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Infection prevention and control guidelines
10. Reprocessing reusable medical devices
For items that require sterilisation, reprocessing involves (Table 10.3. Summary of steps for processing reusable medical devices):
Packaging and sterilisation steps include:
Regular routine maintenance also is required for all other reprocessing equipment, including ultrasonic cleaners, washer-disinfectors with or without ultrasonic capacity, drying cabinets, heat sealers, incubators, and biological indicator readers.
To achieve consistently reliable sterility, the practice must set up a comprehensive sterility assurance program incorporating every aspect of reusable equipment processing, including staff education, to avoid common errors (Table 10.4. Common reprocessing errors).
Table 10.3. Summary of steps for processing reusable medical devices
Remove visible soiling by damp or dry wiping at point of care (eg in consulting or treatment room).
Transport to reprocessing area.
Run ultrasonic cleaner cycle (optional) followed by rinsing (before manual cleaning).
Items should not be left in detergent solution for later cleaning
Manually clean items
Run a washer–disinfector cycle.
Use personal protective equipment
Rinsing and drying
(required after manual cleaning or ultrasonic cleaning)
Note: Rinsing and drying is not required after cleaning with an instrument washer–disinfector
Rinse in designated ‘clean’ sink.
Drain on clean surface.
Dry manually or in drying cabinet.
Wear clean latex-free gloves (eg utility gloves or nitrile chemically resistant examination gloves) while drying
Preparing the load for sterilising
Check items are clean, intact and functioning.
Select packaging of appropriate size – to match the item or set of items to be sterilised.
Ensure each package has Class 1 chemical indicator incorporated into its surface.
Seal the package – ensure there are no gaps through which air can enter and contaminate the contents.
Label packages (date, load number and, if required, description of contents, and the signature of person responsible for packing).
Loading the steriliser
Place items in steriliser:
Enter description of contents into the logbook.
Running the sterilisation cycle
Check water level – add if necessary (follow manufacturer’s instructions for use).
Choose correct cycle (if steriliser has multiple cycles).
Select correct cycle parameters (if steriliser validated for multiple load types) – check validation record.
Enter required details in steriliser logbook (date, load description and load number, name of the person who prepared the load).
Close door and start steriliser cycle.
Do not attempt to open the steriliser door while the cycle is in operation.
Unloading the steriliser
When the cycle is completed:
1. Check the physical parameters
2. Remove trays using tray lifter or heat-resistant gloves – do not touch packages while hot
3. Place trays on drying surface – allow to cool for minimum of 30 minutes
4. With clean hands, check cooled packages for class 1 indicator pass and for moisture or damage.
Classify load as PASS or FAIL.
Documenting the cycle
Record details in the steriliser logbook (in addition to previously recorded details):
Storing sterilised equipment
When cool, store sterilised packs in clean enclosed storage area.
Only handle packs with clean hands.
Rotate stock so that items sterilised earlier are used first.
TGA: Therapeutic Goods Administration
Table 10.4. Common reprocessing errors
Inadequate instrument cleaning leaving debris
Incorrect choice of packaging material type
Too many items in package
Excessive wrapping material used on package
Overloading of steriliser
Inadequate maintenance of steriliser
Use of sterilisation equipment not registered by the Therapeutic Goods Administration for the purpose