It is customary to distinguish the following processing stages:
1. Disinfection. It is carried out using chemical or physical methods: their advantages are ease and comfort of use.
2. Pre sterilization cleaning. The stage of processing instruments, carried out after disinfection and washing them from disinfectants. Self-monitoring of the procedure is carried out daily.
3. Sterilization. At this stage, a set of measures is being taken to destroy bacteria and viruses on surgical and other medical instruments.
Disinfection
Disinfection is a set of measures taken to effectively destroy and disinfect microorganisms. For the first time, people understood the importance of disinfection during mass epidemiological diseases, which killed a third of the population of medieval Europe.
The emergence of various means specifically designed for medical disinfection has made it possible to minimize the number of infections, as well as prevent the spread of epidemics of dangerous diseases.
The purpose of disinfection is to prevent and prevent the spread of infectious diseases, as well as to create acceptable conditions for treatment and life. Timely disinfection measures make it easier to treat diseases. Products are disinfected using physical and chemical methods. The choice of disinfection method depends on the characteristics of the product and its purpose.
Physical disinfection.
UV Light and Heat Methods
Physical disinfection methods, such as UV light and heat, offer an alternative to chemical disinfection. These methods work by directly damaging the DNA or proteins of microorganisms, preventing them from replicating and causing infection.
UV light is a non-chemical method of disinfection that has been used for many years. It works by emitting ultraviolet radiation that damages the DNA or RNA of microorganisms, preventing them from replicating. UV light can be used to disinfect air, water, and surfaces. It is commonly used in healthcare settings, laboratories, and water treatment facilities.
Heat is another physical method of instrument disinfection that can be used to kill microorganisms. High temperatures can denature the proteins and disrupt the cellular structures of microorganisms, leading to their death. Heat can be applied through dry heat or moist heat methods, depending on the desired level of disinfection and the type of surface or object being treated.
Physical disinfection methods offer advantages such as being non-toxic and not leaving any residue. They can be particularly useful in situations where chemical disinfectants may not be suitable or effective. However, these methods may have limitations in terms of their reach and effectiveness on certain surfaces. UV light, for example, may not penetrate opaque or shadowed areas, while heat may not be suitable for heat-sensitive materials.
Boiling water saturated steam under pressure dry, hot air is reliable, environmentally friendly and safe for personnel, therefore, in cases where conditions allow (equipment, product range, etc.), preference should be given when disinfecting products this method. Basic rules for disinfection using the physical method:
1. Before boiling, the products are cleaned of organic contaminants by rinsing with tap water in compliance with anti-epidemic protection measures. The countdown of the disinfection holding time begins from the moment the water boils.
2. With the steam method, preliminary cleaning of products is not required. They are placed in sterilization boxes and placed in a steam sterilizer.
3. Disinfection by air method is carried out without packaging in an air sterilizer. This method can only disinfect products that are not contaminated with organic substances.
Chemical disinfection.
Basic rules for the disinfection stage of medical instruments using disinfectants:
1. only approved physical and chemical agents are used as sterilization agents;
2. when choosing products, you should take into account the recommendations of product manufacturers regarding the impact of specific products (from among those permitted in our country for this purpose) on the materials of these products;
When carrying out disinfection, it is allowed to use only equipment that is authorized in accordance with the established procedure for industrial production and use;
Pre sterilization cleaning
This is the 2nd stage of disinfection of medical instruments, which immediately follows disinfection. Its purpose is to remove all types of contaminants.
What is pre sterilization cleaning of medical devices?
Pre sterilization cleaning - it removal from medical products of any inorganic and organic contaminants (including protein removal, fat, mechanical and others), including drug residues, accompanied by a decrease in general microbial contamination to facilitate subsequent sterilization of these products.
The quality level of pre sterilization anti-epidemic cleaning is checked by a number of samples.
Thus, in accordance with sanitary requirements, samples are taken for the presence of blood residues and other types of biological material on the instruments, as well as for the presence of a certain amount of powder and other substances. Cleaning involves immersing medical instruments in water with special cleaning solutions or special enzymatic cleaner.
