Failure to follow the appropriate sterile processing standards results in infections, so we put together a list of the five most common mistakes we have observed over the years.

1. Temperature and Humidity Control
Be sure to follow the ASHRAE guidelines in place when your facility was built.

2. Wearing Proper PPEs
Contaminated instruments and other medical devices are sources of microorganisms to which personnel can expose through nicks, cuts, abrasions in the skin or contact with the mucous membranes of the eyes, nose, or mouth. Below is a list of the proper PPEs to wear in the decontamination area1:

  • Fluid-resistant face masks and eye protection
  • Liquid-resistant covering with sleeves which is disposed or laundered after every use
  • General purpose gloves
  • Shoe covers if there is potential for shoes becoming contaminated and/or soaked with blood or other bodily fluids
  • All head and facial hair (except for eyebrows and eyelashes) should be completely covered

3. Improper Mechanical Washer Loading
Here are a few tips from AAMI on how to ensure you properly utilize your mechanical washers during the decontamination process:2

  • Filter retention plates should be separated to allow full contact with cleaning/disinfection solution
  • Process indicators, disposable labels, and disposable locks should be removed before cleaning of a rigid sterilization container
  • Silicone mats should be washed separately from instrument sets
  • Multi-level trays should be placed on the washer rack in a single level manner
  • Devices requiring disassembly prior to mechanical washing should be disassembled and cleaned according to the IFU
  • Hinged instruments should be placed on a decontamination stringer before being washed
  • All cannulated instruments should be brushed and flushed with a cleaning solution before going in the washer

4. Daily Cleaning and Disinfection
Terminally cleaning the Sterile Processing Department daily, even when the area is not being used, should include3:

  • Damp dusting of all horizontal work surfaces
    • Countertops and sinks
    • Furniture, shelving, and worktables
    • Sterilizers
  • Cleaning and disinfecting all work surfaces and high-touched objects using a low-linting cloth or single-use wipes
  • Mopping of floors with either single-use mop or wet vacuum

5. Sterilizing Reusable Brushes
Disinfecting or sterilizing reusable brushes daily ensures microorganisms, as well as patient tissue, blood, and other lubricants, do not survive on the brushes. Two keys to remember about reusable brushes4:

  • Replace reusable brushes that look worn and bristles are missing or bent
  • Reusable brushes can go through the mechanical washer-disinfector and/or sterilizer

After a review of this information, take a look at your facility’s policies and procedures to find out if there are any gaps in your policy and procedures in decontamination. Is everyone complying with established policies? Perform random audits of sterile processing personnel to ascertain a level of understanding and help develop proficiency.

Author: Michelle Gallagher, CRCST

References:

  1. AAMI ST 79, 4.5.2
  2. AAMI ST 79, 7.5.9
  3. AAMI ST 79, 3.4
  4. AAMI ST 79, 7.5.6