Steris...

[orrn1991]

What are your hospitals/surgery centers policy on using the Steris? Where I work we are having some disagreements about the timeline of use of the tray. How long do you have to actually "use" the tray? Our policy states the tray will be opened and used immediately. Sounds easy enough right? Well, some staff members are taking this to the extreme. Can the scrub person open the tray on a ring stand, go to the sink and scrub and then use the tray? At my previous employer, we would put the trays in the room without opening them and use them when needed. No real time table was in place. I am interested in how other facilities utilize their steris systems. Thanks!

[brewerpaul]

We're not rigid about using them right away. We only have two Steris machines and sometimes more than one OR is competing for them. We'll sometimes process equipment in advance then leave them, covered and with a sterile sheet over and under them with a note not to disturb them.

[Rose_Queen, BSN, MSN, RN]

Our policy is that anything run in the steris is good for up to four hours after the end of the cycle. Very helpful when trying to set up add on cases or if one is needed for our traveling urology cart and a sterile one isn't available.

[cdsga]

Wow, you really need to contact your Steris rep.

Steris is a point of use sterilization. It is not to be done ahead of time and just left to sit with sterile sheets with notes on them. That is amazing.

So many things wrong with that scenario. Unsupervised sterile items, competing machines, on and on and on. My suggestion is to track the amount of time you use the Steris and buy more equipment to accomodate what you need to provide the quality of service your patient's deserve and expect.

[cdsga]

to follow up. If your hospital doesn't feel they have the budget for more equipment to meet the demand, just wait until they pay a few law suits or Medicare doesn't pay for the infection within the 1st 30 days after the procedure. They will certainly spring for the equipment when that happens, or they'll shut the doors.

Don't lower your standards.

[GadgetRN71, ASN, RN]

Wow, you really need to contact your Steris rep.

Steris is a point of use sterilization. It is not to be done ahead of time and just left to sit with sterile sheets with notes on them. That is amazing.

So many things wrong with that scenario. Unsupervised sterile items, competing machines, on and on and on. My suggestion is to track the amount of time you use the Steris and buy more equipment to accomodate what you need to provide the quality of service your patient's deserve and expect.

I've worked in ORs where we'd leave them for a couple of hours with a note and never had an infection problem. We had the steris containers that had a plastic cover with metal clips so it's not like they are exposed to the air. In one of the ORs, the policy was the scopes/instruments were good for 24 hours in an undisturbed container. They never sat for 24 hours though, because I worked in cysto and we went through a lot of scopes.

The OR I'm in now, they're good for an hour or two and again, we have a very low(almost nonexistant) infection rate.

[cdsga]

I know what's done in reality--If your facility ok's that time factor then do it. I know that cysto's are semi-restricted cases and are always classified as clean contaminated cases (at the very least). When you are dealing with monitoring sterility--and these things are left unmonitored you are really setting your self up. Other cases that require steris use are also clean contaminated cases, but you have added skin incisions with those cases. What your facility takes on as risk, as opposed to best practice, unless emergent, is what you have to research.

[GadgetRN71, ASN, RN]

I think you also have to know your coworkers as well. I work on a closed team in Ortho. We steris the arthroscopes. Orthopedics is one of those specialties where sterility is really stressed and we have a very low infection rate. These steris containers are placed in a safe spot and we know each other well enough that someone tampering with the container isn't a concern.

I can see your point though about people messing with stuff...I think if an OR is going to allow steris containers to be counted as sterile past a certain pont, then there has to be compliance/education among the staff. I know that ORs certainly aren't going to be adding extra Steris machines anytime soon. The last place I worked, we had one for the whole OR!!

[brewerpaul]

I should have been a bit more specific-- the processed instruments that we've left covered ARE in closed cases, and only for cysto cases as noted by another contributor. Things for all "real" sterile cases are used immediately.

[Rose_Queen, BSN, MSN, RN]

Ours are also left in covered cases. We only steris for cystos and our ENT scope, which is only for decontamination purposes.

[mcmike55]

Steris' s logo, or saying is JIT. Just in Time. JIT for the procedure that is.

In our hosptial, we look towards about 60 minutes, preferrably less, from the time the cycle is done, and it's delivered to the field.

Typically, we take the scope, often a ureterscope to the room, case and all, and remove it there.

We don't use our flash steamer or the steris as much as we used to.

Management, in an effort to decrease their usage, invested in a Sterad and additional instruments, to decrease their usage.

Sterad, takes about 60 minutes, Steris about 30.

Mike

[IPrepU]

Hmmm, brings up a story. I was working in an outpatient surgery center. The city notified us that there had been an issue with one of the water lines to the facility. As you know, the last cycle of Steris is rinsing. Steris was contacted and could not guarantee that the filter in place would be adequate. The facility decided not to take a chance and closed for the day. I guess my point is, if the final stage is rinsing with city/town/etc. water, then exactly "how sterile" is the equipment in the Steris?