Sterilization
Sterilization is the complete killing of microorganisms of all types, including spore forms, on surfaces and inside products. Sterilization of medical devices is carried out with the aim of killing all pathogenic and non-pathogenic microorganisms on them, including their spore forms.
Sterilization of medical devices must ensure the death of microorganisms of all types at all stages of development.
This is the conventional name for a set of measures taken to destroy bacteria, fungi, and viruses on objects used in medical institutions. Instruments and materials that will come into contact with the patient’s wound are especially carefully sterilized. This prevents the occurrence of infection and the spread of pathogenic diseases.
Steam sterilization equipment
The main equipment for steam sterilization is an autoclave. A steam sterilizer or autoclave is a device that performs the most common type of sterilization today. With its help, even those medical products that cannot be subjected to dry air treatment with its high temperature regime are disinfected.
What is the purpose of sterilization?
Sterilization is the final stage of medical device processing. The purpose of sterilization is to destroy microbiological contamination and thus prevent the transmission of infectious diseases associated with the use of medical devices and drugs.
Types of sterilization. Sterilization techniques
directly depend on the material from which the medical item is made. There is the following classification sterilization technologies:
1. Air Heat Sterilization. Involves treatment with dry hot air. Tools made of metal and glass are placed in a special dry-heat cabinet. Sterilization modes are as follows: at 180 degrees, objects are processed for 60 minutes, at 160 – 150 minutes.
2. Steam (steam-air). This is a method of destroying bacteria and other microorganisms on medical objects through the use of hot steam. This type of sterilization is used for metal instruments, rubber gloves, glass syringes and test tubes, and dressings. Modes: 132-135 degrees Celsius – 3.5-18 minutes, 121 degrees Celsius – 15-45 minutes.
3. Chemical. According to the regulations, this means placing objects and instruments in an disinfectant solutions. In this way, you can clean products made of rubber, glass and other materials that cannot withstand heat treatment.
4. Gas. Some gases can have a bactericidal effect on the item being sterilized. This method is most suitable for cleaning objects made of polymers. Specialists use ethylene oxide for such sterilization.
5. Radial. This sterilization method uses ionizing radiation or ultraviolet irradiation. Used for disinfection of endoprostheses, disposable medical products, suture materials.
6.Low temperature sterilization by hydrogen peroxide plasma
Low-temperature sterilization its sterilization technology by plasma gas
Sterilization Validation Testing: Ensuring Safety and Quality
Sterilization validation testing is a critical process that ensures products are free from harmful microorganisms, safeguarding public health across various industries. In this article, we'll delve into the intricacies of sterilization monitoring, the significance of quality control, the role of sterilization indicators, and the parallel process of cleaning validation.
Sterilization Validation Testing
Sterilization validation testing is the methodical examination and confirmation of the effectiveness of sterilization processes. This process is crucial in industries where product safety is paramount, such as healthcare, pharmaceuticals, and food production.
Different methods are employed for validation, including heat, chemical, and radiation sterilization. Regulatory bodies mandate specific validation requirements to ensure products meet stringent safety standards.
Sterilization Quality Control
Quality control plays a pivotal role in maintaining the efficacy of sterilization processes. Monitoring key parameters such as temperature, pressure, and exposure time is essential to guaranteeing that sterilization is consistently effective. Inadequate quality control can compromise product safety, leading to severe consequences.
Sterilization Indicators
Sterilization indicators are tools used to monitor and confirm the effectiveness of the sterilization process. They come in various types, including chemical indicators, biological indicators, and physical indicators. These indicators contribute significantly to quality assurance by providing real-time feedback on the success of sterilization procedures.
Pre-sterilization cleaning. Cleaning and disinfecting medical equipment.
