Sterilization and Autoclave Practices

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Why is it essential to load items properly inside the sterilizer chamber?

To allow for adequate penetration, removal, and contact between the sterilant and items being processed (correct)

To ensure the sterilizer chamber is fully utilized

To minimize the sterilization cycle time

To reduce the risk of contamination

What should you avoid when loading the sterilizer?

Overloading (correct)

Placing heavier items on lower shelves

Underloading

Mixing textile packs with pouches

How should you place non-perforated trays and containers in the sterilizer?

Upright, with the opening facing upwards

On their edge (correct)

Flat on the bottom of the chamber

On top of other packages

What should you verify on the sterilizer printout after the cycle is complete?

The correct sterilization parameters, cycle time, and date Signup and view all the answers

What should you inspect the load items for after unloading?

Visible signs of moisture or compromised packaging integrity Signup and view all the answers

What should you retain after the sterilization cycle?

Printed records of each cycle parameter Signup and view all the answers

What should you do before touching or moving sterile packs?

Allow the load to cool to room temperature Signup and view all the answers

Why should you not stack rigid containers unless validated by the manufacturer?

To avoid compromising the sterilization process Signup and view all the answers

What factor affects the amount of time required for cooling after sterilization?

Type of devices being sterilized Signup and view all the answers

What should be done when a wet pack is found in the operating theatre?

Reject the package and check other packs for wetness Signup and view all the answers

What is the consequence of poor steam quality on devices?

Stress corrosion, pitting, and discoloration Signup and view all the answers

Why is it important to use reverse osmosis water in sterilization?

To prolong the life of RMDs Signup and view all the answers

What should be done when multiple wet packs are found in one load?

Reprocess the entire load Signup and view all the answers

What is the purpose of investigating the incident of wet packs?

To identify the root cause and prevent future occurrences Signup and view all the answers

What is the typical cycle time for vaporized hydrogen peroxide sterilization?

28-55 minutes Signup and view all the answers

What is a limitation of vaporized hydrogen peroxide sterilization?

It may not be suitable for long, narrow lumens Signup and view all the answers

What is the primary mechanism of action for vaporized hydrogen peroxide sterilization?

Oxidization Signup and view all the answers

What is generated via radio frequency energy in a sterilization cycle?

Gas plasma Signup and view all the answers

What type of filter is used to vent filtered air into the chamber?

HEPA Signup and view all the answers

What is the primary advantage of ozon sterilization?

It requires no sterilant purchase Signup and view all the answers

What is a potential risk of inadequate sterilization due to areas where organisms can accumulate?

Increased infection transmission risk Signup and view all the answers

Which of the following is an advantage of steam sterilization?

Highly effective Signup and view all the answers

What is the primary difference between steam sterilization and dry heat sterilization?

Use of steam Signup and view all the answers

What is a consideration for low temperature sterilization methods?

All of the above Signup and view all the answers

Which of the following is a disadvantage of dry heat sterilization?

Unsuitable for heat sensitive items Signup and view all the answers

What is a common use of low temperature sterilization methods?

Sterilizing delicate heat sensitive surgical instruments Signup and view all the answers

Which of the following is a characteristic of low temperature sterilization methods?

Use of chemicals with potential toxic properties Signup and view all the answers

Which of the following is a common low temperature sterilizer used in CSSD?

All of the above Signup and view all the answers

What is the primary reason for banning Ethylene Oxide (EO) sterilizers in many hospitals?

Costly health and safety requirements Signup and view all the answers

What is a characteristic of Ethylene Oxide (EO) sterilizers that makes them suitable for heat sensitive items?

Extremely penetrative and non-damaging Signup and view all the answers

What is a common application of Ethylene Oxide (EO) sterilizers?

Sterilization of invasive flexible endoscopes Signup and view all the answers

What is a disadvantage of Gas Plasma sterilizers?

Expensive equipment Signup and view all the answers

What is the typical operating temperature range of Ethylene Oxide (EO) sterilizers?

37 ºC to 55 ºC Signup and view all the answers

What is a necessary step in the Ethylene Oxide (EO) sterilization process?

