As a patient you should have the complete right to know what goes into maintaining a strict standard of asepsis to protect from any potential biohazard.
Sterilization can be broadly divided into two
Physical methods and
Chemical methods.
Physical methods are mostly used in the form of Autoclaves.
In addition to the above physical methods certain chemicals are also used as a precursor to Autoclaving in order to achieve a thorough sterilization.
An overview of the sterilization guidelines is mentioned in a stepwise manner :
Traffic Control
Controlled access to the sterilization areas minimizes the potential for transfer of micro- organisms between contaminated items, patients, and staff. These areas must be off limits to anyone not involved in the sterilization process.
Instrument Cleaning
You should take contaminated instruments from the receiving area wearing heavy duty puncture- resistant gloves while handling all potentially contaminated items. Break down all packs and place disposable items and contaminated linens in appropriate containers. All contaminated, reusable items must be decontaminated by immersion in an Enviormental Protection Agency (EPA) registered disinfectant before further handling. This step can be eliminated if these items are cleaned in an ultrasonic cleaner (bath) with an EPA-registered disinfectant that also is approved as an ultrasonic cleaning solution. Process instruments using one of the following methods.
Processing
All inspecting, sorting, wrapping, and packaging of contaminated materials occur here.
Sterilization
The space requirements for the sterilization process should be determined by the available size, the degree of sufficient access for the loading and unloading, and the ability to service the sterilizer. In case of chemical sterilization the solution should lie with the instruments undisturbed for the time mentioned by the manufacturer.
Sterile Storage and Issue
To protect and maintain all sterile items, the storage and issue areas should not be in the immediate vicinity of the contaminated processing areas.
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Presterilization Processing
Inspection and Sorting of Instruments
After drying, you must inspect items closely for wear, breakage, and cleanliness. Sort instruments according to sets or packs. This is the area where your instruments are sorted before wrapping and packaging.
Wrapping and Packaging
Wrapping and packaging is the last step just before the sterilization process Before terminal (final) sterilization, wrap or package all critical and semi critical items individually or in sets. Ensure you place consumable supplies that are required by your command in each particular pack before wrapping such items as needles, cotton rolls and pellets, gauze, aluminum foil for dental light handles, internal indicators, and towels. Dental instruments are usually placed in packs, on trays or cassettes, before placing them into the sterilizer.
The most common wrapping materials and containers are paper, paper/plastic, nylon tubing, and cloth. Aluminum foil, closed metal trays, and perforated cassettes may also be used. The packaging or wrapping materials that you select depends on the compatibility of what type of sterilization method you are using. shows various sterilization packaging materials and their suitability to withstand steam or dry heat sterilization.
Always refer to the sterilizer manufacturer's instructions for suitability. Paper materials are available in the form of bags or flat disposable wraps. Both types are sealed with adhesive indicator tape. Thecombination paper/ plastic peel packs are available in varied sizes of preformed bags or rolls of varied widths that can be cut to the desired length. Either type can be sealed with the adhesive indicator tape or self-sealed. Heat sealed plastic or nylon tubing should only be used as an overwrap after the pack has been sterilized. Heat sealed overwrapping will extend a 30 day shelf life to 180 days.
Protocol : Use of Autoclaves
To sterilise solutions or equipment it is necessary to autoclave them to 15 Psi for 20 minutes. Apparatus to be autoclaved should be placed in sterilising bags or wrapped in tinfoil and autoclave tape placed on the packet (autoclave tape has the barely visible strips. The items may then be placed in the autoclave and sterilised under the operation instructions for the machine.
Autoclaves should be used as the preferred route of sterilisation wherever possible, with the exception of radioactive samples.
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Sterilization procedures