Proper cleaning and sterilization of instruments

The risk of spread of pathogens between clients is minimized when proper cleaning and sterilization of instruments is done, whether in a personal service setting (Ministry of Health and Long-Term Care) or a clinical setting (Public Health Ontario).

To ensure that an autoclave is functioning correctly, monitoring of the physical (time, temperature, and pressure), chemical (colour changing tape/label) and biological (spore test challenge) parameters must be performed on a schedule in line with the best practice guidelines for the setting. All autoclave runs must be monitored and recorded on a sterilization log sheet.

What does a biological spore test tell me about my autoclave?

There are two types of biological spore test results:

Negative (passed) test results (no spore growth) indicate that the mechanical sterilizer is operating properly. Continue to routinely challenge the sterilizer using spore tests in accordance with the best practice guidelines for the setting.
Positive (failed) test results (spore growth observed) indicate that the sterilizer has failed and is not operating effectively. Immediately implement the following steps.

What to do in the event of a positive (failed) biological spore test:

STOP use of this sterilizer immediately and initiate your written backup plan. Do not use any instruments that were reprocessed in this sterilizer since the last negative (passed) biological spore test. As an interim measure, use an alternative method of sterilization or single-use/disposable sterile instruments.
Immediately contact the Health Unit at 705.522.9200, ext. 464 or toll-free 1.866.522.9200 upon notification from the laboratory of a positive (failed) biological spore test.
Repeat the test. Do not release any items that were processed since the last negative (passed) test. If this repeat test is negative, and there is not an indication of a system malfunction based on physical and chemical parameters – continue as normal.
If it is determined that the sterilizer malfunctioned, have it repaired and then biologically tested until 3 consecutive negative results are obtained.
If the repeat test yields a positive (FAILED) result, review all items that were processed since the last negative test.
Complete a report that includes time, date, load description, results of mechanical, and chemical monitoring and contact the Health Unit to facilitate the conduction of a risk assessment.

To speak with a public health inspector for more information please call 705.522.9200, ext. 464 or toll-free 1.866.522.9200.

This item was last modified on April 21, 2016