Sterilization Monitoring
- MECHANICAL MONITORING. Physical or mechanical monitoring involves physically checking the sterilization equipment during use to ensure that the cycle indicators are coming on at the appropriate times, which indicate that ...
- CHEMICAL MONITORING. Chemical monitoring involves the physicochemical change of a chemical system in the presence of heat. ...
- TABLE 1. COMMON REASONS FOR STERILIZATION FAILURES IN DENTISTRY.
- BIOLOGICAL MONITORING. Biological indicators, impregnated with nonpathogenic bacterial spores, provide the quintessential test for sterilization.
- PROCEDURES FOR POSITIVE SPORE TESTS. If a positive result occurs with any sterilizer other than steam, all items that were processed in the failed sterilizer need to be identified and ...
- TABLE 3. REASONS FOR A POSITIVE BIOLOGICAL INDICATOR TEST. Exposure time not appropriate. The biological indicator was contaminated during the process. The biological indicator test was not appropriately prepared.
- DOCUMENTATION. Written documentation is almost as critical as the process itself. Failure to document is often interpreted as failure to implement.
- CONCLUSIONS. The monitoring and documentation of sterilization parameters are critical components of quality assurance.
- REFERENCES. Kohn WG, Collins AS, Cleveland JL, et al. Guidelines for infection control in dental healthcare settings—2003.
What are the different sterilization parameters used for monitoring?
Temperature and time are examples of steam sterilization parameters. The concentration of ethylene oxide and time are selected for EO sterilization. We have available several different products for use in sterilization monitoring.
What are the methods of sterilization?
Sterilization by means of hot formaldehyde vapors under pressure. Clean area Place where sterilized instruments, fresh disposable supplies, and prepared trays are stored. Contaminated area Place where contaminated steam are brought for pre-cleaning. Critical instruments Item used to penetrate soft tissue or bone. Dry heat sterilizer
What information should be included in a sterilization report?
For each sterilization cycle, record the type of sterilizer and cycle used; the load identification number; the load contents; the exposure parameters (e.g., time and temperature); the operator’s name or initials; and the results of mechanical, chemical, and biological monitoring.
What is a sterilization indicator?
Sterilization indicators are useful tools that help in routine monitoring, load monitoring, and qualification of the steam sterilization procedure. Sterilization indicators show whether the conditions in a steam autoclave process were sufficient to achieve a specific state of microbial inactivation.
What are the three types of sterilization monitoring quizlet?
Describe 3 forms of sterilization monitoring. 1) Physical- tempt, pressure, exposure time 2)chemical- change colors when exposed to certain conditions. 3) Biologic- only way to verify sterilization.
What 3 monitors should be used as quality assurance for every sterilization process?
As part of the quality assurance program, the practice should comply with the CDC, which recommends that three types of sterilization monitoring take place to ensure reusable dental instruments are safe for patient use: mechanical, chemical, and biological1-3.
What is physical sterilization monitoring?
Physical or mechanical monitoring involves physically checking the sterilization equipment during use to ensure that the cycle indicators are coming on at the appropriate times, which indicate that the equipment is functioning properly.
What are the methods of monitoring the quality of sterilization?
Biological indicators, or spore tests, are the most accepted means of monitoring sterilization because they assess the sterilization process directly by killing known highly resistant microorganisms (e.g., Geobacillus or Bacillus species).
What are sterility indicators?
Sterility indicators, are the indicators that are used for check the quality of sterilization & monitoring of the sterilization process. It may be also required to check whether microbial growth occurs or not in terms of sterilization quality & process known as “sterility indicators”.
What are the two types of physical indicators?
Physical Indicators.Chemical Indicators (Internal and External)Biological Indicators.Sterilization Monitoring Record.Sterilizer Maintenance Record.
What are methods of sterilization?
Sterilization can be achieved by a combination of heat, chemicals, irradiation, high pressure and filtration like steam under pressure, dry heat, ultraviolet radiation, gas vapor sterilants, chlorine dioxide gas etc.
What is biological monitoring in the or?
Biological monitoring is a way of assessing chemical exposures by measuring the chemical or its breakdown products in a biological sample (usually urine, blood or breath).