Load pre-conditioning with vacuum and humidiﬁcation Signup and view all the answers

Study Notes

Sterilization Process

In non-emergency situations, the risk/benefit ratio is higher, particularly when implantable devices are involved.

Loading Sterilizer

Load sterilizers properly to allow for adequate penetration, removal, and contact between the sterilant and items being processed.
Avoid overloading and place non-perforated trays and containers on their edge.
Keep packages away from chamber walls and place concave items, such as basins, on an angle to avoid condensate pooling.
Load textile packs perpendicular to the sterilizer cart shelf and place pouches on their edge.
Place multiple packages paper to plastic and do not stack rigid containers unless validated by the manufacturer.

Unloading Sterilizer

Unload the sterilizer in the following manner:
- Place heavier items, trays, and containers on lower shelves.
- Place lighter items, e.g., peel packs, on higher shelves.
Review the sterilizer printout for correct sterilization parameters, cycle time, and date.
Verify that the cycle number matches the lot control label for the load.
Verify and initial that the correct cycle parameters have been met.
Examine the load items for any visible signs of moisture, compromised packaging integrity, and retain printed records of each cycle parameter in accordance with local policy.

Load Cool-Down

After removing the sterilized load, visually verify the results of the external chemical indicators.
Allow the load to cool to room temperature before touching or moving sterile packs.
Ensure that cool-down occurs in a traffic-free area without strong warm or cool air currents.

Troubleshooting - Wet Pack Problems

Packages are considered wet when moisture in the form of dampness, droplets, or puddles is found on or within a package.
If moisture is noticed on or in one pack, the problem is isolated to this pack, but other packs of the same load should be opened and checked for wetness.
If there are several wet packs in one load, the entire load should be rejected and re-processed according to local policy.
The incident of wet packs must be investigated to identify the root cause and documented to prevent any future re-occurrence.

Steam Quality

Proper steam quality will prolong the life of RMDs by reducing water impurities that have adverse effects on device materials.
Lime, rust, chlorine, and salt can be left as deposits on devices if treated with reverse osmosis water.
These compounds can lead to stress corrosion, pitting, and discoloration of the devices and the sterilizer.
Pitting, corrosion, and precipitates provide areas where organisms can accumulate and be protected from the killing effects of the steam process, increasing the infection transmission risk due to inadequate sterilization.

Steam Sterilization: Advantages and Disadvantages

Advantages: highly effective, inexpensive, rapid process, items may be packaged, no toxic residues, moist process.
Disadvantages: unsuitable for heat-sensitive items.

Dry Heat Sterilization

The dry heat method may be used for glassware and metal items, heat-stable powders, and non-aqueous liquids like paraDin.
A typical cycle consists of heating the chamber to the required sterilization temperature, holding the load at this temperature for a defined time period, and then cooling the load.
Advantages: suitable for non-aqueous fluids and glassware, high temperatures.
Disadvantages: unsuitable for heat-sensitive items, long sterilization and cooling times, items cannot be wrapped.

Low Temperature Sterilization Considerations

Temperature involved: is the method compatible with the devices being processed?
Cycle time: will this fit with the workload/turnaround time of the CSSD?
Will more devices be required?
Availability of equipment and validation requirements.
Compatibility with devices being processed.

Low Temperature Sterilizers

Ethylene Oxide (EO): operates at 37 ºC or 55 ºC, suitable for heat-sensitive items, uses chemicals with toxic properties, requires very long cycle durations to allow for adequate aeration.
Gas Plasma/2: operates at less than 55 ºC, suitable for heat-sensitive items, short cycle, non-cellulose wrapping materials required.
Vaporized Hydrogen Peroxide/3: utilizes hydrogen peroxide to kill a wide spectrum of microorganisms, operates at less than 50 ºC, lumened and non-lumened instruments can be sterilized.
Ozon Sterilization/4: eliminates the need for purchasing a sterilant, generates O3, operates at 30.8-36 ºC.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Learn about the essential practices for sterilization, including the risk/benefit ratio and proper loading of items inside the sterilizer chamber to ensure effective sterilization.