ASC Spotlight - Q2 2019 - 28

HEADER
INSTRUMENT REPROCESSING

High-Level Disinfection
and Sterilization Scoring
Re-Evaluated
by Sylvia Garcia-Houchins, RN, CIC
Director of Infection Prevention and Control
The Joint Commission

After a careful evaluation of high-level
disinfection (HLD) and sterilization process
steps, The Joint Commission has refined its
scoring as of September 1, 2018, to focus on
the process steps that pose the highest risk to
patients if they fail.

and other equipment that will protect
employees from possible exposure/injury.

Last year, 72 percent of surveyed hospitals
and critical access hospitals were found to be
noncompliant with The Joint Commission's
high-level disinfection and sterilization
standard IC.02.02.01. We are refining some of
the scoring guidelines to clarify expectations.

Surveyors may ask staff to: watch the case
being opened, describe what they check for
when opening a tray, open a tray that will not
be needed for 24 hours and explain what they
would do if they found an instrument with
bioburden when opening a sterile pack or tray.

Seven areas have scoring revisions specific
to high-level disinfection-the common
theme is establishing processes that support
manufacturers' instructions.

Maintain the Moisture of Soiled Instruments
The facility may choose the manner in which
it keeps soiled instruments moist. The Joint
Commission requires that a process is in place
to maintain moisture, as recommended by the
instrument manufacturer, the Association for
the Advancement of Medical Instrumentation
(AAMI) and the Association of perioperative
Registered Nurses (AORN). The process and
product choice are the organization's decision.

The Joint Commission will continue to score
IC.02.02.01 as noncompliant whenever
manufacturer instructions are not followed.
Over the next several months, we will closely
monitor the revisions to ensure consistent
scoring.
Instruments
Wipe & Flush at Point of Use, As Needed
There is no expectation that visible blood or
tissue be removed from instruments at the
point of use.
Clinically appropriate wiping/flushing of
soiled instruments may be observed during
a case in the operating or procedure room.
Facilities may be asked about their wiping/
flushing policy, but there's no expectation
that all instruments will be wiped or flushed.
Instrument cleaning should be performed in
the decontamination area with appropriate
personal protective equipment (PPE), facilities
28

To Order: 1.800.P.SCHEIN (1.800.772.4346) 8am-8:30pm, et

*

Organizations will also be scored if an
instrument that is ready for use on a patient is
visibly soiled.

Options include: moistened towels, containers
that maintain moisture, and products for
maintaining moisture in accordance with
manufacturer instructions.
Transporting Soiled Instruments Safely
Non-sharps must be transported in a way that
cannot lead to contamination.
Occupational Safety and Health
Administration (OSHA) states reusable sharps
must be placed in a puncture-resistant red
container or one marked "biohazardous," and
this requirement is reflected in the refined
scoring guidelines.

To Fax: 1.800.329.9109 24 Hrs

19MS4306
ASC Spotlight - Q2 2019

Table of Contents for the Digital Edition of ASC Spotlight - Q2 2019
