sterilization process & management

PRESENTED BY:

ATAULLA KHAN

MOHAMMAD ZUBAIRM. ARCH. HEALTHCARE ARCHITECTURE

1ST SEMESTER SESSION 2016-17

STERILIZATIONPROCESS & MANAGEMENT

CONTEMPORARY TECHNOLOGY

What is Sterilization?? Sterilization is the process used to render a product free from all

forms of viable micro-organisms (bacteria, spores, fungi, andviruses)

Sterilization is required because not all micro-organisms have

been completely destroyed during the decontamination

process.

Within the SPD, the sterilization area is where sterilizers (steam,

and/or low temperature processes), are located including the

space for loading, unloading, and cooling. This can be

accommodated by a two or three zone system.

Variables that affect sterilization are:The dryness of devices to be processed

The temperature and humidity of the processing area

Whether or not the devices were properly prepared and loaded into the

sterilizer

Whether or not the sterilant is properly delivered into the system

The sterilizer’s condition and maintenance protocol

Whether or not the correct sterilization method and cycle were used

1/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT

SPEAKER: ATAULLA KHAN

2/22

Types of sterilizationSterilization falls into the following three categories:

A. High temperature/pressure sterilization (autoclave)B. Chemical sterilization

C. Radiation sterilization

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


3/22

Steam autoclave is the oldest, safest, and

most cost effective method of sterilization

in the medical equipment industry.

The steam reaches 121-148°C

The pressure chamber at 15 PSL.

The sterilization period is 10-60 minutes.

When steam enters the sterilization chamber

under pressure;It condenses upon contact with

cold items.

This condensation frees heat,

simultaneously heating and wetting

all items in the load, thus providing

heat and moisture.

A. Steam Autoclave

Application:Used mostly for surgical Instruments.

Not well suited for heat sensitive

materials and instruments.

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


Low Temperature Hydrogen Peroxide Plasma It is a low temperature, non-toxic, but fairly

expensive sterilization method.

Hydrogen peroxide is activated to create a reactive

plasma or vapor. Temperature range from 45-50°C.

Operating cycle times range from 45-70 minutes.

Best suited to sterilize heat sensitive medical equipment

such as endoscopic equipment.

4/22

Ethylene Oxide Gas: It is an effective, low temperature chemicalsterilization method. Temperatures reached are usually in the 50-60°Crange. It takes longer than steam sterilization, typically,16-18 hours.Used to sterilize items that are heat or moisturesensitive.

B. Chemical Sterilization

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


5/22

C. Radiation Sterilization

VHP, (Vaporized Hydrogen Peroxide): it only uses hydrogen peroxide in vaporized form

for sterilization.

In the VHP process, hydrogen peroxide vapour is

injected into the chamber via a series of pulses to

sterilize packaged medical and diagnostic

devices.

The cycle time is 2 hours.

The operating temperature ranges from 30-40°C.

A. E-Beam RadiationE-beam generator delivers a high dose of electrons in a narrow beam at the items to be sterilized.

B. X-Ray SterilizationThis is the process that is based on obtaining X-rays through

conversion of electron beams. X-rays offer excellent product penetration in sterilization, thoroughly

treating the surface and interior of a product.

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


6/22

A. Gamma, Beta Sterilization The product to be sterilized is exposed to radiation for 10 to 20 hours,

depending on the strength of the source.

The highest temperatures reached in gamma sterilization are usually

30-40°C.

The result is ionic energy that becomes converted to thermal and

chemical energy.

This energy kills microorganisms by disruption of the DNA molecule,

therefore preventing cellular division and propagation of biologic life.

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


7/22

The sterile processing department (SPD)…

THEY DIVIDE EACH OF THE CLEANING STAGES INTO SEPARATE ZONES

Decontamination

Prep and PackSterilization

The SPD is the department within a healthcare facility that

processes and controls medical supplies, devices, and equipment,

for patient care areas of the facility.

The SPD plays an integral role within a healthcare facility by providingsterile surgical instrumentation to the OR as well as all other areas

that require sterile goods.

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT

SPEAKER: MOHAMMAD ZUBAIR

8/22

Decontamination

Prep and Pack

Sterilization

Soiled Return

Sterile Storage

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


9/22

Design Layout

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


10/22

What is the Decontamination Process??

The use of physical or chemical means to remove, inactivate or

destroy blood borne pathogens on a surface or item to the point

where they are no longer capable of transmitting infectious particles

and the surface or item is safe for handling, use or disposal.

