A Brief Overview of Medical Equipment Sterilization in Healthcare Settings
Patient health and safety are healthcare providers’ number one priority. Because bacteria and disease can easily spread from patient to patient in unsterile healthcare environments, it is critical that healthcare workers do everything they can to minimize the risk. The key to ensuring that infectious pathogens are not transferred between patients is to maintain strict medical equipment sterilization standards. Health care policies for each instrument and piece of equipment should be established to determine if cleaning, disinfection, and/or sterilization are required. When instruments are not properly cleaned between patients, there is a risk of introducing pathogens that can lead to infection.
Disinfection is the process in which pathogenic microorganisms, except bacterial spores on inanimate objects, are eliminated. Sterilization is the process that destroys or eliminates all forms of microbial life. This process is completed in healthcare facilities via physical and/or chemical methods. Finally, there is the cleaning method, which removes all visible soil from objects and surfaces. This process is accomplished using water with either detergents or enzymatic products. Cleaning is essential prior to high-level disinfection or sterilization, as any inorganic or organic material left on the surface of instruments interferes with the effectiveness of these other cleaning processes. Decontamination is another vital aspect of cleaning and sterilizing medical instruments, as it removes pathogenic microorganisms from objects, making them safe to handle, use, or discard.
There were guidelines established more than thirty years ago that outline the different processes used in hospital settings today. These guidelines are pertinent for disinfection and sterilization of patient-care items and equipment. Here is a brief overview of the types of recommended guidelines.
When completed effectively, surface disinfection is part of a multibarrier strategy intended to prevent infection from spreading in health care facilities. Surfaces are defined as being noncritical because they only come in contact with intact skin. It is recommended that germicidal chemicals are used on a regular basis to disinfect floors and other noncritical surfaces.
Many hospitals utilize disinfectant sprays and fogs to control antimicrobials found in the air. This process has replaced the older method of formaldehyde fumigation. While this method can kill antimicrobials found in the air, it is not recommended for general infection control in areas that are frequented by patients—wards, critical care areas, etc. When fogging is not available, other methods, such as filtration, ultraviolet germicidal irradiation, chlorine dioxide, can be used to reduce the amount of contamination in the air.
Cleaning of Instruments
Thorough cleaning of instruments is vital for a couple of reasons. One of the most important reasons is that when foreign contaminates remain on instruments, disinfection and sterilization aren’t as effective. Another reason why it is important to use water and detergents to thoroughly clean instruments after use is that when foreign contaminants remain on instruments and dry or bake on, the removal process becomes increasingly more difficult. Following a surgical procedure, surgical instruments should be presoaked or rinsed to prevent foreign contaminants from drying onto the surface of the instrument. Cleaning is a manual cleaning method, meaning it is performed without mechanical units (i.e., ultrasonic cleaners or washer-disinfectors).
Some disinfectants can be used as stand-alone products, while others are used in combination with other products. Common products used to disinfect instruments and surfaces include hydrogen peroxide and peracetic acid. The commercial formulation of these products are considered to be unique, therefore, they must be approved and cleared by the FDA prior to use.
Glutaraldehyde is a saturated dialdehyde that has gained popularity as a high-level disinfectant and chemical sterilant. Most often, glutaraldehyde is used as a high-level disinfectant for medical equipment such as endoscopes, spirometry tubing, dialyzers, transducers, anesthesia, and respiratory therapy equipment.
Any medical device that comes into contact with body tissues or fluids is considered a critical item. Critical items must be completely sterile to be used on different patients. It is recommended that in order to achieve this level of sterilization, facilities use steam sterilization (autoclave), ethylene oxide, hydrogen peroxide, gas plasma, peracetic acid, etc.
There’s a lot that goes into medical equipment sterilization behind the scenes to protect patients and reduce the risk of infection. If you are not sure the best method to clean and sterilize a piece of equipment, check with the equipment’s manufacturer to learn what methods they recommend.