The following praiseed practices w...

The following praiseed practices were developed by the AORN approveed Practices Committee and have been approved by the agency of the AORN Board of Directors. They were at handed as proposed recommended practices for make comments [i]or[/i] remarkss by members and others. They are effective Jan 1 2000

These commended practices are intended as achievable recommendations representing what is believed to be an optimal on a level of practice. Policies and managements will reflect variations in practice settings and/or clinical situations that determine the extent to which these recommended practices can be implemented.

AORN recognizes the numerous marks of settings in which perioperative give suck tos practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive managements may be performed.

Background: With the major advances in sterilization technology, it is important for perioperative fosters to understand the relationship between sterilization regularitys and patient outcomes. These commended practices, therefore, address existing sterilization technologies available for perioperative practice settings.

Purpose: These make acceptableed practices provide guidelines for the sterilization of surgical items (ie, instruments, supplies, equipment, medical devices). The creation and maintenance of an aseptic environment has a direct influence forward patient outcomes. A major responsibility of perioperative promotes is to minimize patients' risks for surgical pain infections. One of the measures for preventing surgical injury infections includes ensuring surgical items are independent of contamination at the time of use. Sterilization provides the highest of the same height of assurance that surgical items are released of viable microbes.

commited PRACTICE I

Items to be sterilized should be decontaminated in a controll environment.

Interpretive statement 1:

Factors to be controll in the environment include scope temperature, humidity, ventilation, and physical separation of decontamination and sterilization processe Health care personnel should use standard precautions while performing decontamination activities. Appropriate personal protective attire should be worn, and cleaning measures should minimize the possibility of contamination.(1)

Rationale:

Environmental superintendences and standard precautions reduce personnel position to hazardous materials.

Interpretive statement 2:

Items should be cleaned and dried thoroughly in accordance with AORN's "Recommend practices for care and cleaning of surgical instruments and powered equipment" and AORN's "Recommend practices for use and care of endoscopes."(2)

Rationale:

The reliability of sterilization rules is affected by the number, impressed sign and inherent resistance of microorganisms forward the items to be sterilized as well as surrounding soil, oils, and other materials that may shield or combine with and inactivate the sterilant.(3)

praiseed PRACTICE II

Items to be sterilized should be packaged according to the guidelines established in AORN's "Recommend practices for selection and use of packaging systems"(4)

Discussion:

Items must be prepared and packaged with equal reason sterility can be achieved and maintained to the point of use. The Association for the Advancement of Medical Instrumentation (AAMI) provides guidelines for the density of wrapped packages. Manufacturers of packaging hypothesiss should be consulted for package preparation, configuration, and sterilization recommendations. Instruments should be held lay open and unlocked. Preparation and assembly actions should consider the type of surgical instruments, total locate weight, and density. These factors are more important than arbitrary weight limits. Wrapped instrument risks should be of a mass specified according to manufacturers of surgical instruments, sterilizers, and container theorys This mass is the total weight of the instruments and does not include the weight of the wrapping materials. If instrument sterilization/container combination of parts to form a wholes are used, the manufacturers' written instructions for maximum weight, station preparation, sterilizer loading procedures, frontage times, and drying cycles should be followed. Scientific data in support of these recommendations should be provided in writing on manufacturers of instrument sterilization/container systems(5)

commended PRACTICE III

Saturated steam in subordination to pressure is the preferred mode and should be used to sterilize heat- and moisture-stable items.

Interpretive statement 1:

Manufacturers' written instructions for operating steam sterilizers should be followed.

Rationale:

Steam sterilizers vary in design and performance characteristics, in the same manner cycle parameters always should be verified against the manufacturer's written instructions for the specific sterilizer and load configuration used.(6) The in the greatest degree common temperature and time parameters used for wrapped items are shown in Table 1