To date, the most advanced sterilization technology is the sterilizing device which is usually only found in large hospitals. However, nowadays the demand for more sophisticated sterilization technology is increasing in various professions. By following a few simple steps, you can get instruments that are clean, sterile and can be used for any medical situation.
Step
Method 1 of 6: Preparing the Instrument for Sterilization
Step 1. Move the instrument
Instruments that have been used should be collected and removed from the area where they were used. Bring the instrument to an area that is intended to be a place for decontamination in your environment, such as the Decontamination Area at the Sterilization Center Installation. This will help reduce the possibility of contamination of personal areas or other surfaces in the workspace.
Instruments must be wrapped when transported in a cart, sealed container, or plastic bag
Step 2. Wear the right clothes
Before handling contaminated instruments, you should wear proper clothing. Workers working in decontamination areas should wear protective clothing, such as scrubs or other waterproof clothing. You should also wear a face shield, plastic or rubber gloves, and a head covering or other covering.
You may also need protective eyewear in case the material used to decontaminate the instrument splashes
Step 3. Clean yourself
Before starting the instrument cleaning process, you must be sterile so that you will not transfer any bacteria or germs to an already sterile instrument. You should also wear sterile clothing when washing instruments. Then you should also wear a sterile hair covering and cover your face with a face shield (mask). Eye protection should also be used to keep harmful liquids splashed from getting into the eyes. Finally, put on a pair of sterile gloves.
Step 4. Clean the instrument immediately after use
Instruments should be cleaned immediately after use and before being sterilized. Note that cleaning an instrument is not the same as sterilizing it. Remove inorganic and organic debris from the instrument with a soft plastic brush and a detergent intended for medical use. Scrub each instrument well to remove any adhering material (blood, pus, etc.) residue, such as blood and organic tissue. If the instrument has hinges or can be opened, make sure you clean both the inside and the outside. Make sure that there are no material residues stuck in between. After scrubbing, you should spray the instrument with high pressure water to ensure all residue is removed. This step also helps clean areas that the brush can't reach.
- If the instrument is not washed first, the sterilization process may not be able to sterilize the residue left behind and fail all your efforts.
- You can immerse the instrument in a liquid that can be easily purchased. Look for a liquid detergent with a neutral pH. The addition of enzymes will also make it easier for you to clean the surface of the instrument.
- Instruments that are not cleaned properly can affect the patient's health.
- You can use an automatic washing machine at this stage, but its use will depend on the facility and location of the cleaning process.
Step 5. Rinse and dry the instrument
After cleaning the instrument, rinse for 30 seconds. Then place the instrument on a clean towel and allow it to dry completely. Instruments must be dry and free of mineral deposits as such substances can cause damage to the instrument or sterilizer.
- Again, cleaning an instrument is not the same as sterilizing it. Washing only prepares the instrument for the sterilization process. Sterilization destroys all microorganisms on the surface of the instrument thereby preventing infection.
- Be careful when cleaning sharp objects such as scissors, knives, and other sharp instruments.
- If the instrument is designed for single use, to prevent contamination you should generally dispose of it properly and should not attempt to wash and reuse it.
Method 2 of 6: Preparing the Instrument for Autoclaving
Step 1. Sort the instruments
Check each instrument being sorted to make sure it is clean. Arrange the instruments according to their use and placement. Ensuring the instruments are well organized is very important because each tool has its own function. Make sure you know what the instrument will be used for next before starting to sort it out.
Arrange and pack instruments for distribution prior to autoclaving. If you wait after the process is done and open it, the instrument will not be sterile
Step 2. Put the instrument in the pouch
After sorting, you should place the instruments in a sterile bag that can be used in the autoclave. You should use a special autoclave bag designed to withstand the high temperatures in the autoclave. This bag has a piece of test tape that will change color if the autoclave is effective. Take the stack of each sorted instrument and put it in the bag as many times as needed.
