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Where can I source a copy of the Sterilisation Standards?
Relevant
Standards for those involved in decontamination and
sterilization in both hospitals and office-based practice are as
follows:
Hospitals:
Australian/New Zealand Standard 4187 2003 (AS/NZS 4187:2003)
Cleaning, disinfecting and sterilizing reusable medical and
surgical instruments and equipment, and maintenance of
associated environments in health care facilities.
Office-based
facilities:
Australian/New Zealand Standard 4815 2006 (AS/NZS 4815:2006)
Office-based health care facilities not involved in complex
patient procedures and processes-Cleaning, disinfecting and
sterilizing reusable medical and surgical instruments and
equipment, and maintenance of the associated environment.
Copies of
current Standards are available from:
Standards New
Zealand, Level 10, 155 The Terrace, Wellington 6001
or
Standards New
Zealand, Private Bag 2439, Wellington 6020
Telephone:
(04) 498 5990, Facsimile: (04) 498 5994, E-mail: snz@standards.co.nz
Web site:
https://www.standards.co.nz
How should
instruments be presented for sterilization?
AS/NZS 4187:2003
states in 3.4 Specific Packaging and Wrapping Requirements,
Clause 3.4.1 Instruments (Page 28) the following:
Instruments
with hinges or ratchets
shall remain open and unlocked. Consultation shall take
place with end users regarding the presentation of instruments
for sterilization. For ease of handling after sterilization,
instruments in the open and unlocked position may be placed on
specially designed instrument holders, in required order, as
prescribed by the end user.
Multiple-part
instruments for sterilization shall be disassembled or
sufficiently loosened prior to packaging to permit the
sterilizing agent to come into contact with all parts of the
instrument. Instrument sets should be packaged in a manner that
prevents damage to delicate items.
Trays used for
packaging instrument sets should be perforated to allow for
penetration of the sterilizing agent and efficient drying.
Note: Recent
audits in both Australia and New Zealand have revealed that
instruments supposedly closed to 1st ratchet position only for
sterilization have been closed to 2nd, 3rd
and 4th ratchet position.
How should
hollowware be packaged?
AS/NZS 4187:2003
Section 3 PACKAGING AND WRAPPING OF ITEMS PRIOR TO STERILIZATION
Clause 3.4.2 (Page 29) states the following:
Hollowware
sets shall be packaged so that all openings face the same
direction and so that the contents cannot move inside the pack.
Non-porous
spacers
shall be used to separate hollowware when nested.
Clause 3.4.3.3
Flexible packaging materials also states:
Hazards exist
in the use of flexible packaging materials such as laminated
pouches. Hollowware items such as gallipots may entrap
condensate in the gusset or against the plastic surface of the
pack when laid flat, thus defeating the sterilizing process.
This form of packaging is best positioned on its side to allow
egress of air or condensate and ingress of the sterilizing
agent.
Hollowware
should be placed with the opening against the paper and not the
plastic.
Note: Non
porous spacers are not linen guards, single use tray liners or
non woven wrapping material, which are all porous items.
It should be
noted that some autoclavable plastic ware is designed with
spacers built in, therefore no additional spacer is required.
Do we really need to clean instruments on loan prior to use?
AS/NZS
4817:2003 Clause 12.4.3 Instruments on loan states the
following:
On receipt
into the health care facility, instruments on loan (loan
instruments), including loan sets, instruments from other health
care facilities and individual clinicians, shall undergo a
complete routine cleaning and processing prior to sterilization
by the wrapped method. Perceived lack of time shall not permit
the cleaning process to be bypassed. If soil and debris are
found to be present on receipt of the instruments on loan, the
condition of the instruments shall be reported to the supplier.
Following use, all instruments on loan shall be subjected to the
full cleaning process and sterilized before being returned to
their source.
Note: Some semi-critical and non-critical loan items, e.g.
gastroscopes, may require disinfection only. However, advice
should be sought from the instrument supplier as to the process
to be used prior to return. |