December 2018 The self-study lesson on this central service topic was developed by 3M Health Care. The lessons are administered by Endeavor Healthcare Media

Earn CEUs After careful study of the lesson, complete the examination at the end of this section. Mail the completed test and scoring fee to Healthcare Purchasing News for grading. We will notify you if you have a passing score of 70 percent or higher, and you will receive a certifi cate of completion within 30 days. Previous lessons are available at

Certifi cation The CBSPD (Certification Board for Sterile Processing and Distribution) has pre-approved this in-service for one (1) contact hour for a period of fi ve (5) years from the date of original publica- tion. Successful completion of the lesson and post test must be

documented by facility management and those records maintained by the individual until re- certifi cation is required. DO NOT SEND LESSON OR TEST TO CBSPD. For additional information regarding certifi cation contact CBSPD - 148 Main Street, Suite C-1, Lebanon, NJ 08833 • www.

IAHCSMM (International Association of Health-

care Central Service Materiel Management) has pre-approved this in-service for 1.0 Continu-

ing Education Credits for a period of three years, until November 6, 2021. The approval number for this lesson is 3M-HPN 180611. For more information, direct any questions to

Healthcare Purchasing News (941) 927-9345, ext. 202.


OBJECTIVES 1. Recognize the change in culture regarding the use of vaporized hydrogen peroxide sterilization in healthcare facilities.

2. Identify clinical practices that can adversely affect the outcome of vaporized hydrogen peroxide sterilization in healthcare facilities.

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regarded as nature’s own disinfec- tant and preservative. It is naturally present in milk, and in honey which helps to prevent spoilage, and it is an ordinary resident of human tissues as a result of normal cell function. Furthermore, hydro- gen peroxide protects us from infection by invading pathogenic microorganisms as a part of phagocytosis. In the mouth, where it is present in the mucous membranes, it acts as a powerful oxidant. Hydrogen peroxide is produced by both animal and plant cells.1 The Bombardier Beetle uses a combination of hydrogen peroxide and other biochemicals as an explosive defense mechanism.2 From beetles to bees, to our saliva and our immune system, from water disinfection to the sterilization of reusable medical devices in healthcare facilities, hydrogen peroxide is used widely in nature and industry. 3M Technical Services and 3M Clinical Spe- cialists have worked closely with hundreds of healthcare facilities regarding the suc- cessful use of vaporized hydrogen peroxide (VH2O2) sterilization. Based upon a mass of observational data, we have noticed a change in culture since the inaugural use of this ster- ilization modality in the 1990s in healthcare facilities. We discovered noteworthy best practices and found some common themes amongst VH2O2 users.

H ydrogen peroxide (H2 O2

VH2O2 sterilization is technique sensitive

We have quickly come to realize that VH2O2 sterilization is technique sensitive. Technique sensitive is a term we have coined to describe that the variability introduced by the end- user or VH2O2 sterilizer operator can have a signifi cant impact on the outcome of the VH2O2 sterilization process as compared to

) may be

Collaborating a culture change

Relearning vaporized hydrogen peroxide sterilization by Larry Talapa

other sterilization processes. There are several reasons why. To expand further let us com- pare VH2O2 sterilization to steam steriliza- tion. One of the most signifi cant differences is that VH2O2 sterilization processes provide a set fi xed amount of sterilant for each cycle type for every load placed in the chamber. In contrast, steam sterilization continuously provides the sterilant (steam) during the ster- ilant exposure phase to maintain the defi ned sterilization parameters. This difference is signifi cant because if an operator places a small load in the VH2O2 sterilizer chamber or the complete opposite, a large load over the weight limit or a load with non-compatible materials, the VH2O2 sterilizer will still only provide the same fi xed amount of sterilant. In contrast, a steam sterilization cycle may compensate with steam make-ups and use more sterilant (steam) for a heavier denser load. Each VH2O2 cycle could be compared to an oven that only has one temperature setting for every recipe.

VH2O2 is technique sensitive as well be-

cause the fi xed amount of VH2O2 injected, by its nature, is relatively unstable and readily depletes during the exposure phase via sev- eral different chemical mechanisms.1,3,4


1 illustrates the relative differences in sterilant levels maintained in steam sterilization vs the natural depletion that occurs during after the fi xed injection amounts during VH2O2 sterilization.

To complicate the situation ever so slightly,

the VH2O2 cycles available in the U.S. market are different in several design features: Dif- ferent indications for use, different loading weight limits, different VH2O2 concentra- tions (mg /L), different sterilant exposure times and different cycle report acceptance criteria. The user must be knowledgeable about a lot of detail to assure their practices

Figure 1. Relative sterilant levels in steam and VH2O2 sterilization


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