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Effective sterilization and high-level disinfection are critical in reducing the risk of transmission of healthcare associated infections.

The ASC Quality Collaboration has assembled a variety of resources and information that may be used to supplement your current processes to improve sterilization and high-level disinfection practices.

The Sterilization and High-Level Disinfection Toolkit contains both essential resources and a broader array of materials, including:

• Assessment Tools
• Implementation Aids
• Training Materials
• Monitoring Tools
• Workplace Reminders
• Guidelines from Leading Authorities

Assessment Tools

• Sterilization and High-Level Disinfection: What CMS Surveyors Are Looking For: Perform a self-assessment using the same tool CMS surveyors use when evaluating sterilization and high-level disinfection practices in the ASC setting.
• Immediate Use Steam Sterilization Memorandum (CMS): This memorandum from the Centers for Medicare & Medicaid Services (CMS) includes guidance from the agency to ASC surveyors on immediate use steam sterilization and how to distinguish appropriate from inappropriate use.

Implementation Aids

• Sterilization Competency (APIC): This competency checklist from the Association for Professionals in Infection Control and Epidemiology (APIC) may help facilitate teaching and ensure compliance with sterilization standards.
• ISO Training Program (CBSPD): This program description from the Certification Board for Sterile Processing and Distribution (CBSPD) provides guidance in the development of quality systems for sterile processing.
• Immediate-Use Steam Sterilization Policy and Procedure Template: This basic immediate-use steam sterilization policy and procedure is based on guidelines from the Association for the Advancement of Medical Instrumentation (AAMI) and recommended practices from the Association of PeriOperative Registered Nurses (AORN). It should be adapted as needed for use in each facility.
• High Level Disinfection Policy and Procedure Template: This basic high level disinfection policy and procedure is based on recommended practices from the Association of PeriOperative Registered Nurses (AORN). It should be adapted as needed for use in each facility.

Workplace Reminders

• Sterilization Reminders Poster – This poster reminds staff members of steps needing particular attention during the sterilization process. It may be modified to meet the sterilization performance improvement goals of the individual center.

Guidelines from Leading Authorities

• Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 (CDC) – This 2008 guideline was developed by the developed by the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC).
• Immediate-Use Steam Sterilization Position Statement (Multiple) – This position statement provides guidance on the implementation of standardized practice for immediate-use steam sterilization. It has been adopted by AAMI, Accreditation Association for Ambulatory Health Care, AORN, APIC, ASC Quality Collaboration, and IAHCSMM.
• Guidelines for the Cleaning & Sterilization of Intraocular Surgical Instruments (2018) – These guidelines provided by the American Academy of Ophthalmology (AAO) are intended to assist ASCs in their efforts to adopt appropriate practices for cleaning and sterilization of intraocular surgical instruments.

Resources Cited

The materials presented here include publicly available resources from the following organizations:

• Centers for Disease Control and Prevention (CDC)
• Centers for Medicare & Medicaid Services (CMS)
• American Society of Cataract and Refractive Surgery (ASCRS)
• American Society of Ophthalmic Registered Nurses (ASORN)
• Association for Professionals in Infection Control and Epidemiology (APIC)
• Certification Board for Sterile Processing and Distribution (CBSPD)
• SPSmedical
• Steris

Comments and other feedback may be directed to Kathy Wilson, Executive Director, ASC Quality Collaboration.