Sterilization and disinfection
From IDWiki
Disinfection & Sterilization
- 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