The main stages of processing medical instruments:
Stage I: disinfection
Stage II: pre cleaning (Pre-sterilization cleaning)
Stage III: sterilization
Pre cleaning leaning is a stage in the cleaning medical equipment, which follows disinfection and precedes sterilization. Pre sterilization cleaning can be carried out either in combination with disinfection or as an independent procedure. If pre sterilization cleaning is carried out after high-level disinfection, the remaining disinfectants should be thoroughly washed off the instruments under running water. Pre sterilization cleaning, combined with disinfection, is carried out using disinfectants that have both disinfectant and detergent properties.
Pre cleaning instruments prior to sterilization:
-1. DEFINITION
-2. TYPES OF PRE STERILIZATION CLEANING
-3. STAGES OF PRE STERILIZATION CLEANING
-4. QUALITY CONTROL
-5. CLEANING OF MEDICAL DEVICES
The regulatory document on which surgical instrument cleaning activities are based is regulated by the relevant directives and standards in each country. For example, requirements of HTM 01-05. Health Technical Memorandum (HTM) 01-05 advice on patient safety when decontaminating reusable instruments in primary care dental practices. (HTM 01-05) Decontamination in primary care dental practices ( https://www.england.nhs.uk/publication/decontamination-in-primary-care-dental-practices-htm-01-05/)
Prevention and infection control is the most important task in the activities of all medical organizations. The use of disposable instruments can reduce the risk of nosocomial infection, but a complete abandonment of the use of reusable instruments is not yet possible. Therefore, high-quality processing of medical products is necessary at all stages, including at the stage of pre sterilization cleaning.
1. DEFINITION
Pre-sterilization cleaning is a set of measures aimed at removing any organic and inorganic contaminants, including drug residues, from the surface of medical products. Pre-sterilization cleaning should be accompanied by a reduction in overall microbial contamination to facilitate their subsequent sterilization.
Pre-sterilization cleaning is carried out in a centralized sterilization department (CSSD, Central Sterile Supply Department), and in its absence, in a specially equipped room (for example, a washing room). All medical instruments undergo pre-sterilization cleaning:
in contact with blood, open wounds, mucous membranes, drugs for parenteral administration, as well as with the risk of damage to the integrity of the skin and mucous membranes during use.
2. TYPES OF PRE STERILIZATION CLEANING
At the stage of pre-sterilization cleaning surgical instruments are washed manually or using special equipment.
2.1 Manual Cleaning instruments method
The manual method is relevant for solutions that involve manual cleaning equipment such brushes or gauze wipes.
2.2 Mechanical Hydrosonic Cleaning method by automatically cleaning machines
For effective pre-sterilization automated cleaning of products sensitive to mechanical stress, we recommend using ultrasonic washers. The supersonic frequency causes vibrations of the aqueous solution, as a result of which all areas of the instrument are cavitation cleaning of the surface layer of contaminants using the “microscopic brush” principle.
After disinfection and cleaning, rotating instruments should be rinsed in running water for the time specified in the instructions for the detergent. Then desalting in distilled water and drying is necessary. Your instruments are now ready for sterilization.
-Importance of ultrasonic clean for processing medical products
An assessment of the most labor-intensive and dangerous aspects for medical personnel shows that one of them is cleaning medical instruments from contamination. To solve this problem, mechanized cleaning through the use of ultrasonic washers is increasingly being used in world practice. Sonic cleaning helps nurses perform much of their routine manual labor by cleaning hard-to-reach areas of products without the use of organic solvents. Thanks to the use of ultrasound in the cleaning of medical instruments, the degree of cleanliness of the process is increased, processing time is reduced, and the formation of deposits on the surfaces of instruments is reduced.
Ultrasonic installation for mechanized cleaning of medical instruments
Modern devices of this type are ultrasonic installations for mechanized cleaning of medical instruments. These installations are designed for pre-sterilization medical instrument cleaning and medical products (especially small ones, with a complex configuration, piercing and cutting) from various contaminants in the form of:
-water-soluble and partially soluble polar organic and inorganic compounds, such as blood, protein, drugs, etc.;
-solid and liquid films from oils and fats of vegetable, mineral (new instruments) and animal origin; solid sediments - dust, bone tissue, etc.; corrosion products.
