Steris P & P question

[mcmike55]

A question to you all about the Steris.

We have been using a Steris, you know paracetic acid, to sterilize different scopes.

Recently we got an update to our manual from the company. It basically said that instruments in the Steris are sterile "just in time" for the procedure.

Our question is what is "just in time", and how "immediately before the procedure" is that. 5 minutes, 15, half an hour? I know that each hospital must set that amount of time. Our policy says to start the Steris about one hour before the expected time of the case, allowing 30 mins for the cycle, that's less that a half an hour.

We can't find any studies or data that says one amount of time is better than another. Less time sitting in the machine the better I know, but what is a reasonable cut off?? I and a couple others think around an hour.

What's your thoughts, or you know any data to support this???

Mike

[lindaloo51]

Our policy is that sterility is event related. We have no set time in our policy for how long instruments may be open before a case.

That said, a general rule of thumb is about an hour from the time the case is set up. If possible, with Steris, we leave the instruments sealed in the processor until just before the procedure. This has to be done within reason because it's not good for the unit to continue holding the seal for a long period of time. Also, you have to consider that anything coming out of Steris is warm and wet which will provide a lovely haven for any environmental bacteria.

It's hard to imagine that when I first started in the OR, we would set up all of our cases between 7 and 8 am and cover them with baylors. Then as the day progressed if we needed something from a different set up, you would lift up the drape and reach under with a "sterile" lifting forcep and take what you needed. I don't think our infection rate was any higher then than now.

[spineCNOR]

you might want to check with your Steris rep, but I think the "Just-in-Time" refers to the fact that items sterilized in the Steris cannot be stored for use at a later date, like things sterilized with steam, EtO, Sterrad, etc.

[mcmike55]

Yeah, I'm sure you're right. I think what Steris was trying to get across, that you can't leave things in there too long.

I'm imagining in my mind, people running stuff the night before for an early case.

Right now, we leave the boot up until the last minute, and try to start the process less than an hour before the case. I guess what we're looking at is stuff in there for 30 to 60 mins tops. I just don't like the idea of leaving things sitting in a damp environment for too long.

Mike

[Marie_LPN, RN, LPN, RN]

you might want to check with your Steris rep, but I think the "Just-in-Time" refers to the fact that items sterilized in the Steris cannot be stored for use at a later date, like things sterilized with steam, EtO, Sterrad, etc.

This is what our Steris rep says.