process of destroying pathogenic microorganism except bacterial spores to a level that is not harmful to man.

   Classification:

1.  High level disinfection- kills all bacteria, viruses, and fungi. Process may kill spores if contact time is sufficient and other parameters are met.

2.  Intermediate level disinfection- kills most bacteria, viruses, and fungi. The process cannot attack spores. It inactivate mycobacterium tuberculosis.

3.  Low level disinfection- kills most vegetative bacteria, fungi and the least resistant viruses including HIV.

Classification- 

    -E.H Spaulding’s Category of instruments    (1968)

1. Critical- items that enter normally sterile tissues or the vascular system. (e.g. surgical instruments, vascular catheters, implants, needles

2. Semi Critical- items that come in contact with mucous membranes or non-intact skin. (e.g. bronchoscope, gastrointestinal endoscope, vaginal speculum.)

3. Non- Critical- Items that come in contact with intact skin but not mucous membranes. (e.g. bed pans, BP cuffs, linens, food utensils, bedside furniture, walls.)

• Designated for this function - cleaning

• Adequate space

• Proper airflow and ventilation

• Workflow pattern

ATTIRE:

•  scrub uniform

• moisture-resistant barrier or apron

• shoe cover

• rubber gloves

• hair covering or cap

• safety goggles

• face mask

• neutral pH hemolytic enzyme solution/ enzymatic solution 5-10 mins. especially for lumens or other complex designs that are filled with debris or if the devices are very bloody and cannot be rinsed or wiped.

• Aniosyme DD1

-25ml of solution: 5 liters of cold or lukewarm water

• Cleaning agents should be:

-low foaming

-free rinsing

-preferably liquid

-biodegradable

-non corrosive

-non abrasive

• Ultrasonic cleaners- high frequency energy causes microscopic bubbles to form on a surface of the instruments and bubble implode, minute vacuum areas created, drawing out the tiniest particles of debris from the crevices of the instruments.

• Washer decontaminator- cycle consist of several washes and rinses followed by a steam sterilization.

• Cart washers

• Tunnel washers

EFFECTIVE PACKAGING SHOULD BE:

• Allow sterilant penetration

• Barrier to microorganisms

• Resist tearing/ puncture

• Seal with integrity

• Allow ease of presentation

• Be free of toxins/ low linting

• Be cost effective

CONSIDERATION:

• Packaging materials should be compatible with the sterilization process.

• Wrappers should be kept snug to prevent low spots, but not to allow strike through.

• Indicator tape should be used to secure the wrap (not safety pins, paper clips staplers, etc.)

• Identification should be written on the indicator tape and not on the wrapper.

• Size of packs- 12"x12"x20" 

• Weight 5.5 kg (12 lbs.)

• Density- should not exceed to 3.5 kg (7.2 lbs.)