Medical instrument washing rendered sterile surgical instruments, at the completion of the instrument washing process.
APIC Association for Professionals in Infection Control
Presented by: A. Drake, RN,
Director CS, Ohio State University,
International Annual Conference of APIC,
Oral Presentation by Ann Drake, President of APIC
The medical instrument washer, used with an all-in-ONE enzyme detergent medical instrument cleaning solution, offered increased protection to our reprocessing staff due to decreased handling but raised concerns about the efficacy of washer thermal disinfection as opposed to using the traditional washer sterilization. The medical instrument washer temperatures, times, and cycle treatments used rendered sterile medical instruments at the completion of the washer process.
The sequential functions of the medical instrument washer process from flush and rinse ultrasonic cleaner cycle, enzyme cold water washing, elevated temperature detergent washing, redundant rinses, lubrication with deionized water (DI) sprays, and to hot air drying at 240° F, for 4 minutes.
The medical instrument washer was challenged with selected medical instruments and utensils that are considered to be very difficult to clean. Included were 30 each of stainless steel non-perforating towel clips and stainless steel and glass medicine cups. Each item was rinsed (contaminated) with a 105 ml suspension of Staphylococcus aureus, Pseudomonsaeruginosa, Enterococcus fecalis and Candida albicans, in nutrient media, and then dried.
The medical instruments were processed in the medical instrument washer, in 3 separate loads during times of high volume SPD operation. All medical instruments were tested for sterility. Ten separate cultures were taken of the final rinse solution of instrument lubricant and deionized water prior to the drying cycle. A separate culture was taken of the instrument lubricant fluid.
All medical instruments were sterile at the completion of the cleaning process.
The medical instrument washer using the proper sequence of times and temperatures, and a medical instrument cleaning solution enzyme detergent is a valid replacement for the washer sterilizer.
Surgical instrument washers that are properly designed and use disinfector times and temperatures, can deliver sterile medical instruments at the completion of the washing cycles.
The medical instrument washer temperature cycles are:
cold water pre wash cycle: ambient to 95 F, 35 C,
wash cycle: 131 to 137 F, 55 to 58 C,
elevated thermal rinse cycles: 194 to 209 F, 90 to 98 C, and
hot air dry cycle temperatures: 158 to 230 F, 70 to 110 C.
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Medical instrument washer using the proper times, temperatures, and medical instrument enzyme detergent lubricant cleaner, rendered sterile surgical instruments.
All medical instrument were sterile at the completion of the instrument washing process.