Over the past 17 years of my career, I have never scrubbed in on a surgery case, never set up a sterile field, never prepped a surgical site and never opened a sterile package, being ever so diligent to maintain the contents’ integrity. But what I have done is provided sterile instruments and supplies for hundreds of thousands of surgical operations.
When a patient consents to undergo a surgical procedure it is imperative that they have an inherent trust that the clinicians performing the surgery possess the knowledge and skills to provide a successful outcome. They’ve met with the surgeon and discussed the procedure including any complications that might transpire. But what about the instruments? Few patients, if any, put much thought into what instruments will be required and whether or not they will be sterile. Of course they will be sterile, right?
I tend not to discuss my job with family or friends who are not involved in the field of sterile processing since, as we all know, we cannot answer the aforementioned question with a 100 percent certainty. It is not practical to prove that an item processed through a sterilizer is, in fact, sterile. But what we can do is to afford the highest assurance as possible that the conditions required for sterility to occur actually did occur. This is considered the sterility assurance level (SAL) of 10-6. This means that there is less than or equal to one chance in a million that a single viable microorganism is present on a sterilized item. It is generally accepted that this SAL is appropriate for items intended to be used for invasive or surgical procedures. To achieve this level of sterility assurance, sterile processing professionals must employ all physical, chemical and biological monitors available to reduce the chance for a healthcare-acquired infection.
The objective of this article is not to offer a review of all of the SAL monitors that are available nor is it to promote any respective brand. My intention is to discuss the benefits and provide insight into the appropriate use in regards to sterilization process monitoring of a new chemical monitoring device recently approved for use in the United States, Class 6 emulating indicators. Please note, that as is the case with any type of sterilization monitoring device, it is crucial that the manufacturer’s instructions be consulted and followed for appropriate use.