- Do not put too many instruments in one bag as this can hinder the sterilization process. Make sure that opening instruments, such as scissors, are left open when they are put in the pouch. The inside of the instrument must be sterilized as well.
- The autoclaving process using a bag will make it easier for you because the instruments in the bag can be seen after the process is complete.
Step 3. Label the pouch
After placing the instrument in the pouch, you must label it so that you or someone else will know what the instrument is needed for. Write your instrument name, date and initials on the pouch. Close each bag well. If the pouch doesn't have a test tape, stick one. The ribbon will indicate whether the sterilization process was successful. Now you can place the bag in the autoclave.
Method 3 of 6: Sterilizing Instruments in an Autoclave
Step 1. Choose a cycle on the autoclave
Autoclaves use high temperature steam emitted at high pressure over a period of time to sterilize medical instruments. Autoclaves work by killing microorganisms through time, heat, steam, and pressure. Autoclave machines have various settings that work for different objects. Since you will be sterilizing the instrument in a bag, choose a quick discharge and dry cycle. This suit is best suited for wrapped items such as instruments. A quick discharge autoclave can also be used to sterilize glass items.
Step 2. Stack the trays
The instrument bag must be placed on top of the tray to be loaded into the autoclave. You have to stack them in a row. Do not stack bags on top of the tray. The steam must reach every instrument in every bag. You must ensure that all instruments are placed separately from each other during the sterilization cycle. Leave space between each instrument to allow steam to circulate.
Step 3. Load the autoclave
Place the trays about 2.5 cm apart in the machine to allow steam to circulate. Do not load too many instruments on the sterilization tray. Overloading will cause the sterilization and drying process to be incomplete. You should also ensure that the instrument does not slide and stack when placing it in the machine. Place the empty container upside down to prevent water from accumulating.
Step 4. Run the autoclave
The autoclave must run for a certain period of time at a certain temperature and pressure. Instruments in the bag must be autoclaved at 250 degrees for 30 minutes at 15 PSI or 273 degrees for 15 minutes at 30 PSI. After the engine is finished, you should open the door slightly to let the steam out. Then, run a drying cycle in the autoclave until all instruments are dry.
Drying takes an additional 30 minutes
Step 5. Check the indicator tape
After the drying process is complete, remove the tray containing the instrument bag from the autoclave with sterile tongs. Now you have to check the indicator tape on the pouch. If the tape changes color according to the manufacturer's instructions, the bag has been exposed to heat to 250 degrees or more and the decontamination process is considered successful. If the tape does not change color or you see wet spots in the bag, the sterilization process must be repeated.
If the bag is fine, place it somewhere to cool. Once the bags have come to room temperature, store them in a warm, cool, covered cupboard until needed. Instruments will remain sterile as long as the bag is dry and closed
Step 6. Make a log
Record data in a log sheet, using information such as operator initials, instrument sterilization date, cycle length, autoclave max temperature, and results. For example, note if the indicator band changes color or if you perform biological controls. Make sure you follow company protocol and retain data for as long as needed.
Step 7. Perform a quarterly biological control test
Biological control tests are important to ensure that the sterilization process is adequate. Place a test vial containing the bacterium Bacillus stearothermophilus in the center of the bag or on a tray in the autoclave. Then, run the autoclave as usual. This will test whether the machine can kill Bacillus stearothermophilus in the autoclave.
Step 8. Check the control test results
Leave the bottle at 130-140 degrees for 24-48 hours, depending on the manufacturer's protocol. Compare this bottle with a control bottle that is stored at room temperature and not processed in an autoclave. Bottled products that have not been autoclaved should turn yellow to indicate bacterial growth. If not, there may be a problem with the sample bottle. If this is the case, repeat the test, maybe the bottle is a defective product and you need a new set.
- If there is no bacterial growth in the bottles that have been processed by autoclaving after 72 hours, it means that the sterilization process is complete. If the test vial turns yellow, the sterilization process failed. Contact the manufacturer if a failure occurs and use of the autoclave should not be continued.