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


11/22

Workflow for Decontamination

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


12/22

Decontamination Cleaning & Drying

Automated Cleaning Manual Cleaning

The washer disinfector renders itsload, i.e. safe to handle.

No automated disinfection ofinstruments and utensils, increasesthe risk of contaminations andinfections.

Disinfection and cleaning ofnoncritical goods prevents hospitalacquired infections.

Contamination risk for staff due toexposure to soil and liquids.

Staff safety-cleaning process takesplace in a closed chamber whichmeans no risk for splashes andthereby contamination.

Wet goods may cause re-contamination

Correct drying after cleaning caneasily be arranged and integrated intothe process.

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


13/22

This area as being the ‘clean room’ Where-

-Instrument sets and trays are assembled,

-wrapped

-and placed

into the sterilizers correctly

Prep & Pack?

S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


Work flow for Prep & Pack

14/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


It is the instrumentation and equipment

warehouse.

If a product is disinfected and/or sterilized

it will have a home in this department or in

another sterile storage location.

Like a warehouse, orders are packed

and sent to other locations for use on

specific patients undergoing specific

procedures.

Sterile storage

15/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


Sink modules are used for--manual soaking-hand washing-and rinsing

of instrumentation.

The sink may include--a main and treated water faucet-a spray rinser,-air gun-and tubular manifold.

Material comes to the SPD decontamination room via a “Dirty Elevator” or door way. First area for processing is the SSS.

Usually there are three sinks.The first sink is filled with water and an enzymatic cleaner. Here the surgical items are allowed to soak. The second sink is used for washing and scrubbing of the surgical devices and instruments. The third basin is the rinse sink…

Stainless Steel Sink Module

16/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


These are used for instruments that are-

-heavily covered in bio burden or

-have hard to clean surfaces.

-This machine creates vibration or cavitations

waves that shear soils from instruments.

Ultrasonic Cleaner

Instruments are submersed in a liquid detergent bath.

The passage of Ultrasonic waves cause

cavitations (vibration).

The vibrations create mechanical energy

which removes debris from the surfaces.The detergent traps the loose debris from

settling on the instruments.

17/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


The washer-disinfectors effectively cleans-

-thermally disinfects,

-and dries moisture

From-

-temperature stable utensils,

-surgical instruments,

-anesthesia materials

-and glassware prior to any necessary

sterilization.

water boils at 212 degrees F .when it boil it means water is turning into

steam.

At these extreme temperatures most organic

organism will meet their demise.

Washer Disinfector Accomplish

18/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


The sterilizing agent can be steam, plasma, ozone, EO Gas, or other

low temperature solutions.

Sterilizer Achieve

Sterilizers kill the remaining microbial

life left on surgical instruments.

How do we know if the sterilizer is killing

microbial life?

Biological indicators monitor the effectiveness of the steam sterilization

process.

Sterilizers work by using steam that is

forced through valves, channels,

chambers, and drains.

19/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


Sterilization planning

Sterilizers generate intense heat.

Due to these conditions architects and

hospitals must make sure the adequate space

is giving for cooling of the cart and wrapped

instrument trays.

20/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


Improved ergonomics

Improved throughput

Efficient staging of loads to be

processed

Reduction of labor time

Less handling of heavy and hot

(temperature) loads

Reduction of amount of loading

equipment required

Benefits of Automation

21/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT


Sterilization: A review of the basics, By Gayla Tilton and Myrna KauffmanMedical sterilization methods, By mehul patel, Design engineer, Lemo usa, inc.http://medcitynews.com/2012/09/hospital-are-using-pulses-of-uv-light-from-this-device-to-kill-superbugs-that-cause-infections/http://www.slideshare.net/dpjphx/optimizing-sterile-processing-workflowhttp://www.maximintegrated.com/en/app-notes/index.mvp/id/5068

Bibliography:

22/22 S

TE

RIL

IZ

AT

IO

N:P

RO

CE

SS

&

M

AN

AG

EM

EN

TT

Thank You!For listening, joining and cooperating us…


http://medcitynews.com/2012/09/hospital-are-using-pulses-of-uv-light-from-this-device-to-kill-superbugs-that-cause-infections/

http://www.slideshare.net/dpjphx/optimizing-sterile-processing-workflow

http://www.maximintegrated.com/en/app-notes/index.mvp/id/5068

sterilization process & management

Education