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Sterilize Instruments

Sterilize Instruments. UNCLASSIFIED//REL TO NATO/ISAF. Sterilization and Disinfection. Patient-care items are categorized as critical, semi critical, noncritical, depending on the potential risk for infection associated with their intended use. Critical Items.

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Sterilize Instruments

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  1. Sterilize Instruments UNCLASSIFIED//REL TO NATO/ISAF

  2. Sterilization and Disinfection • Patient-care items are categorized as critical, semi critical, noncritical, depending on the potential risk for infection associated with their intended use.

  3. Critical Items • Critical items used to penetrate soft tissue or bone have the greatest risk of transmitting infection and should be sterilized by heat. • Surgical instruments, periodontal scalers, scalpel blades, surgical dental burs

  4. Critical Items • Dental Scalers • Surgical Forceps • Periosteal Elevator

  5. Semicritical Items • Semicritical items touch mucous membranes or nonintact skin and have a lower risk of transmission; because the majority of semicritical items in dentistry are heat-tolerant, they also should be sterilized by using heat.

  6. Semicritical Items • If a semicritical item is heat-sensitive, it should, at a minimum, be processed with high-level disinfection. • Dental mouth mirror, amalgam condenser, reusable dental impression trays, dental handpieces.

  7. Semicritical Items • Although dental handpieces are considered a semicritical item they should always be heat-sterilized between uses and not high-level disinfected.

  8. Semicritical Items • Dental Mirror • Amalgam Condenser • Reusable Impression Trays

  9. Noncritical Items • Noncritical items contact intact skin and can be disinfected. • Radiograph head/cone, blood pressure cuff, pulse oximeter

  10. Noncritical Items • Radiograph Head • Blood Pressure Cuff • Pulse Oximeter

  11. Transport Contaminated Items • Handle carefully to prevent exposure to sharp instruments that can cause a percutaneous injury. • Place items in a puncture proof container, at the point of use (operatory), and transport to the sterilization area.

  12. Transport Contaminated Items • Containers or dental cassettes are ideal ways to transport contaminated items.

  13. The Central Processing Area • The central processing area (or sterilization area) should be divided into sections. 1) receiving, cleaning, and decontamination 2) preparation and packaging 3) sterilization 4) storage

  14. The Central Processing Area • Contaminated items should never be mixed with sterilized items.

  15. Receiving, Cleaning, Decontamination • Contaminated items should be received, sorted, cleaned, and decontaminated in one section of the processing area. • Cleaning should precede all disinfection and sterilization processes manually or mechanically.

  16. Precleaning Instruments • To avoid injury from sharp instruments, wear puncture- resistant, heavy-duty utility gloves when handling or manually cleaning contaminated instruments. • A mask, protective eyewear and gown or jacket should also be worn. 

  17. Precleaning Instruments • Personal Protective Equipment

  18. Precleaning Instruments • Visible debris left on instruments makes sterilization and disinfection ineffective.

  19. Precleaning Instruments • Precleaned instruments

  20. Preparation and Packaging • In another section of the processing area, cleaned instruments and other dental supplies should be inspected, assembled into sets or trays, and wrapped, packaged, or placed into container systems for sterilization.

  21. Preparation and Packaging • Hinged instruments should be processed open and unlocked.

  22. Preparation and Packaging • Sterilizer indicators should be used in every package as well as an external indicator with each sterilization load. (example indicator tape) • Types of indicators vary with the type of sterilizer.

  23. Preparation and Packaging • Packaging materials (example, wraps or container systems) allow penetration of the sterilization agent and maintain sterility of the processed item after sterilization. • Critical and semicritical items that are stored should be wrapped.

  24. Preparation and Packaging • Self-sealing pouches • Sterilization wrap for cassettes • Indicator tape

  25. Sterilization • The sterilization section of the processing area should include the sterilizers and related supplies, with adequate space for loading, unloading, and cool down without cross contamination.

  26. Sterilization • The sterilization times, temperatures, loading and other operating parameters recommended by the manufacturer, as well as instructions for correct use of containers, wraps, and chemical or biological indicators, should always be followed.

  27. Sterilization • When loading the sterilizer, items to be sterilized should be arranged to permit free circulation of the sterilizing agent (example: steam, chemical vapor, or dry heat). Manufacturer’s instructions for loading the sterilizer should always be followed.

  28. Sterilization • All pouched instruments should be placed in a rack for proper sterilization and drying.

  29. Sterilization • Clear side of one pouch faces the paper side of the next pouch. • If rack not available, place pouches paper side up to allow venting of the water that forms inside the bag.

  30. Sterilization • Do not pile pouches on top of each other or allow packs or wrappings to touch chamber walls.

  31. Sterilization • Packs require space between them to allow proper sterilization.

  32. Sterilization • Allow sterilized packs and pouches to dry inside the sterilizer. • Packs should not be touched until they are cool and dry because hot packs act as wicks, absorbing moisture, and hence, bacteria from hands.

  33. Sterilization • Sterilizers should be monitored by mechanical, chemical, or biological indicators to ensure sterilization is attained. • Consult with the manufacturer’s directions for proper selection and use of indicators.

  34. Sterilization Processes • Steam Sterilization • Dependable and economical • Unsaturated Chemical-Vapor Sterilization • Less corrosion than steam sterilization • Hazardous waste disposal requirements

  35. Sterilization Processes • Dry-Heat Sterilization • Prolonged process • High temperatures required are not suitable for certain patient-care items and devices. • Sterilization of Unwrapped Instruments • Sterilizing unwrapped items for immediate use • “Flash sterilizing”

  36. Sterilization Processes • Other Sterilization Methods • Heat-sensitive critical and semicritical instruments can be sterilized by immersing them in liquid chemical germicides with certain essential post sterilization steps. • May require12 hours of complete immersion.

  37. Storage of Sterilized Items • The storage area should contain enclosed storage for sterile items and disposable (single-use) items. • If packaging is compromised, the instruments should be recleaned, packaged in new wrap, and sterilized again.

  38. Storage of Sterilized Items • Dental supplies and instruments should not be stored under sinks or in other locations where they might become wet.

  39. Replenishing Operatory • At the end of every day, an inventory of the supplies in the dental operatory should be done to identify inventory deficiencies and should be replaced to be prepared for the following day.

  40. سوالات؟ Questions? UNCLASSIFIED//REL TO NATO/ISAF

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