- This test should be done every time you have used the machine for 40 hours or once a month, whichever condition is reached first.
- The spore test should be carried out in the most inaccessible area for steam. Please note that testing standards may vary.
Method 4 of 6: Sterilizing Equipment with Ethylene Oxide
Step 1. Understand the method used
Ethylene Oxide (EtO) is used for equipment that is sensitive to moisture and heat, such as instruments with plastic or electrical components that cannot withstand high temperatures. EtO helps sterilize instruments from microbes to prevent disease from occurring. Studies prove that EtO is an important sterilization technology for medical and health care purposes. The EtO sterilization method is unique and irreplaceable. The use of EtO includes the sterilization of certain instruments that are sensitive to heat and irradiation, as well as some instruments and equipment located on hospital premises. EtO is a chemical liquid that can kill all microorganisms, and ultimately sterilize equipment.
Step 2. Begin the sterilization process
If you use ethylene oxide as a sterilization method, the process includes three stages, namely the conditioning stage, the sterilization stage, and the degasser stage (removing gases from the solution). In the conditioning stage, the technician must make the organism grow on the equipment so that it can be killed and the instrument can be sterilized. This process is done by bringing the medical equipment to an environment where the temperature and humidity can be controlled.
Step 3. Perform the sterilization step
After the conditioning stage, the long and complicated sterilization process begins. The whole process will take about 60 hours. The most important thing here is temperature control. If the temperature drops below the sterilization level, the process must be repeated from the beginning. Engine vacuum and pressure are also important. The machine will not be able to operate without perfect conditions.
- Towards the end of this stage, a number of reports will be generated. Reports will provide information if there are problems during the process.
- If the engine is set to auto mode, the engine will proceed to the degasser stage if the report shows no error.
- If an error occurs, the machine will automatically stop the process and give the operator the opportunity to correct it before further sterilization can be carried out.
Step 4. Perform the degasser stage
The degasser stage is the final stage. During this stage, any remaining EtO particles will be removed from the apparatus. This process is important because EtO gas is highly flammable and hazardous to humans. You must ensure that this process is complete so that you and other lab personnel are not injured. This process is also completed under controlled temperature.
- Please be aware that this substance is very dangerous. Operators, staff and patients who may come into contact with the gas should receive training on the hazards.
- This method takes longer than the use of an autoclave.
Method 5 of 6: Sterilization with Dry Heat
Step 1. Learn the process
Dry heat is a process that is applied to oils, petroleum, and powders. In addition, all moisture sensitive equipment is dry heat sterilized. Dry heat is used to slowly burn microorganisms and is usually done in an oven. There are two types of dry heat methods; static air type and compressed air type.
- The sterilization process with static air is slower. It will take longer to raise the temperature of the air in the oven to the sterilization level because the coils must be preheated.
- The sterilization process with compressed air uses a motor that circulates air in the oven. The heat used ranges from 150 degrees Celsius for 150 minutes or more to 170 degrees Celsius for an hour.
Step 2. Begin the sterilization process
Just like the autoclave sterilization process, you start the dry heat method by washing your hands and wearing non-sterile gloves. Next, wash the instrument to remove any dirt or debris that may have been left behind. This step ensures that all instruments placed in the oven are as clean as possible and that no non-sterile material remains on the surface.
Step 3. Put the instrument in the pouch
Just like the autoclave process, medical equipment is also inserted into the bag during this sterilization process. Put the cleaned instrument into the sterilization bag. Seal the bag until it is airtight. This step is important because wet or damaged bags will not be sterilized during the process. You should make sure the bag has a temperature sensitive tape or indicator tape. If it's not there, you'll need to install it.
The indicator tape helps ensure the bag has been sterilized by reaching the temperature required for sterilization
Step 4. Run the instrument sterilization process
Once all the instruments are in the pouch, you should place the pouch in an oven that gives off dry heat. Do not put in too many pockets as the instrument will not be sterilized properly. Once the bags are inserted, start the sterilization cycle. The sterilization process will not start until the space in the oven reaches the correct temperature.
