Infection Preventionist Starter Kit: Cleaning, Disinfection, and Sterilization

A pair of blue gloved hands spraying and cleaning a cupboard door.

Reprocessing, which includes cleaning, disinfection, and sterilization of medical devices, is essential to ensure reusable medical and surgical instruments do not transmit infectious pathogens. Failure to properly disinfect or sterilize reusable medical equipment has led to numerous outbreaks.

 Infection preventionist (IP) tip: Ensure your facility utilizes the performance indicators recommended by the CDC (Centers for Disease Control and Prevention) outlined in Guideline for Disinfection and Sterilization in Healthcare Facilities.

Cleaning

Cleaning refers to the process of removing visible soil from items and surfaces. As discussed in an earlier chapter, cleaning must occur in order for disinfection and sterilization to be effective. It is important that initial cleaning occurs as close to point of use as possible, to prevent drying or caking of materials (bioburden) onto instruments. If cleaning must be delayed, instruments should be kept moist with a material such as enzymatic pretreatment cleaner to facilitate better cleaning in the reprocessing area.

Disinfection

Disinfection refers to the process of eliminating many pathogenic microorganisms, but not necessarily spores.

  • Low level disinfection: Kills some viruses, bacteria, and fungi.
  • Intermediate level disinfection: Kills a larger range of pathogens than low-level disinfection, but does not kill bacterial spores.
  • High level disinfection: Complete elimination of all microorganisms in or on an instrument, except for small numbers of bacterial spores. This can be achieved both manually (by hand scrubbing for example) and with automated systems. Some devices may require elements of both manual and automated reprocessing. Chemicals used for high level disinfection can be particularly harsh, so caution should be exercised where high level disinfection occurs. The IP should know where all high level disinfection occurs within the facility.

Sterilization

Sterilization refers to the process of destroying or eliminating all forms of microbial life, including spores.

Competency-based training

Your facility should have competency-based training programs for all personnel responsible for disinfecting and sterilizing equipment. It is strongly recommended that the sterile processing department lead and individuals who perform the majority of sterilization and disinfection procedures hold current certification from a recognized sterile processing course. One such certification is called Certified Registered Central Service Technician (CRCST).

Policies, procedures, and activity documentation

Reprocessing policies and procedures should be available in the event of a reprocessing error or failure that could result in the transmission of infectious disease, including the recall or removal of the device and risk assessment.

Reprocessing activity documentation should be kept and readily available in the location where the reprocessing occurs. The documentation varies according to the type of reprocessing and the associated requirements.

 IP Tip: Conduct routine audits to monitor adherence to and documentation of reprocessing procedures at least annually, as well as whenever a problem is suspected. Spend time observing the sterile processing department and staff in order to become more familiar with this critical area of the facility.


 Next steps for IPs

Click to expand the tabs below to see tips and activities for IPs.


Resources

Webinar recording

Watch the IP Lunch and Learn: Disinfection and Sterilization webinar recording (opens external video) for additional information and resources.

Slides (PDF) (opens external video) for this webinar recording are also available.

Observational and assessment tools

Reference and use the following observational and assessment tools as applicable in your facility.


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 Next: Laboratory and Surveillance

Last revised October 16, 2024