STERILIZATION PROCESS & MANAGEMENT

PRESENTED BY:
ATAULLA KHAN
MOHAMMAD ZUBAIR
M. ARCH. HEALTHCARE ARCHITECTURE
1ST SEMESTER SESSION 2016-17
STERILIZATION
PROCESS & 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, and
viruses)
 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
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STERILIZATION:PROCESS&MANAGEMENTT
SPEAKER: ATAULLA KHAN

2/22
Types of sterilization
Sterilization falls into the following three categories:
A. High temperature/pressure sterilization (autoclave)
B. Chemical sterilization
C. Radiation sterilization

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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.

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.
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Ethylene Oxide Gas:
 It is an effective, low temperature chemical
sterilization method.
 Temperatures reached are usually in the 50-60°C
range.
 It takes longer than steam sterilization, typically,
16-18 hours.
Used to sterilize items that are heat or moisture
sensitive.
B. Chemical Sterilization

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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 Radiation
E-beam generator delivers a high dose of electrons in a narrow beam
at the items to be sterilized.
B. X-Ray Sterilization
This 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.

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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.

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The sterile processing department (SPD)…
THEY DIVIDE EACH OF THE CLEANING STAGES INTO SEPARATE ZONES
Decontamination
Prep and Pack
Sterilization
 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 providing
sterile surgical instrumentation to the OR as well as all other areas
that require sterile goods.
SPEAKER: MOHAMMAD ZUBAIR

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Decontamination
Prep and Pack
Sterilization
Soiled Return
Sterile Storage

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Design Layout

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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.

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Workflow for Decontamination

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Decontamination Cleaning & Drying
Automated Cleaning Manual Cleaning
The washer disinfector renders its
load, i.e. safe to handle.
No automated disinfection of
instruments and utensils, increases
the risk of contaminations and
infections.
Disinfection and cleaning of
noncritical goods prevents hospital
acquired infections.
Contamination risk for staff due to
exposure to soil and liquids.
Staff safety-cleaning process takes
place in a closed chamber which
means no risk for splashes and
thereby contamination.
Wet goods may cause re-
contamination
Correct drying after cleaning can
easily be arranged and integrated into
the process.

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This area as being the ‘clean room’ Where-
-Instrument sets and trays are assembled,
-wrapped
-and placed
into the sterilizers correctly
Prep & Pack?

Work flow for Prep & Pack
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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
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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
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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.
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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

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.
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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.
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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
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Sterilization: A review of the basics, By Gayla Tilton and Myrna Kauffman
Medical 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-workflow
http://www.maximintegrated.com/en/app-notes/index.mvp/id/5068
Bibliography:
22/22
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STERILIZATION PROCESS & MANAGEMENT

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