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STERILISATION

STERILISATION. AS/NZS 4815: 2006 Office-based health care facilities – Reprocessing of reusable medical and surgical instruments and equipment, and maintenance of the associated environment. Packaging and wrapping Steam sterilisers Loading of sterilisers

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STERILISATION

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  1. STERILISATION Francie Morgan ICNS Nov2012

  2. AS/NZS 4815: 2006 Office-based health care facilities – Reprocessing of reusable medical and surgical instruments and equipment, and maintenance of the associated environment. • Packaging and wrapping • Steam sterilisers • Loading of sterilisers • Unloading of sterilisers • Validation and monitoring of sterilisers • Quality management • Storage of sterile items Francie Morgan ICNS Nov2012

  3. Packaging and wrapping Instruments remain opened and unlocked Trays used as part of the instrument set shall be perforated Bags - single use steri peel pouches. Positioned on side. Holloware should be placed with the opening against the paper side of the pouch Sealing: Heat sealers most preferred. Cannot tape down steripeel bags Steriliser indicator tape colour change and bag folded down correctly An external chemical indicator is required on the outside of all wrapped items An internal class IV clemical indicator to be placed inside each package in the area considered to be least accessible to steam penetration. May or may not be the centre of the pack THE USE OF INDICATING TAPE OR OTHER CHEMICAL INDICATOR IS PURELY TO INDICATE THAT THE ITEM HAS BEEN EXPOSED TO THE CONDITIONS OF THE STERILISER, AND SHOULD NOT BE TAKEN AS EVIDENCE OF STERILITY Francie Morgan ICNS Nov2012

  4. YES ! Francie Morgan ICNS Nov2012

  5. Microwave ovens, pressure cookers, incubators, ultraviolet cabinets, boiling water units, ultrasonic cleaners and similar appliances will not sterilise. Operator manual with each machine is essential DRYING CYCLE for packages Do not sterilise liquids Steam Sterilisers Francie Morgan ICNS Nov2012

  6. NO ! Francie Morgan ICNS Nov 2011

  7. Loading of Sterilisers • Packaged items • Correct loading is essential, efficient air removal for total steam penetration and saturation and drainage of condensate • Side rather than flat • No packs touching chamber walls • “Toaster” rack • Side loading - paper to laminate • Flat loading - paper surface downwards • Unpackaged items • Perforated trays, placed flat • New chemical indicator in each tray per each cycle Francie Morgan ICNS Nov2012

  8. Unloading of sterilisers • For packaged items (drying cycle) • Visual inspection to check load is dry and indicators have made colour change • Check print outs for compliance with parameters • Items requiring cooling are to be placed in low activity area, on surface/shelf/rack that allows for cooling • Items that have been dropped on floor, compressed, torn, have broken seals, or are wet are considered non sterile and should be reprocessed • For unpackaged items • Sterility maintenance is not possible. Store clean and dry. Consider re sterilisation immediately prior to use Francie Morgan ICNS Nov2012

  9. Monitoring of sterilisers • Internal cleaning of loading tray, rack and internal walls weekly • Manufacturer’s instruction for cleaning agent • Calibration isNOTvalidation • Schedule for monitoring as per Table 7.1 A/NZS 4815:2006 Francie Morgan ICNS Nov2012

  10. Validation of sterilisers • To be done following: • installation and commissioning of new equipment • major equipment servicing of the steriliser • modifications or technical changes to the steriliser • changes to the packaging materials • changes to the contents and size of trays and load packs Francie Morgan ICNS Nov2012

  11. What is validation? • Validation policy/protocol includes: • Calibration • Parameters of cycles selected for validation • Description of items being validated • Description of cleaning, drying and packaging of items prior to validation • Location and position of biological indicator • Location and position of packs • 3 sterilisation cycles time and date • Results of all monitoring processes • If cycle failure, a written report of investigation into cause of failure • The date the vaildation was completed , name of person performing validation and name of person confirming results Francie Morgan ICNS Nov2012

  12. Ultrasonic cleaners • Aluminium foil test performed daily • Water strainers and drain filters are visually inspected and cleared daily • Change water frequently Francie Morgan ICNS Nov2012

  13. Francie Morgan ICNS Nov2012

  14. QualityManagement • Procedure manual • Maintenance records • Monitoring tests records • Training of users • Correct use of relevant class of chemical indicator (class IV) • Use of biological indicators • Maintain validation Francie Morgan ICNS Nov2012

  15. Storage of Sterile items • Area free of dust and insects • Open shelving above floor level by at least 250mm and from ceiling by at least 250mm • Protected from direct sunlight • Shelves,cupboards shall be surface intact and easily cleaned • Stock rotation based Francie Morgan ICNS Nov2012

  16. Let’s get it right Francie Morgan ICNS Nov2012

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