5 Critical Sterile Processing Decontamination Tips

Proper sterile processing decontamination is the cornerstone of infection prevention in healthcare facilities. Following industry standards not only ensures patient safety but also protects sterile processing technicians from potential exposure to harmful microorganisms. This comprehensive guide explores five essential decontamination practices based on the authoritative AAMI ST79 guidelines.

What is Sterile Processing Decontamination?

Sterile processing decontamination is the critical first phase in the sterile processing workflow, where contaminated medical instruments and equipment are cleaned and prepared for sterilization. This process involves the systematic removal of organic matter, bioburden, and other contaminants from reusable medical devices through a combination of manual and mechanical cleaning methods.

The decontamination process typically includes:

1. Point-of-use cleaning and preparation in patient care areas
2. Transport to the decontamination area in closed, leak-proof containers
3. Manual cleaning including brushing, flushing, and soaking of instruments
4. Ultrasonic cleaning for items with complex designs or hard-to-reach areas
5. Mechanical washing in automated washers/disinfectors
6. Visual inspection to verify cleanliness before advancing to preparation and packaging

Decontamination is performed in a designated area physically separated from clean zones to prevent cross-contamination. This area operates under negative air pressure and requires specific environmental controls, specialized equipment, and strict adherence to personal protective equipment protocols.

1. Maintaining Optimal Temperature and Humidity in Sterile Processing Areas

Environmental controls play a crucial role in effective sterile processing decontamination. According to AAMI ST79 section 3.3.5.5:

1. Follow ASHRAE guidelines established during your facility's construction
2. Monitor temperature and humidity levels daily
3. Implement proper ventilation systems to reduce biological contamination
4. Document environmental monitoring as part of your quality assurance program

Excessive heat and humidity not only create unsafe working conditions for SPD techs but also accelerate microbial growth, potentially compromising the entire sterile processing decontamination workflow.

2. Personal Protective Equipment: Your First Line of Defense in Decontamination

Proper PPE is non-negotiable in sterile processing decontamination areas. AAMI ST79 section 4.5.2 outlines comprehensive PPE requirements:

1. Face Protection: Fluid-resistant masks combined with eye protection or face shields
2. Body Coverage: Liquid-resistant gowns with sleeves, changed or laundered after each use
3. Hand Protection: Heavy-duty utility gloves with extended cuffs that overlap gown sleeves
4. Foot Protection: Liquid-resistant shoe covers when contamination risk exists
5. Hair Containment: Complete coverage of all head and facial hair (except eyebrows and eyelashes)

Implementing a systematic approach to PPE compliance significantly reduces infection transmission risks in sterile processing departments.

3. Mechanical Washer Loading Protocols for Optimal Decontamination

Improper loading of mechanical washers is a common sterile processing decontamination error. AAMI ST79 provides specific guidelines in sections 7.5.2.2.2, 7.5.2.2.5, 7.6.4.3.4, and 7.4.1:

1. Monitoring: Verify cleaning processes according to manufacturer's IFUs with proper documentation
2. Separation: Ensure filter retention plates are properly separated for complete cleaning solution contact
3. Preparation: Remove all process indicators, disposable labels, and locks before container cleaning
4. Specialized Items: Clean silicone mats separately from instrument sets
5. Proper Positioning: Place multi-level trays on washer racks in single-level configuration
6. Disassembly: Follow the manufacturer's IFUs for devices requiring disassembly
7. Hinged Instruments: Place in an unlocked, open position
8. Cannulated Instruments: Brush and flush with cleaning solution prior to mechanical washing; connect to irrigation ports when possible

4. Daily Cleaning and Disinfection of Decontamination Areas

Maintaining a clean sterile processing decontamination area is essential, even during periods of non-use. AAMI ST79 sections 3.3.6.1.1 and 14.2.3.3 recommend:

1. Use dedicated cleaning supplies exclusively for decontamination areas
2. Perform daily damp dusting of all horizontal surfaces:
   1. Countertops and sinks
   2. Furniture, shelving, and worktables
   3. Ultrasonic cleaners and washers
3. Clean and disinfect all work surfaces and high-touch objects using low-linting cloths or single-use wipes
4. Mop floors daily using single-use mops

Effective environmental control programs are fundamental to successful sterile processing decontamination. You can keep track of these important tasks in your instrument tracking system like CensiTrac using the efficiency task list module.

5. Equipment Maintenance: The Foundation of Reliable Decontamination

Sterile processing decontamination equipment requires regular maintenance to ensure consistent performance. AAMI ST79 section 7.6.4.3.2 emphasizes:

1. Follow the manufacturer's IFUs for operation, loading procedures, and cycle selection
2. Inspect spray arms daily to ensure proper rotation and prevent clogging
3. Clean strainers at least daily to maintain optimal water and detergent flow
4. Schedule preventative maintenance according to manufacturer recommendations

Evaluating Your Sterile Processing Decontamination Protocols

After reviewing these AAMI ST79-based recommendations, we encourage you to examine your facility's sterile processing decontamination policies and procedures. Consider:

1. Are there gaps between current practices and industry standards?
2. Is staff consistently complying with established protocols?
3. Could regular audits help improve understanding and proficiency?

Contact our sterile processing experts for a comprehensive evaluation of your decontamination workflows.

FAQs

What is the difference between decontamination and sterilization?

Decontamination and sterilization represent different levels of the instrument reprocessing continuum:

1. Decontamination is the process of removing visible soil, organic material, and many microorganisms from instruments or surfaces to make them safe for handling. This typically involves cleaning with detergents, enzymatic cleaners, and mechanical action (brushing, sonication, etc.). Decontamination significantly reduces bioburden but doesn't eliminate all microorganisms.
2. Sterilization is a more comprehensive process that eliminates all forms of microbial life, including bacteria, viruses, fungi, and spores. Common sterilization methods include steam autoclaving, hydrogen peroxide gas, ethylene oxide, and other validated processes. Sterilization provides the highest level of assurance that instruments are free from all viable microorganisms.

In a typical instrument reprocessing workflow, decontamination is a necessary precursor to sterilization, as proper cleaning ensures sterilizing agents can effectively reach all instrument surfaces.

What are the risks of improper decontamination?

Improper decontamination practices pose several significant risks:

1. Patient Safety Risks: Inadequately decontaminated instruments can transmit pathogens between patients, potentially causing surgical site infections, bloodstream infections, or the spread of antibiotic-resistant organisms.
2. Staff Safety Hazards: Healthcare workers handling improperly decontaminated instruments face exposure to bloodborne pathogens and other infectious materials.
3. Sterilization Failure: Residual bioburden (blood, tissue, etc.) can shield microorganisms from sterilizing agents, resulting in ineffective sterilization even when proper sterilization protocols are followed.
4. Instrument Damage: Biological materials left on instruments can cause corrosion and deterioration, shortening instrument lifespan and potentially affecting functionality during procedures.
5. Regulatory Compliance Issues: Healthcare facilities must adhere to strict regulatory standards for instrument reprocessing. Non-compliance due to improper decontamination can result in citations, penalties, or even facility closure in severe cases.

Author: Vanessa Cavanaugh, CRCST, CER

References:

1. AAMI ST79 3.3.5.5
2. AAMI ST79 4.5.2
3. AAMI ST79 7.5.2.2.2
4. AAMI ST79 7.5.2.2.5
5. AAMI ST79 7.6.4.3.4
6. AAMI ST79 7.4.1
7. AAMI ST79 3.3.6.1.1
8. AAMI ST79 14.2.3.3
9. AAMI ST79 7.6.4.3.2