Introduction to Sterilization and Disinfection

1. MA responsible for helping to reduce and eliminate MOs a. Accomplished by practicing good techniques of
medical and surgical asepsis
2. Physical and chemical agents are used to destroy MOs a. Agent depends on intended use of article (e.g., surgical
instruments must be sterilized)
3. Sanitization, disinfection, and sterilization involve hazardous chemicals a. MA must be knowledgeable of
precautions required
True or False
1. Sanitization, disinfection, and sterilization involve hazardous chemicals.
2. Sanitization is done to remove all microorganisms and their spores.
3. According to OSHA the medical assistant does not need to wear gloves during the sanitization process.
4. Glutaraldehyde (Cidex) is a high-level disinfectant.
5. Sterilization is the process of destroying all forms of microbial life including bacterial spores.
6. Chemical indicators contain a thermolabile dye that changes colors when exposed to the sterilization process.
7. Autoclave tape changes color to let you know the article inside the package is sterile.
8. The purpose of wrapping articles is to protect them from recontamination during handling and storage.
9. To allow for proper steam penetration, packs should be arranged as loosely as possible inside the autoclave.
10. Lubricating hinged instruments should be done after the sterilization process.
Material Safety Data Sheet (MSDS)? Name all sections.
Sanitization?
Sanitizing Instruments
1. Steps include:
2. Manual method
3. Ultrasound method
Guidelines for Sanitizing Instruments; ALL 7 SECTIONS
Disinfection
Levels of Disinfection: ALL THREE
Types of Disinfectants?
Autoclave
1. Most common method used in medical office to sterilize articles
2. Used to sterilize items not harmed by moisture or high temperature
3. Consists of outer jacket surrounding inner sterilizing chamber
4. Distilled water is converted to steam under pressure (fills inner chamber) a. The pressure does not kill MOs; it
functions to attain higher temp
5. Cooler air forced out of chamber through the exhaust valve a. Air reduces the temp that is adequate for sterilization b.
Exhaust valve seals off the inner chamber when all air is removed c. Temperature begins to rise
6. Steam penetrates the materials a. Materials are cooler: causes steam to condense and release heat b. Heat kills all
MOs and spores
7. Autoclave usually operated at 15 pounds of pressure per square inch (psi) at a temp of 250° F
8. Most MOs killed in a few minutes (130° F to 150° F)
9. Spores can withstand a temp of 240° F for more than 3 hours
10. No living organism can survive exposure at 250° F for 15 min or longer
11. Sterilization process consists of the following: a. Monitoring program b. Sanitizing articles c. Wrapping articles d.
Operating the autoclave (autoclave cycle) e. Handling and storing packs f. Maintaining the autoclave
Sterilization Indicators:
Chemical indicators:
Biologic indicators:
Operating the Autoclave
1. Operated according to operating manual
2. Autoclave cycle: Steps involved in achieving sterilization
3. Can be operated manually or automatically
4. Location of the autoclave a. Place on level surface • Ensures chamber will fill correctly
5. Filling the water reservoir a. Use distilled water • Tap water: contains minerals that produce corrosive effects b. Fill to
proper level
6. Loading the autoclave a. Position packs to allow free circulation and penetration of steam • Small packs are best-
steam penetrates them easier • Pack loosely inside autoclave ▪ 1 to 3 inches apart for small packs ▪ 2 to 4 inches apart
for large packs ▪ Packs should not touch walls See Figure 3-14 • Place jars and glassware on sides with lids removed ▪ If
placed upright, air may be trapped See Figure 3-15 • Place pouches on their sides ▪ Maximizes steam circulation ▪
Facilitates drying
7. Timing the load a. Operated at: • 15 pounds of pressure • Temp of 250° F b. Length of time varies depending on item
• Hard, nonporous items need less time (instruments): steam can reach surface easily • Large MOS pack requires more
time for steam to penetrate to center of pack See Table 3-2 c. Do not start time until temp has been reached •
Automatic method: begins timing automatically when temp has been reached • Manual method: must set timer by hand
8. Drying the load a. Articles are moist: • Must be dried before removal from autoclave • MOs can move through
moisture on a wet wrap and contaminate sterile article inside b. Steam must be vented from chamber (most vent
automatically) • Makes it safe open the door c. Open door ½ inch • More than 1 inch causes condensation of water on
packs d. Cracking door allows moisture to change from liquid to vapor e. Dry load for 15 to 60 min depending on the
load • Large packs require a longer drying time
Other Sterilization Methods
1. Dry heat oven a. Used to sterilize articles that: • Cannot be penetrated by steam • Are damaged by steam b. Dry heat
less corrosive than moist heat • Does not dull instruments with sharp cutting edge c. Longer exposure time required •
MOs and spores more resistant to dry heat • Dry heat penetrates more slowly and unevenly d. Temp and time: 320° F
for 1 to 2 hours e. Wrapping material: aluminum foil • Good conductor of heat • Protects during handling and storage f.
Dry heat indicators available
2. Ethylene oxide gas sterilization a. Colorless gas that is toxic and flammable b. Used to sterilize heat-sensitive items c.
Expensive d. Used in manufacturing industry for disposable sterile items (e.g., syringes, sutures, catheters, surgical
packs)

3. Cold sterilization a. Use of a chemical agent for an extended length of time b. Must be designated as sterilant by EPA
c. Completely submerge item for 6 to 24 hours d. Prolonged immersion can be damaging to instruments (follow
manufacturer’s instructions) e. Clock must be restarted each time new instrument added 4. Radiation a. Uses high-
energy ionizing radiation b. Used by medical manufacturers to sterilize prepackaged surgical equipment and instruments
that cannot be sterilized by heat or chemicals