Joint Commission clarifies its position on sterilization practices

The American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgery (ASCRS), and the Outpatient Ophthalmic Surgical Society have discussed with the Joint Commission the concerns and confusion of ophthalmic surgery centers about the interpretation of standards and survey process regarding sterilization in ophthalmic facilities. A new position statement has been released by the Joint Commission to clarify the interpretation of standards regarding steam sterilization.

The Joint Commission announced that it will refocus its survey efforts on all of the critical processes involved in sterilization, not just the sterilization cycle or method, according to a press release from ASCRS. If the process is considered complete and performed well, then the Joint Commission will consider it effective. Thus, the use of a shorter steam sterilization process for unwrapped instruments will no longer be considered “ineffective.” without considering all aspects of the sterilization process.

Joint Commission surveyors will observe processes of cleaning, sterilization, and transportation of instruments and will ask for manufacturers’ instructions.

Ophthalmic surgery centers under the purview of the Joint Commission should be familiar with the position statement on steam sterilization as well as the Centers for Disease Control/Hospital Infection Control Practices Advisory Committee Guideline for Disinfection and Sterilization in Healthcare Facilities.

Additional recommendations include:

Avoid using the antiquated term "flash sterilization.”

Clean and rinse all surgical instruments appropriately after each case as per the manufacturer’s instructions.

Follow manufacturers’ instructions for instrument sterilization, both the sterilizer and the instrument manufacturer.

Protect instruments from recontamination during the transport to the sterile field.

Have a written policy in place for protocols for what happens (cleaning, handling, sterilization procedure) to the instruments prior to each surgical case and after each case in accordance to manufacturers’ instructions.