Sterilization

Objectives
 Understand and utilize correct sterilization

and disinfection techniques  Distinguish between sterilization and disinfection  List the characteristics of an ideal antiseptic  Describe sterilizing agents and rank their effectiveness  Discuss the time/temperature relationship in destroying microorganisms

 Microorganisms
 

Invisible Cause infections Destruction of all microorganisms Destruction of harmful organisms, or pathogens on nonliving objects

 Sterilization


 Disinfectant


 Disinfectants


Types of disinfectants
   

Bactericides Fungicides Germicides Virucides

All prevent transfer of infection

 Sterilization  Antiseptics  Prevent growth of microorganisms without destroying them  Not harmful to patients


Characteristics  Active against pathogens  Non-irritating  Cleansing  Cost-effective  Long shelf life  Safe for patient and handler  Stable in the presence of organic matter

Sterilizing Agents
 Type of agents
 

Chemical Physical
 

Moist heat Dry heat

 Most clinics use physical agents

 Moist heat  Steam and boiling water  Alone not effective  Captured steam effective  Autoclave  Sealed chamber that furnished both hear and pressurized steam for sterilization  Inexpensive  Sterilizes
    Instruments Syringes Needles Other materials

 Dry heat
  

Slow sterilizer Higher temperatures Penetrates

 

Oil-based materials Closed containers

Steps of Dry-Heat Sterilization Step 1 Decontaminate, clean, and dry all instruments and other items to be sterilized. Step 2 Either 1) wrap the instruments and other items using foil, double-layered cotton, or muslin fabric; 2) put unwrapped instruments and other items on a tray or shelf; or 3) place instruments and other items in a metal, lidded container. Note: Because dry-heat sterilization works by raising the temperature of the entire item to the designated temperature, it is not necessary to open or unlock hinged instruments or other items or to disassemble those with sliding or multiple parts. In addition, instruments and other items can be placed in closed containers. Step 3 Place instruments and other items in the oven, and heat to the designated temperature. The oven must have a thermometer or temperature gauge to make sure the designated temperature is reached. Use the list here to determine the appropriate amount of time to sterilize instruments and other items for different temperatures. (do not begin timing until the oven reaches the desired temperature, and do not open the oven door or add or remove any items). The times shown here represent the amount of time that items must be kept at the desired temperature to ensure that sterilization is achieved. Keep in mind that the total cycle time-including heating the oven to the correct temperature, sterilization, and cooling--is usually twice as long as the time noted here. Temperature 170 degrees C (340 degrees F) - 1 hour 160 degrees C (320 degrees F) - 2 hours 150 degrees C (300 degrees F) - 2.5 hours 140 degrees C (285 degrees F) - 3 hours Note: Because dry heat can dull sharp instruments and needles, these items should not be sterilized at temperatures higher than 160 degrees C. Step 4 Leave items in the oven to cool before removing. When they are cool, remove items using sterile pickups and use or store immediately. Step 5


Store items properly. Proper storage is as important as the sterilization process itself: Wrapped items. Under optimal storage conditions and with minimal handling, properly wrapped items can be considered sterile as long as they remain intact and dry. For optimal storage, place sterile packs in closed cabinets in areas that are not heavily trafficked, have moderate temperature, and are dry or of low humidity. When in doubt about the sterility of a pack, consider it contaminated and re-sterilize it. Unwrapped items. Use unwrapped items immediately after removal from the autoclave or keep them in a covered, sterile container for up to one week.

 Direct flame


Can damage the exposed object

Time/Temperature Relationship
 Most important factor in destroying

microorganisms is length of exposure to heat  Varies with microorganisms  The higher the temp the faster it will kill microorganisms exposed  Temps lower than boiling point can sterilize some medications and milk

Other Sterilization Technology

 Filtration  Ultraviolet irradiation  Cold sterilization  Ethylene oxide

 Filtration


Complete removal of microorganisms and particles of a certain size from liquid or gas Used by vet personnel in producing sterile and particle-free fluids, such as intravenous fluids

 Ultraviolet irradiation


Destroys microorganisms in air, liquid, and surface Germicidal UV radiation is generated by passing electricity through mercury vapor in special glass tubes UV lamps sterilize most effectively in still air at room temperature

 Cold sterilization
 

Gamma radiation Kill microorganisms without a rise in temperature Highly successful in sterilizing
  

Syringes Stitching (sutures) materials Containers

 Ethylene oxide


Makes possible the use of low cost, plastic materials for sterile, disposable medical instruments Primary gas used in hospitals and clinics to sterilize items that cannot withstand steam sterilization Vapors are hazardous to people