Sterilization
Gravity displacement sterilizer cycle
1. Condition 2. Exposure phase 3. Exhaust phase 4. Dry phase
Advantages of pre-vac steam sterilizer
1. Increases speed of operation and lowers total cycle time 2. More efficient at removing air than gravity sterilizes 3. Not as dependent on the positioning of loaded contents 4. Condensate is produced during preconditioning phase, reducing time
3 methods of monitoring sterilization process
1. Mechanical 2. Chemical 3. Biological
Basic components of autoclave
1. Pipe to bring steam in 2. Drain to let steal air, and water out 3. Pipe to deliver filtered air at end
Pre-vac steam sterilizer cycle
1. Pre-vac phase 2. Conditioning phase 3. Second pre-vac 4. Exposure phase 5. Exhaust phase 6. Drying phase
What are the 5 major causes of sterilization failures?
1. Strainer is obstructed 2. Containers are positioned incorrectly 3. Items are inadequately cleaned 4. Wrapped packs are too close together on cart 5. Instrument trays, basins are warped too tightly
Disadvantages of Steam Sterilization
1.Not all items can be steam sterilized. Heat- and moisture- sensitive items must be sterilized by other methods. 2.Human error is a factor that can contribute to sterilization failures.
Advantages of Steam Sterilization
1.Saturated steam is many times more effective in transferring thermal energy than hot air. 2.It is the most economical and inexpensive sterilizing agent. 3.It is the safest method of sterilization in comparison to other methods. 4.The method is relatively quick. 5.It is nontoxic and does not leave a toxic residue on items.
What are 2 types of Sterris?
(Chemical Sterilization) Glutaraldehyde (Cidex) and Peracetic Acid
What are 2 types of Sterrad?
(Gas Sterilization) Hydrogen Peroxide Gas Plasma and Ethylene Oxide (EtO)
EtO Biological Indicator
Contains the spore Bacillus Atropdaeus, resistant to EtO but harmless to humans. Incubated between 24-48hrs. Indicator will turn from blue to pink (Hydrogen Peroxide B.I. will turn pink also)
Steam Biological indicator
Device that contains Geobacillus stearothermophilus, a highly resistant spore to steam. Must be incubated for 24hrs at 131°-140°F to determine if contents are sterile and done at least once a week and on every implant.
Class 6 Indicator
Emulating indicators—designed to react to all sterilization parameters of a specific sterilization cycle.
Steam Sterilization Minimum Exposure Temperature and Pressures
Gravity sterilizers are 250°-275°F at 15-17 psi. Pre-vac sterilizers the temperature is 270°-275°F at 27-30 psi.
Class 2 Indicator
Indicators for use in specific tests—assessment of a specific function of the steam sterilizer (e.g., Bowie-Dick test).
Class 5 Indicator
Integrating indicators—designed to react to all sterilization parameters. Most common and accurate of the internal chemical indicators and used as pack control monitoring. They can be used to release loads that do not include implants. Will turn black if process is achieved.
What items need to be Chemically Sterilized?
Lensed instruments, Fiber-optics and cables, heat sensitive instruments
Minimum Cycle Times: Dynamic-Air-Removal Steam Sterilization Instrument set, wrapped: 270°F for 4 minutes 20-30 minutes Drying Time Instrument set, unwrapped, no lumen instruments: 3 minutes-No Dry Time Instrument set, unwrapped, some instruments with lumens: 4 minutes No Dry Tme
Minimum Cycle Times: Dynamic-Air-Removal Steam Sterilization Instrument set, wrapped: 270°F for 4 minutes 20-30 minutes Drying Time Instrument set, unwrapped, no lumen instruments: 3 minutes-No Dry Time Instrument set, unwrapped, some instruments with lumens: 4 minutes No Dry Tme
Minimum Cycle Times: Gravity-Displacement Steam Sterilization: Instrument set wrapped 250°F=30 minutes 270°F=15 minutes Drying Times 15-30 minutes Instrument set, unwrapped, no lumen instruments 270F=3 minutes 0-1 min Dry time Instrument set, unwrapped, some instruments with lumens 270F=10 minutes 0-1 min dry tme
Minimum Cycle Times: Gravity-Displacement Steam Sterilization: Instrument set wrapped 250°F=30 minutes 270°F=15 minutes Drying Times 15-30 minutes Instrument set, unwrapped, no lumen instruments 270F=3 minutes 0-1 min Dry time Instrument set, unwrapped, some instruments with lumens 270F=10 minutes 0-1 min dry tme
Microbes are killed by what 2 factors?
Moisture and heat
Items that can be Dry or Steam Sterilized?
Most metal surgical instruments, Power instruments, Microinstruments
Class 4 Indicator
Multi-variable indicators—designed to react to two or more of the parameters of the sterilizing process (e.g., temperature and exposure to sterilant).
Items that can be Gas Sterilized?
Powered instruments, Delicate instruments, Fiber-optic instruments, plastic, rubber, porous instruments or heat sensitive instruments
What is Event Related Sterility?
The sterility of an item is determined by how it is handled and that contamination is "event related" rather than "time related." Items will remain sterile indefinitely until the package becomes wet or torn or the seal is broken and package opened.
What are the 5 critical factors of sterilization?
Time, contact, temperature, moisture, pressure
Steam sterilization
The distruction of all microbs in or about an object with the useofsyeam under pressure
Class 1 Indicator
Process indicators—external indicators that provide a visual indication of exposure of the package/item to the sterilizing agent.
Class 3 Indicator
Single-variable indicators—determine if a single parameter is being met, such as a sterilizer reaching the preset temperature.
Bowie-Dick test
Test to show that the pre-vac machine is working. Does not prove that it is sterile.
What are the steps in Sterris Sterilization Cycle?
• 1-2 minutes: Water enters the processor through a three-step treatment process. • 2-4 minutes: Treated water mixes with a peracetic acid germicide, creating a solution to process the items. • 4-10 minutes: 6-minute exposure phase destroys all microbial life on items. • 10-12 minutes: Solution rinses safely down the drain. • 12-18 minutes: Two rinse phases remove chemical residue. • 18-23 minutes: Automated filter integrity test confirms that the filter operated successfully. • 23rd minute: Validated items are ready for immediate use.
