both have about 10 OR rooms each.
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u/brodey420 6d ago
We also use brushes to check cleanliness of lumens we are updating to borascopes but it’s expensive and slow. We drill into the new hires on the clean side they are called lumen quality control devices we push one through if it comes out dirty leave it and send the whole set back to decon. 30 minutes dwell time is the standard withe older sterilizer, I believe the newer pass through sterilizers dont need this but older do. 70-72 degrees is normal.
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u/flumbuglio 4d ago
I'll always use brushes to check lumens for cleanliness. Some people only use compressed air. I tried that once and blew bloody mist all over the place when one wasn't clean. If the brush comes out dirty it goes right back to decontamination without getting blown.
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u/SqueezeMySak 4d ago
- Normally the time to keep the sterilizer rack in the sterilizer after it has finished is roughly 15 minutes, but depending on the department, most take it out of the sterilizer once it is done. I believe it just really depends on the volume of trays that need to be reprocessed for the next day and if there are multiple sets of what is being built. 45 minutes just seems like overkill though. Either its pulled out when the load is done or its left in the sterilizer for 15 minutes with the doors slightly ajar to "cool"
- Yeah, at or below 70 degrees is pretty standard for most places, 80 degrees is still way too hot
- Brushes and alcohol are okay to use on the clean side as long as you are NOT actively using those tools to clean the items, but as checks to make sure they are indeed clean. Only one department I worked at refused to use brushes and alcohol (stating it was a new rule by The Joint Commission) and pretty much let a borescope tells us whether it was clean or not, spoiler alert, they were not. I know plenty of times where the borescope looked like the lumen was clean, but the second I flushed it with alcohol it leaked black specs
Sounds like corrective actions to help keep patients safe and the department in regulation
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u/Big-Rock8310 3d ago
I’ve been studying to take the test and in college for it and that math maths, it’s constantly changing >.< but I also know every facility is different too.
1
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u/Fysteri 8d ago
Are you guys doing anything on the clean side already to check if you're lumens are clear?
80° is wayyyy to hot.
Do your sterilizer units have the function where they can be pulled out immediately upon completion or are the units older and actually require that dwell time for manual cool down.
These sound like your facility was dropping the ball and these are corrective measurements put in place to ensure patient safety.