What is ultrasonic cleaning?
Ultrasonic cleaning is a powerful technology that allows you to remove even the most stubborn dirt from surfaces.
How does ultrasonic cleaning work?
However, to ensure that your ultrasonic cleaner is working effectively, you need to perform a test to check the cleaning ability of your ultrasonic cleaner. These simple indicators will help you determine if your cleaning solution is at the correct concentration and if your ultrasonic cleaner is working properly.
Unleash the potential of pre-sterilization ultrasonic cleaning with our performance check indicators for your ultrasonic bath. Be confident in the performance of your sink and the correctness of the actions you perform. Conduct a test to see if your washer is working properly and if the actions you are performing are correct. This test is proof of the success of your actions in cleaning medical instruments and the performance of your ultrasonic cleaner.
-3. STAGES OF PRE-STERILIZATION CLEANING (Cleaning Procedures)
· Currently, the following stages of pre-sterilization medical equipment cleaning are distinguished:
· Washing after disinfection.
· Soaking.
· Ultrasonic wash in detergent cleaning.
· Rinsing with normal running water.
· Rinsing with distilled water.
· Hot air dry.
· Pack surgical instruments in sterilization packaging materials
PRE-STERILIZATION CLEANING: Sterility assurance of ultrasonic cleaning efficacy.
How to check the cleaning quality and performance of your ultrasonic cleaner?
1. We offer modern indicators to monitor the process and quality of your ultrasonic cleaner.
Cleaning Validation
Cleaning validation is closely linked to sterilization, as the cleanliness of equipment is crucial for effective sterilization. This process ensures that residues from previous processes do not compromise the sterilization process. Common methods for cleaning validation include visual inspection, swab testing.
Cleaning Indicator for cleaning performance tests.
Challenge level: high. Detects all the factors that affect the result of a washing process. Initial Color: pink.
Result: removal of the pink organic substance from indicator surface.
Designed for routine control of cleaning processes and for monitoring automatic washing machines effectiveness as well as monitoring ultrasonic washing machines which operate at frequencies equal to or greater than 35 kHz, and temperatures between 30 ºC and 70 ºC.
Allows quick and easy weekly validation of the washer disinfector in accordance with the requirements of HTM 01-05.
Characteristics
-Challenge level: very high.
-Allows detection of all factors affecting the outcome of cleaning process.
-Initial Color: pink.
-Size: 10 mm x 60 mm (aproximate).
-Synthetic temperature-stable support.
-Result: elimination of fuchsia organic substance.
To interpret results visually, use the results reference guide on product's instructions for use.
PRE-STERILIZATION CLEANING: CLEANING QUALITY CONTROL. How to check the quality of pre-sterilization cleaning?
The purpose of PSC is to completely remove traces of blood, protein, fatty, mechanical contaminants and drugs from the surface of the MI. The effectiveness of subsequent sterilization depends on the completeness and quality of PSO, which is why medical organizations carry out mandatory daily quality control of PSC.
After all stages of instrument cleaning, random quality control must be carried out. For this purpose the following are usually used:
Azopyram or amidopyrine test - shows the quality of blood purification. To evaluate this stage, you can perform an azopyram (or amidopyrine) test. This will detect any residual blood.
Phenolphthalein test - shows the quality of cleaning from detergents and disinfectants. If you used working solutions of products with a pH greater than 8.5. You will need to check your tools for traces of alkaline components. For this purpose, a phenolphthalein test is used.
Test for residual protein. A negative test allows you to be sure that there is no residual protein on the surfaces of medical instruments. The quality of pre-sterilization cleaning is also checked by a sample for residual protein. A negative test allows you to be sure that there is no residual protein on the surfaces of medical instruments.
1% of the total number of processed instruments is subject to control, but not less than 3-5 units. If a test for blood or detergent is positive, the entire group of products from which samples were taken is re-processed until negative results are obtained. The result of the control is recorded in a special journal.