Date of Graduation


Document Type



Immediate use steam sterilization, terminal sterilization, steam sterilization, surgical site infection

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level



Callie Bradley

Committee Member

Allison Scott


In 2015, healthcare-associated infection (HAI) prevalence survey found that there were an estimated 110,800 surgical site infections (SSIs) associated with inpatient surgeries in 2015. Consequently, instruments and implants sterilized by immediate use steam sterilization (IUSS) have been found to increase the patient’s risk for an SSIs. Due to these risks, the Joint Commission (TJC) determined that organizations should implement evidenced-based protocols to reduce IUSS use. A needs assessment revealed a gap in care in that the increasing SSI rates appeared to be correlated with the misuse of IUSS at the physician owned surgical hospital in Tulsa, Oklahoma. This Doctor of Nurse practice (DNP) project was designed to close that gap in care by creating an IUSS reduction process protocol. A review of literature analyzed IUSS use and its correlation with increased SSI rates. Lewin’s Change Theory provided the underlying theoretical framework for this quality improvement (QI) project development and implementation. Pre-implementation and post-implementation SSI and IUSS rates were compared and determined that decreasing IUSS rates reduces SSI rates. Pre-educational seminar surveys and post-education seminar surveys were compared, and it was determined that the surgical staff’s knowledge of IUSS and its correlation with SSIs increased after the seminar.

Available for download on Thursday, April 27, 2023