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Sterilizers

Sterilizers. Sterilizers Definition of sterile Free of microorganisms ( bacteria) Bacteria Bacteria can be broken down into two groups Pathogenic - cause disease Nonpathogenic - do not cause disease. Pathogenic / Nonpathogenic To make something sterile, we want to destroy ALL bacteria.

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Sterilizers

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  1. Sterilizers

  2. Sterilizers • Definition of sterile • Free of microorganisms (bacteria) • Bacteria • Bacteria can be broken down into two groups • Pathogenic - cause disease • Nonpathogenic - do not cause disease

  3. Pathogenic / Nonpathogenic • To make something sterile, we want to destroy ALL bacteria

  4. Bacteria • Some bacteria are “spore forming” which means they have the ability to transform themselves into spores and hibernate for an indefinite period of time • They begin to grow again when placed in a favorable environment (such as the human body) • Spore forming bacteria are extremely durable and a great deal of effort is necessary for their destruction

  5. Bacteria (Continued) • Sterilization is successful in destroying all • bacteria because it fools the spore forming • bacteria out of hibernation by giving it two of • the three conditions necessary for growth • Correct temperature • Moisture • Once bacteria starts to grow and reproduce, it is • easy to destroy

  6. Sterilizing vs. Sanitizing • Sanitizing is the process of cleaningsomething • A dishwasher sanitizes dishes by killing most of the bacteria but not all, so the item cannot be considered sterile • Sanitizing an item is not effective for killing spore forming bacteria

  7. What is sterile? • There is no way we can measure all products being sterilized to ensure that every organism has been destroyed • Instead, a standard has been established that uses probabilities

  8. Sterile • An item is considered to be sterile when: • All the conditions necessary for sterilization are present • And the probability is that no more than 1 in 1 million microorganisms survived • This is the present standard used in the United Statesfor labeling a product “sterile”

  9. The ideal sterilant would • Destroy all types of microorganisms including viruses, bacteria and fungi • Not adversely affect medical instruments • Act rapidly, allowing use of the instruments again as soon as possible • Penetrate thoroughly enough to ensure sterilization of even the most inaccessible surfaces • Diffuse through barrier packaging, allowing sterilization of the instruments without risk of recontamination after sterilization

  10. The ideal sterilant would (Continued) • Be non-hazardous to humans, non-flammable and non-explosive • Leave no residue after sterilization which could • harm the patient • Be readily available, easy to store and use • Be inexpensive • Unfortunately, since no single agent meets all of • these criteria, healthcare facilities must utilize a • range of sterilization methods to meet their needs

  11. Methods of Sterilization • Based on several factors such as cost, type of • material to be sterilized, and size of the material to be sterilized, overview of methods; • Flame • Chemical Agents • Gamma Radiation • Ethylene Oxide (ETO) • Plasma • Heat

  12. Heat • The most widely used method of sterilization • If a microorganism is exposed to the right • amount of heat for the right amount of time, that • microorganism will be destroyed • The method of heat being used will have an important impact on the sterilization time • Two types of heat • Dry Heat • Moist Heat

  13. Dry Heat Sterilization • Works much like an oven • “Cooks” the microorganism at temperatures around 420°F for 3 to 5 hours

  14. Moist Heat Sterilization • The most widely used because microorganisms are most easily killed by moist heat • The most common type is the steam pressure • Sterilizer • The most cost effective method of sterilization • The greater the pressure the greater the temperature

  15. Moist Heat Sterilization (Continued) • Sterilization is achieved by injecting steam, under pressure, into the sterilizer chamber • The increase in pressure causes a corresponding increase in temperature • Once the necessary temperature for sterilization has been achieved we stop injecting steam

  16. Sterilization • Sterilization is achieved by ensuring that the • following conditions exist in the chamber • Correct temperature • Time

  17. Basic Steam Sterilizers • High Vacuum Sterilizers (Autoclave) • Rely on electrical pumps or mechanical devices to produce a high vacuum in the chamber • This vacuum removes air from the chamber • This is to ensure all air has been removed from the packages so that steam will penetrate well

  18. Basic Steam Sterilizers (Continued) • Gravity Sterilizers • Uses steam entering from the top of the chamber to drive the relatively cold air out through the bottom of the chamber and drain • Generally used for smaller packages that do not • contain much air • While it is not a “vacuum sterilizer” a vacuum can still be drawn in the chamber

  19. Basic Steam Sterilizers (Continued)

  20. Washer Sterilizers • Uses the same sterilization procedures as a • steam sterilizer but has the capability to wash the instruments before they are sterilized • These larger versions of sterilizers are usually • found in the Central Sterile Section (CSS)

