1. Matthews, Theresa RN, CNOR, CSPDM

Article Content

Flash sterilization is an aspect of perioperative nursing that's been under the scrutiny of many regulatory agencies governing our practices. Among these are standards and practices from the Association for the Advancement of Medical Instrumentation (AAMI ST79) and the Association of PeriOperative Registered Nurses (AORN, "Recommended Practices for Sterilization in the PeriOperative Practice Setting" and "Recommended Practices for Cleaning and Caring for Surgical Instruments and Powered Equipment"). These documents have strict guidelines for using flash sterilization. The various regulatory agencies will review your practices to ensure that you're following the standards for optimum patient safety.


When should flash sterilization occur?

According to AAMI ST79:2006, flash sterilization of instrumentation should only be considered if all of the following conditions are met;1


* Instruments must be decontaminated and cleaned properly according to facility policy in compliance with AAMI ST79:2006 and AORN Recommended Practices.


* Inspection of all items is conducted per facility standard processes.


* Sterilized items are directly delivered to point of use.


* The facility has procedures that are followed and audited to show compliance.


* The item must be used immediately.



The documentation of flash sterilization must include the following information:


* sterilizer identification and cycle number


* item sterilized


* time and temperature of the cycle


* identification of the staff member autoclaving the items


* date and time of the cycle


* results of the chemical integrator


* medical record number or patient's name for traceability.



Other considerations

For performance improvement, include the reason why you've flashed the items. This will assist you in validating the need for additional instrument purchases.


Flash sterilization of implantable items is not recommended. If it's unavoidable, you must have a biological indicator (BI) and a class V integrator in the load. A class V integrator is an indicator that reacts to all the critical parameters of the sterilization cycle. In the event that an implant is released onto the field before the completion of the BI's incubation period, an exception form for the premature release of the implant must be documented. The following information must be included on this form:


* patient name or medical record number


* surgeon name


* time of procedure


* reason for premature release


* perioperative staff completing this report


* the results of the BI when the incubation period is complete.



Flash sterilization needs to be limited to urgent and emergent situations. All of the processes and practices must be followed whether using standard cycles or flash.




1. Association for the Advancement of Medical Instrumentation. Comprehensive guide to steam sterilization and sterility assurance in healthcare facilities ANSI/AAMI ST79; 2006. [Context Link]


2. Association of periOperative Registered Nurses. Standards, recommended practices, and guidelines; 2006.