Sterilization and disinfection: Difference between revisions
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== Disinfection & Sterilization == |
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* Equipment must be ''cleaned'' first, before attempting to disinfect or sterilize it |
* Equipment must be ''cleaned'' first, before attempting to disinfect or sterilize it |
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== Spaulding Classification of Medical Equipment == |
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=== Rutala modification === |
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* Endoscopes, which secondarily enter steril tissues, should be considered critical |
* Endoscopes, which secondarily enter steril tissues, should be considered critical |
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== Medical Device Reprocessing Department (MDRD) == |
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* Needs separate areas for receiving soiled instruments, decontaminating, cleaning, sterilizing, and storing |
* Needs separate areas for receiving soiled instruments, decontaminating, cleaning, sterilizing, and storing |
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* Negative pressure in decontamination areas and positive pressure in clean areas |
* Negative pressure in decontamination areas and positive pressure in clean areas |
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=== Pre-cleaning === |
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* Dismantle and sort devices, then soak them |
* Dismantle and sort devices, then soak them |
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=== Cleaning === |
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* Remove all visible soil from every accessible surface |
* Remove all visible soil from every accessible surface |
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* Rinse to remove detergents, then dry |
* Rinse to remove detergents, then dry |
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=== Sterilization === |
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* High temperature sterilization whenever possible |
* High temperature sterilization whenever possible |
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** Hydrogen peroxide most common liquid |
** Hydrogen peroxide most common liquid |
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==== Monitoring ==== |
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* Spore tests: compare a strip that went through the autoclav to a control that was held outside |
* Spore tests: compare a strip that went through the autoclav to a control that was held outside |
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* ATP system test strips |
* ATP system test strips |
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=== Storage === |
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* Equipment must be stored until results are available from the spore test for that batch |
* Equipment must be stored until results are available from the spore test for that batch |
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* Controlled temperature and humidity |
* Controlled temperature and humidity |
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== Further Reading == |
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* [https://apic.org/ APIC] |
* [https://apic.org/ APIC] |
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Revision as of 00:45, 5 October 2019
- Equipment must be cleaned first, before attempting to disinfect or sterilize it
Spaulding Classification of Medical Equipment
| Classification | Contact with | Processing | Examples |
|---|---|---|---|
| Critical | Sterile tissue or vascular system | Cleaning followed by sterilization | Surgical instruments, biopsy instruments, and foot care equipment |
| Semi-critical | Non-intact skin or mucous memranes, but not penetrating the skin | Cleaning followed by a minimum high level disinfection | Respiratory equipment, flexible endoscopes |
| Non-critical | Intact skin | Cleaning followed by low level disinfection | Trourniquets, BP cuffs, linen, and furtniture |
Rutala modification
- Endoscopes, which secondarily enter steril tissues, should be considered critical
Medical Device Reprocessing Department (MDRD)
- Needs separate areas for receiving soiled instruments, decontaminating, cleaning, sterilizing, and storing
- Treated essentially like an OR, with controlled temperature and humidity, with dedicated ventilation system
- Negative pressure in decontamination areas and positive pressure in clean areas
Pre-cleaning
- Dismantle and sort devices, then soak them
Cleaning
- Remove all visible soil from every accessible surface
- Can use ultrasonic machines and washing machines
- Rinse to remove detergents, then dry
Sterilization
- High temperature sterilization whenever possible
- Low-temperature sterilization can be done for heat sensitive critical and semi-critical items
- Uses gas, including hydrogen peroxide gas plasma or vapour, or ozone (but that needs 4 hours)
- Needed for things with plastic, for example
- Liquid emersion can be done for heat sensitive crticical and semi-critical items
- Hydrogen peroxide most common liquid
Monitoring
- Spore tests: compare a strip that went through the autoclav to a control that was held outside
- ATP system test strips
Storage
- Equipment must be stored until results are available from the spore test for that batch
- Controlled temperature and humidity
