Published on March 03-10-22

5 Keys to better infection prevention #2

Maintain Sterilization Area

 

When it comes to maintaining your practice’s sterilization area, details matter – especially for maximizing the efficiency and functionality of your sterilization area. More importantly, how well you follow National and International guidelines for setting up your sterilization area will have a major impact on patient safety.
The four review steps of the instrument reprocessing are:
1) receiving, cleaning and decontamination
2) preparation and packaging
3) sterilization
4) storage Here are some best practices for each of those steps.

Receiving, Cleaning and Decontamination

✔ Remove Soils, Residues and Heavy Decontamination: Whether your instruments are loose or in a cassette, they need to be processed immediately after being transported to the dirty side of the sterilization area. If the instruments cannot be processed immediately, they should be sprayed with an enzymatic pre-cleaner or placed in an enzymatic solution for pre-soaking to prevent any materials from drying.

✔ Resist the Urge to Hand Scrub Instruments: Hand scrubbing increases the risk of sharps injuries and exposure to aerosols and bloodborne pathogens.

✔ Follow Ultrasonic Cleaning Best Practices: Your team should always follow instructions when using an ultrasonic cleaner and pay close attention to the time of exposure, detergent concentration, and temperature based on the Instructions for Use (IFU). An alternative to the Ultrasonic Cleaning is using a Thermodisinfector: in this way, you could save even more time by cutting the rinse and drying steps.

Preparation and Packaging

✔ Conduct a Thorough Inspection of Instruments: Before packaging instruments, make sure your team inspects them for debris, contamination, rust, breaks, cracks or any type of damage.

✔ Ensure Everything is Dry: The instruments and cassettes should be fully dry before they are packaged in a pouch or wrapped.

✔  The 3 different kind of packaging used in the sterilization process must meet all conformity requirements of the EU Medical Devices Regulation such as are sterilization pouches, sterilization wraps, or sterilization containers.

✔ Follow IFU to Package Instruments: Because sterilization wrap and pouches come in a variety of sizes, your team will need to follow the IFU for packaging.

✔ Use Chemical Indicators and Labels: Place an internal chemical indicator or integrator inside every instrument package before it’s sterilized. If the internal indicator cannot be seen from the outside, you must also use an external indicator. Then label packages with the date and load. If your facility has multiple sterilizers, then the sterilizer used should also be noted. Additionally, if sterilizing an implantable device, a biological indicator must be used.

Sterilization

✔ Know Your Sterilizer: In addition to routine inspections and maintenance, make sure your team knows your sterilizers’ weight and load capacity and adhere to those maximums. (Note: Using cassettes will help you stay compliant.)

✔ Allow for Full Access: Your team should not stack pouches and wrapped cassettes on top of one another in the sterilizer.

✔ Don’t Cut Corners: Always allow the sterilizer to complete its full cycle, including drying, before removing any items.

✔ Use Internal and External Indicators: Make sure to keep both processed and unprocessed indicators at room temperature and away from sources of heat, steam and moisture. Create record-keeping protocols to demonstrate compliance and protect patients.

Storage

✔ Keep Them Dry: Store sterile packages, pouches, and wrapped cassettes where they won’t be exposed to moisture.

✔ Keep Them Clean: Make sure storage areas are clean and free of debris, dust, or contaminated substances or instruments.

✔ Keep Them Safe: If you store packs in drawers or cabinets, make sure they are not compromised or damaged when drawers or doors are opened and closed.

Setting up your sterilization area properly contributes to the efficacy of your sterilization efforts and, ultimately, the safety of your patients. That’s why the guidelines recommends focusing on receiving, cleaning and decontamination, preparation and packaging, sterilization, and storage. By following our best practices in each of these four steps, you can ensure an efficient, smooth, and successful sterilization process.

 

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