1. Mechanical or physical autoclave sterilization monitoring
Mechanical monitoring means using hardware or tools that are used to check the time cycle, pressure, and temperature.
3. Biological autoclave sterilization monitoring
Biological autoclave sterilization operate with the use of two identical vials from the same lot.
What are the guidelines for sterilization?
For sterilization at a dental practice, the Centers for Disease Control guidelines recommend consistent monitoring and record-keeping of biological, physical/mechanical and chemical indicators for the type of sterilizer in use.
What is the only way to confirm a sterilizer is in working order?
With some indicators, monitoring will occur with every load, and with others, only periodically. · Biological indicators, or spore tests , offer the only definitive way to confirm a sterilizer is in working order, and effective in killing known highly-resistant microorganisms, such as Geobacillus or Bacillus species.
How often should you test a prevacuum sterilizer?
· Pre-vacuum sterilizers require additional testing, at least once per day. If a dental practice uses a pre-vacuum autoclave system, the team must confirm it is achieving the air removal level required for sterilization. The CDC recommends performing a Bowie-Dick test to detect air removal at least once per day, but tests can also be run with every load.
How often should a biological indicator test be run?
Stringent challenge to the sterilizer exist to ensure microorganisms are killed. The CDC recommends biological indicator tests run at least once per week. If the biological indicator fails, the CDC recommends running a second test.
What are mechanical and chemical indicators?
Note: Mechanical/physical and chemical indicators do not guarantee sterilization. Rather, they detect malfunction of equipment or errors in the process. · Physical/mechanical indicators provides vital clues in the sterilization process obtained by recording procedural and equipment data and checking for issues.
Is a sterilizer considered nonfunctional?
Until results are available ( more on that later), the sterilizer should be considered non-functional, and any instruments from that batch quarantined. In the meantime, mechanical/physical and chemical monitoring should be completed with every load. Note: Mechanical/physical and chemical indicators do not guarantee sterilization.
Is physical monitoring required for sterilization?
Otherwise, the recommendation is to complete physical monitoring in every sterilization cycle. While physical/mechanical indicator data is not legally required, documenting it is a really good idea. Think of it as an insurance policy, because it shows a sterilizer achieved the proper temperature for the correct amount of sterilization time gives ...
What are the advantages and disadvantages of heat sterilization?
Describe the three most common methods of heat sterilization, and list the advantages and disadvantages of each. -Dry heat: ortho, oral surgery, 1 hour, drys fast, no corrosion. Disadvantage: no plastic or fabric, cannot sterilize liquid. Disadvantage: not environmental, special solution, damage plastic & rubber.
What is a biological indicator?
Are vials or strips, also known as spore tests, that contain harmless bacterial spores and are used to determine whether a sterilizer is working . Chemical Vapor Sterilization. Is a piece of equipment that is used for sterilizing by means of hot formaldehyde vapors under pressure.
Why is sterilization monitoring important?
Sterilization monitoring involves assessing the effectiveness of the sterilization process so that problems with the use or functioning of the sterilizer can be detected ...
What is sterilization in dental?
Sterilization is a process designed to kill all microbes. In the dental office, sterilization mainly in-volves the heat processing of cleaned and packaged instruments through a steam autoclave, dry-heat sterilizer or unsaturated, chemical-vapor sterilizer. Also, sterilization procedures are used in some parts of the country to process certain kinds ...
What is chemical monitoring in dentistry?
Chemical monitoring in dentistry involves using heat-sensitive chemicals that indicate exposure to a certain temperature, a combination of temperature and time, or the presence of steam. These chemicals change color or form after the appropriate exposure. Their reaction to the exposure can be determined ...
Why should all three types of monitoring be used?
All three types of monitoring should be used because each provides different information. Physical monitoring includes periodically observing sterilizers as they are being operated to see if the gauges are indicating the proper temperatures and/or pressure.
Can you tell if a package is sterile?
They cannot indicate that the processed items are sterile. When process indicators are on the outside of a package or wrapped cassette, they can show if the item has been processed through the sterilizer. Packages ready to be processed through a sterilizer can look just like those that already have been processed.
What are the different types of sterilization indicators?