- Follow the manufacturer's instructions for the recommended oven capacity.
- After the sterilization cycle is complete, remove the instrument pouch. Check the indicator tape to make sure all instruments are properly sterilized. Take the bag and store it in a safe, clean and dry place to protect it from dust and dirt.
Method 6 of 6: Using Alternative Methods
Step 1. Use the microwave
Microwave can also be an alternative to sterilization. Non-ionizing radiation kills microorganisms on the surface of medical instruments. Microwaves emit a stream of heat that acts over the surface of the instrument and this heat is used to kill organisms. The microwave can be used quickly and reliably.
You can also apply this method at home, for example to sterilize baby bottles
Step 2. Try hydrogen peroxide
Hydrogen peroxide in the form of plasma or steam can be used for sterilization. Plasma is converted into a hydrogen peroxide cloud with the help of an electric field or a magnetic field. The sterilization method with hydrogen peroxide consists of two phases; diffusion phase and plasma phase.
- In the diffusion phase you put a non-sterile instrument into a vacuum and then 6 mg/L hydrogen peroxide is injected which is then evaporated. Diffusion of hydrogen peroxide in a vacuum will last for 50 minutes.
- In the plasma phase, 400 watts of radiofrequency is applied into the vacuum chamber, turning hydrogen peroxide into a plasma consisting of hydroperoxyl and hydroxyl radicals. The plasma formed helps to sterilize the instrument. The whole process takes about an hour.
Step 3. Sterilize with ozone gas
Ozone gas is a gas produced from oxygen and is used to sterilize medical equipment. The ozone sterilization method is a newer method and uses lower temperatures. With the help of a converter, oxygen from a hospital source is converted into ozone. The sterilization process is carried out using ozone gas with a concentration of 6-12% which is pumped continuously into a chamber containing medical instruments.
The length of the sterilization cycle is about 4.5 hours with a temperature of about 29 degrees to 34 degrees Celsius
Step 4. Consider a chemical solution
Chemical solutions can be used to sterilize medical instruments by immersing them in the solution for the required period of time. The chemical agents used are peracetic acid, formaldehyde, and gluaraldehyde.
- If you choose to use chemicals, remember to sterilize in a well-ventilated area, and wear gloves, goggles, and an apron for your own protection.
- The instrument must be immersed in peracetic acid for 12 minutes at a temperature of 50 degrees to 55 degrees Celsius. The solution can only be used for one sterilization process.
- If using gluaraldehyde, you must soak for 10 hours after adding the activating chemical which is usually sold in bottles.
Step 5. Try formaldehyde gas
Formaldehyde gas is used for instruments that cannot withstand excessively high heat without warping or other damage. The sterilization process involves an initial suction process to remove air from the sterilizing chamber. Instruments are inserted and then steam is channeled into the chamber. Suction continues to expel air from the chamber while the temperature begins to rise. The formaldehyde gas is then mixed with steam and vibrated into the chamber. After that, the formaldehyde is slowly removed from the chamber and replaced with steam and water.
- This process requires ideal conditions with a humidity of 70% to 100% and a temperature ranging from 60 degrees to 80 degrees Celsius.
- Formaldehyde gas cannot be considered the most reliable, but it is recommended to use if EtO is not available. This technique is an old technique that has been used since 1820.
- The sterilization process with formaldehyde gas is often not recommended because it involves gases, odors and a complicated process when compared to other available methods.
Warning
- Check the manufacturer's instructions so that you can follow the proper procedures for sterilizing each piece of equipment. Medical instrument manufacturers usually provide specific information regarding the proper sterilization temperature and duration.
- Ensure that instruments made of dissimilar metals, such as stainless steel and carbon steel, are separated. Instruments made of carbon steel should be bagged and placed on a towel that can be used in the autoclave and not placed directly on the stainless steel tray. Mixing the two metals will result in the metal being oxidized.
