STERILIZATIONS GUIDELINES
Cleaning and decontamination;
Personnel must wear gloves and appropriate gowns while carrying out cleaning &
decontamination.
Reusable sharps that have been in contact with blood present a special hazard
You must not reach with gloved hands in a container with these sharps to retrieve
them, rather use other tools e.g., forceps.
Items must be cleaned using water with detergent (liquid soap) or enzymatic cleaners.
Cleaning reduces the bioburden and removes foreign material that interfere with
sterilization and act as a barrier to the sterilization agent (steam).
Surgical instruments are generally pre-soaked in diluted chlorine to prevent drying of
blood and tissue.
Cleaning and decontamination should be done as soon as possible after the items
have been used.
Immerse instruments in a clean large bucket containing 0.5% chlorine or bleaching
agent for 10 minutes, this results into inactivation of most organisms.
Use a brush to scrub the instruments with running water and liquid soap or detergents
to remove biological material such as blood, body fluids and tissue remnants.
Special attention should be given to instruments with teeth (e.g., toothed forceps),
joints and screws (e.g., vaginal specula) to which biological material can be stuck.
Rinse the instruments thoroughly with boiled water to remove detergent residue and
leave them to dry.
Packaging;
Once items are cleaned, dried and inspected, those requiring sterilization must be
wrapped or placed in rigid containers and should be arranged in instrument trays or
baskets.
Hinged instruments should be opened.
Items with removable parts should be disassembled unless the device manufacturer
provides specific instructions to the contrary.
Complex devices should be prepared and sterilized according to manufacturer’s
instructions.
Devices with concave surfaces should be positioned to facilitate drainage of water.
Heavy instruments must be positioned not to damage delicate items.
The packaging must allow penetration of sterilant (steam), reduce the chance of
contact contamination during handling and maintain sterility of the processed item
after sterilization.
Loading;
All instruments to be sterilized must be arranged such that all surfaces will be directly
exposed to the sterilizing agent (steam).
Thus, loading procedures must allow free circulation of steam around each item.
Sterilization drums should be open (pores opened) before loading them into the
sterilizer.
Storage;
o Sterile items must be stored far enough from the floor.
o They should not be stored under sinks where they could become wet.
o Closed or covered cabinets are ideal but items can be stored on shelves.
o Sterile items that become wet are considered contaminated because moisture brings
with micro-organisms from air and surfaces.
o Contamination of sterile items is event related and the probability of contamination
increases with increased handling.
o Therefore, sterile items must be handled using aseptic techniques.
o Items that have been wrapped in double linen stay sterile for at least 30 days if the
above precautions are taken.
Before sterilization;
Check if the sterilizer is clean and has the right amount of water level (distilled water).
If the sterilizer or the water is not clean, pour the water and clean the sterilizer.
The water level should be slightly below the stands in the sterilization chamber.
Check if the power cable is available and connected to the machine.
Sterilization Procedure;
Load the packages in the sterilizer while making sure they are not congested to
allow free circulation of steam during sterilization.
Cover the sterilizer and tighten the nuts diagonally. This is done to avoid
leakages beneath the cover and ensure that the nuts are well tightened. Use the
tightener for effectiveness.
Set the sterilization time and select the required temperature. The sterilization
time control knob is on the left-hand side and the temperature control knob is on
the right-hand side on the control panel.
The sterilization times and temperatures for different materials are as follows;
At temperature at 121OC,
sterilization time 30 minutes for surgical instruments, lab equipment.
sterilization time 20 minutes for silicon rubber materials, linen, cotton and drapes.
At temperature at 134oC,
sterilization time 20-30 minutes for surgical instruments
sterilization time 10 minutes for linen, cotton, drapes and silicon rubber materials.
After selecting the right sterilization time and temperature, switch on the
temperature control and the heater switch on the control panel of the sterilizer.
The on position is the ‘1’ position for both the switches and when the machine is
on, they will both be lighting.
Open the air release valve on top of the cover of the sterilizer by making its top
attachment metal face in the upward direction (vertical). The air release valve is
labelled (air release valve).
When the air release valve starts making a hissing sound and steam is observed
coming out from it, close the air release valve by making its top attachment
metal lie horizontally.
The pressure gauge will start gain gradually and the machine will alarm when the
cycle is complete.
When the cycle is complete, leave the machine to cool down for at least an hour
and then open the air release valve with any suitable long tool.
Take caution not to get burnt by steam.
Unload the sterilized items while wearing gloves and store them in a safe place
i.e., where they are less prone to contamination.
Empty the sterilizer chamber (don’t leave water in it after sterilization).
