In reviewing OR policies and procedures for flash sterilization, staff members at Presbyterian Hospital of Dallas discovered that their process of biological monitoring and flash sterilization needed improvement, and they implemented changes to correct the process. These changes led to questions regarding biological indicators and the flash sterilization container systems being used. As a result, the overall time required for flash sterilization was increased to validate the sterilization process.

In today's complex environment, with an increasing number of chemicals and environmental contamination, some individuals have developed sensitivities to their surroundings. Surgical intervention for environmentally sensitive patients provides an opportunity to reach beyond the boundaries of the OR. These patients require highly individualized perioperative nursing assessments and care planning on a multidisciplinary level. Presbyterian Hospital of Dallas has developed a protocol to initiate collaborative planning for these patients and has had the opportunity to successfully care for these patients.