  21. Major Components of a Steam Sterilizer • Jacket • Chamber

  22. Major Components of a Steam Sterilizer • (Continued) • Jacket • The outer shell and narrow sealed space • surrounding the inner compartment (chamber) • Has two functions: • Fills with steam and acts as a reservoir for the • chamber steam • Helps preheat and regulate the chamber temperature

  23. Major Components of a Steam Sterilizer • (Continued) • Chamber • The inner compartment where the items to be • sterilized are placed • The door is sealed with a gasket to prevent the steam from escaping • At 30 PSI of chamber pressure, a door that measures 20” X 20” will have 12,000 pounds of pressure on it’s inner surface

  24. Common Supporting Utilities • Electricity • 220 VAC, 3-Phase used for steam generator heater operation and vacuum pumps on larger sterilizers • 110 VAC is used for sterilizer control • Water • Every steam sterilizer uses water • Water must be within the pressure range stated and must flow at the necessary volume required by the manufacturer’s specifications

  25. Common Supporting Utilities (Continued) • Poor water supply can lead to poor vacuum which leads to wet packages • Steam • Must be in the correct range of pressure, volume and moisture content • Low pressure may cause a failure to reach • temperature • High pressure may cause an over temperature • condition and may damage plumbing components

  26. Common Supporting Utilities (Continued) • Steam • Typical moisture content is about 97% saturated Steam • Too much saturation may lead to wet packages • Steam pipes should be well insulated, dry, and away from cold areas such as air conditioning piping or the ground

  27. Pressure • Measured in two ways: • Dynamic • Static Dynamic pressure • Dynamic pressure is pressure in the line when the substance (air, water, steam) is flowing • Static pressure • Static pressure is the pressure in the line when • there is no movement of the substance in the • line; is generally lower than dynamic pressure

  28. Vacuum and Pressure • Vacuum is pressure less than 1 atmosphere • Molecules move farther apart – means free path • The Plasma Sterilization Process is a vacuum • process of: • Low Temperature Plasma • Low Thermal Transfer • Faster Diffusion Rates

  29. Atmospheric Pressure • 1 Atmosphere = 760 mm of Hg • 1 Torr = 1 mm of Hg • 1 Torr = 13.3 Pascal • Low Thermal Transfer • Thermos Bottle • 2 degree rise in 24 hours • Load at 20 degrees Centigrade • Walls at 45 degrees Centigrade

  30. Diffusion • Microwave popcorn aroma • Diffusion is limited by collisions • Vacuum has fewer collisions • H2O2 must diffuse from injection valve into load • Water • Higher in the mountains, water boils at lower • Temperatures • Lower pressure = lower boiling temperatures

  31. Quality Assurance • Indicators of Sterilization • Recorders and Printers • Verification of Sterilization • Indicators of Sterilization • Test packs • Used to determine if the product being sterilized has in fact been sterilized • Indicators of sterilization • Does not indicate that sterilization has taken place

  32. Indicators of Sterilization (Continued) • Designed to indicate that certain conditions necessary for sterilization are present • Autoclave Tape • Placed on the outside of packages to hold • them together and show exposure to heat • The tape has strips that will darken when • heated • The tape only indicates that the outside of the package was exposed to heat

  33. Indicators of Sterilization (Continued) • Diac • Small glass tube with a chemical pellet inside that melts and turns to a dark color when exposed to the right amount of heat • Placed in the center of surgical packs to assure the user that the inside of the package was exposed to heat

  34. Indicators of Sterilization (Continued) • “Bowie-Dick”/”Check-a-Clave” Sheets • Sheets of specially prepared paper that turn dark when exposed to heat in a vacuum • Placed inside test packs to determine if high vacuum sterilizers are removing the air from the package • Failure of this test indicates a malfunction of the vacuum system, i.e. Leak • These sheets are only used in high vacuum sterilizers

  35. Recorders and Printers (Continued) • Used to keep a permanent record of each • sterilization cycle • Recorders • The older style device • Uses a round paper disk and an ink pen to record temperature as the disk makes a complete revolution • One complete revolution indicates a 24 hour period and then is replaced • Can be difficult to read and the recorder itself • requires frequent maintenance

  36. Recorders and Printers (Continued) • Printers • Records more data than recorders and no interpretation is required • Prints the status of the sterilizer in every phase of Sterilization • Information may include the sterilizer number, • pressures, temperatures, type of cycle, and alarms • Requires very little maintenance

  37. Verification of Sterilization • The only method that actually proves that sterilization has taken place involves killing live organisms • The two most common forms of this test • Spore strip • “A-test”

  38. Spore Strip and “A-test” • These are spores of non-pathogenic bacteria in a container which is placed inside a test pack and sterilized • After sterilization the spores are placed in an • incubator to provide the correct temperature, moisture, and nutrition necessary for growth • If no growth occurs after the required time (2 to 7 days) sterilization has been proven • This test is usually performed once a day for • steam pressure sterilizers and for every load on a • gas sterilizer

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