Sterilization – Infection Prevention and Control
What Is Sterilization?
Sterilization destroys all microorganisms, including blood-borne viruses such as hepatitis B, hepatitis C and HIV.
What Items Must Be Sterilized?
- Any item or instrument that pierces or penetrates the skin must be sterile. Any item that holds sterile items must also be sterile. These items are called critical items.
- Needles, jewellery and forceps used in body piercing are examples of critical items.
- Critical items must be sterilized because they pose the highest risk of spreading blood-borne infections
What Do I Need to Know About Sterilizing My Equipment in an Autoclave?
- Any item being sterilized must first be cleaned. An ultrasonic cleaner can be used to clean instruments before sterilization.
- All items must be packaged before being sterilized.
- Autoclaves must be monitored to ensure they are working properly.
- There are three types of monitoring that is required; biological, chemical and physical.
Biological monitoring (spore testing) must be done every 2 weeks. You must send the strip tests to a laboratory for testing. A passed (negative) spore test means the sterilizer is working properly. A failed (positive) spore test means the sterilizer is not working properly. Keep copies of the spore test results on site for a year and on file for 5 years.
**Do not use sterilized items or instruments until AFTER you receive the passed (negative) spore test results**
Three consecutive spore tests must be conducted if:
- The autoclave fails a spore test.
- A new autoclave is used.
- The autoclave has not been in use for more than 2 weeks.
- The autoclave has been repaired.
- The business moves to a new fixed location.
Chemical monitoring must be done every time you use the autoclave. This means that all instrument packages must have a heat sensitive indicator on the outside. The indicator will change colour if the instrument has gone through a cycle in the autoclave. It does not tell you if the instrument was sterilized properly.
Physical monitoring means keeping a record for each load. You must write down the date, time, duration, amount of equipment, temperature, pressure and the person who is responsible for the sterilization load. These records must be on site for one year and on file for five years. The date an item is sterilized must also be written on the package. Before writing, wait for the item to dry and be careful not to tear the package with your pen. A sticker can also be used with the sterilization date.
What Should I Do If My Autoclave Fails a Spore Test?
- Discontinue use of the sterilizer until it demonstrates three consecutive negative tests prior to being used to sterilize items again. The sterilizer may need to be serviced as well.
- Do not use any equipment from the failed load and any items sterilized after the last passed spore test.
- You can use any equipment sterilized during the time when the autoclave passed the spore test or use purchased pre-packaged, single-use, sterile items.
- Report the failed spore test to Toronto Public Health.
What Should I Do If My Heat Indicator Does Not Change Colour?
- Reprocess those same items immediately using an indicator. If the indicator fails again, stop using any equipment from the failed indicator tests and conduct a spore test right away.
- Use equipment reprocessed from the last passed spore test or use purchased, pre-packaged, sterile items until you get the spore test results.
Do I Need to Keep Records of Items Purchased Pre-Packaged and Sterile?
- Yes. You must keep a record of all items purchased as pre-packaged, sterile and single-use. Record where, when and who the materials were purchased from for tracking purposes.
- Keep these records on site for one year and on file for five years.
What Else Can I Do to Ensure Items Stay Sterile Until They Will Be Used?
- Open sterile, pre-packaged items in front of the client. Never place items onto any surface that itself is not sterile such as a tray or table.
- Use only packaging materials that are specifically designed for the type of sterilizer being used.
- Sterile items must be cleaned and re-sterilized if the packaging is no longer sealed or in good condition.
- After sterilization, let the package dry thoroughly before handling. Handling wet or warm packages can compromise the sterility of the item.
- Do not write on the paper side of paper/plastic pouches as the pen may puncture the paper. Unless the instructions say otherwise, you can write on the plastic using a felt-tipped marker.
- Packages should be stored at least 1 metre away from sinks, drains and moisture.
- Containers used for storage of sterile instruments should be moisture resistant and cleanable.
- Items purchased as sterile must be used before the expiration date, if one is given.