Understanding current steam sterilization recommendations and guidelines.

Processing surgical instruments in preparation for surgery is a complex multistep practice. It is impractical to culture each and every item to determine sterility; therefore, the best assurance of a sterile product is careful execution of every step in the process coupled with an ongoing quality control program. Perioperative staff nurses and managers responsible for instrument processing, whether for a single instrument or multiple sets, must be knowledgeable with regard to cleaning; packaging; cycle selection; and the use of physical, chemical, and biological monitors. Nurses also should be able to resolve issues related to loaner sets, flash sterilization, and extended cycles.

Rigid endoscopes--ensuring quality before use and after repair.

Rigid endoscopes are complex, expensive, and fragile devices that routinely are subjected to harsh conditions. An endoscope used during only one procedure typically will be handled by a minimum of six people. Understanding what can go wrong with endoscopes and how to test them can help staff members detect problems before rather than during surgery. This article reviews some simple tests that can be used to ensure endoscope quality and provides information about how to demand excellence in endoscope repair.