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Cleaning and care of sterilizers; writing on
packaging; germicidal detergents
by Ray Taurasi
Q What is the recommended
cleaning and care procedure for sterilizers? How frequently should the
inner chamber and walls be cleaned? My staff tells me that my
predecessor used a vinegar mixture for cleaning the sterilizer walls;
do you think this is a good idea?
A The sterilizer
manufacturer’s instruction manual should be consulted for the exact
procedures to be used on their sterilizer equipment. Sterilizers’
makes and models differ and therefore processes may vary somewhat as
well. In general, the following is common protocol:
• Sterilizer chamber should be cool prior to
performing any maintenance or cleaning process
• The chamber screen strainer should be removed at
least daily and cleaned thoroughly. All lint or other debris deposits
must be removed from the screen.
• The use of a soft brush and mild detergent will help
facilitate the cleaning process and the strainer may be flushed by
holding under running water.
• The screen strainer may need to be cleaned more than
once a day depending on volume and load contents. For example, if you
are processing lots of linen or textile loads a significant amount of
lint may clog the drain and affect the sterilizer’s proper
functioning.
• The chamber walls should be cleaned at least weekly
utilizing a mild detergent and a long handled sterilizer cleaning
brush or mop.
• Abrasives or steel wool pads should never be used
when cleaning an inner chamber, as they may damage the
corrosive-resistant surface that protects the chamber walls from
corrosion caused by steam boiler water treatment chemicals.
• Chamber drain lines may be flushed weekly with a
mixture of tri sodium phosphate or hot water and a mild detergent
solution. Household drain cleaning agents should never be used.
• The door gasket should be carefully inspected daily
for any cracks or defects and wiped clean with a lint-free cloth.
• Loading racks, carriages and baskets should be
cleaned at least daily with a mild cleaning agent and wiped dry with a
soft lint-free towel.
There are many cleaning products, agents and
accessories on the market specifically designed for the proper care,
cleaning and maintenance of sterilizers. It is not recommended or
advisable to create your own cleaning mixtures without the expressed
instructions of the sterilizer manufacturer.
Q
Why isn’t it acceptable to write on wrapped packages or
peel pouches? We did this all of the time at the clinic I used to work
for and never seemed to have any problems.
A
Writing on packaging with a pen, pencil or other sharp
or hard writing implement could compromise the integrity of the
packaging material, thus allowing for microbial infiltration and
contamination of the contents. Writing on packaging with soft felt-tip
pens such as magic markers and the like poses a potential risk of ink
leaching which could in turn be deposited on the contents resulting in
toxic reactions. There are permanent felt-tip marking pens readily
available on the market, which come in multi colors, and have been
cleared for labeling sterile packages. These pens are of a medical
grade quality, they are sterilizable, and use non-leaching, non-toxic
permanent inks. Users should not use standard markers that do not have
documentation relative to toxicity and the ability to be sterilized
safely. When writing on a peel pouch you must never write on the paper
side which envelopes the sterile contents.
Preprinted and custom design adhesive labels are
available, which are acceptable for use as labeling on sterile
packages. You of course will want to obtain the appropriate
documentation from the manufacturer for such use.
Q
We have recently purchased a new
washer/disinfector, and we have also converted to the
super-concentrated cleaning agents recommended by the washer
manufacturer. The detergent we previously used to wash instruments
contained a disinfectant/germicidal agent whose properties were
bactericidal, virucidal and fungicidal capable of destroying HBV and
HIV. These new concentrated enzymatic cleaning solutions are
supposedly more economical and better cleaners, but they have no
germicidal properties. I have received the manufacturer’s 510(k) and
instructions for use, but do I need more documentation verifying the
process of effective decontamination with the use of these solutions,
and if so, what? And, should I be concerned about my staff’s safety in
handling instruments that have not been cleaned with a germicidal
detergent?
A
The disinfection process may be
achieved by either a chemical or thermal process. The very first and
most important step in the decontamination/ disinfection process is
thorough cleaning. The process of cleaning is generally focused on the
removal of soils and contaminants vs. the
destruction of organisms. Some, but not all, detergents do
contain some germicidal properties, but for the germicides to be
totally effective the devices must first be free of soil to allow
intimate contact with the chemical agent for a predetermined exposure
time. The chemical spectrum and the length of exposure will determine
the level of disinfection achieved. Generally the detergents utilized
in the cleaning of medical devices in automated washers are
specifically designed to help break down and dislodge organic soils.
Enzymatic detergents, presoaks, and foam sprays are very effective in
breaking down soil which facilitates removal of the soil in the
washing process. Your new washer/disinfector most likely consists of a
wash cycle geared at the removal of soil and the recommended enzymatic
product will break the soil down for easier removal. The wash cycle
will be followed by a thermal disinfection rinse cycle which will
destroy organisms by heat. When using a washer disinfector, a
germicidal detergent is not necessary. The effective decontamination
process renders devices safe for further handling in the reprocessing
cycle. It is suggested that you follow AAMI guidelines which now
recommend weekly (preferably daily) testing and verification of your
cleaning process.
Ray Taurasi is Eastern Regional Director of Clinical Sales and
Services for Healthmark Industries. His healthcare career spans over
three decades as an Administrator, Educator, Technologist and
Consultant. He is a member of AORN, AHA, SGNA, AAMI and a past
president of IAHCSMM and has served on and contributed to many
national committees with a myriad of professional organizations,
manufacturers, corporations and prestigious healthcare networks.
Taurasi has been a faculty member of numerous colleges teaching in the
divisions of business administration and health sciences. In addition
to this column he has authored several articles and has been a
featured speaker on the international scene. |