Different Kinds of Sterilization Indicators. There are different kinds of sterilization indicators. See them listed below: 1. Process Indicators. These are the most basic type of chemical indicators; they are also called throughput indicators. Process indicators are mostly used with people items to be sterilized.
What are some examples of specialty indicators?
Examples of these indicators are tape and the indicators that are found on plastic-peel pouches or paper. 2. Indicators for Use in Specific Tests. They are also called specialty indicators.
What are the indicators for use in specific tests?
Indicators for use in specific tests show the presence of air in the steam sterilizing autoclave. A perfect test would show that air, which prevents the conditions needed for sterilization, has not evaporated during the sterilization process or has entered the chamber via an opening in the system. Maintenance would need to be done on ...
What are multi parameter indicators?
Multi-parameter indicators react to two or more critical parameters of the sterilization cycle and show exposure to the sterilization process at given values of the selected parameters. Temperature and time are examples of steam sterilization parameters. The concentration of ethylene oxide and time are selected for EO sterilization.
How to process dental instruments?
1) Transport- To move contaminated items to the processing area 2) Cleaning- Clean instruments with a hands-free way 3) Packaging- Wrap/package instruments so that they can be sterilized 4) Sterilization- Load it, and label it correctly 5) Storage- Store clean instruments ...
What is the term for a structure formed inside of some bacteria that can withstand adverse conditions?
Sterilization of instruments by the means of heated air. Endospore . A resistant, format structure formed inside of some bacteria that can withstand adverse conditions. Event-related packaging. Instruments in packages should remain sterile indefinitely unless an event causes them to come contaminated.
What is a semicritical instrument?
Semicritical instruments. Items that comes in contact with oral tissues but does not penetrate soft tissue or bone. Single-parameter indicators. Tapes, strips, or tabs with heat-sensitive chemicals that change color when exposed to a particular temperature.
What is process indicator?
Process indicators. Tapes, strips, or tabs with heat-sensitive chemicals that change color when exposed to a certain temperature. Process integrators. Strips placed in packages that change color when exposed to a combination of heat, temperature, and time. Safety data sheet.
Mechanical Monitoring
Chemical Monitoring
- Chemical monitoring involves the physicochemical change of a chemical system in the presence of heat.6 Six classes of chemical indicators (Table 2) are recognized by the International Organization for Standards (ISO); three of these are commonly used in dentistry.7 The monitors used in dentistry contain heat sensitive chemicals/dyes that change color when exposed to cert…
Table 1. Common Reasons For Sterilization Failures in Dentistry.
- Improper timing
- Improper temperature
- Inappropriate sterilization method for item
- Unit malfunction
Biological Monitoring
- Biological indicators, impregnated with nonpathogenic bacterial spores, provide the quintessential test for sterilization. Spore testing is the only process that meets all sterilization parameters.12 The CDC recommends weekly use and some state dental practice acts require weekly spore testing.1 The biological indicator process involves the killing of externally added microorganism…
Procedures For Positive Spore Tests
- If a positive result occurs with any sterilizer other than steam, all items that were processed in the failed sterilizer need to be identified and isolated.1,9A disadvantage of the biological indicators is the extended time factor needed for results, making isolating packages from a sterilizer cycle from the previous 48 hours difficult. Regardless, all items from the failed test sterilizer should b…
Table 3. Reasons For A Positive Biological Indicator Test.
- Exposure time not appropriate.
- The biological indicator was contaminated during the process.
- The biological indicator test was not appropriately prepared.
- The load never processed.
Documentation
- Written documentation is almost as critical as the process itself. Failure to document is often interpreted as failure to implement. Documentation provides an important safeguard against a liability suit. Essential record keeping for every load includes a log of the sterilization date, the person who ran the load as well as the time the cycle was started and finished.14 This importan…
Conclusions
- The monitoring and documentation of sterilization parameters are critical components of quality assurance. Dental hygienists need to use physical, chemical, and biological monitoring systems to determine if sterilization has occurred. Each type has limitations but when used together each helps create a safer clinical work environment for patients and clinicians.
References
- Kohn WG, Collins AS, Cleveland JL, et al. Guidelines for infection control in dental healthcare settings—2003. MMWR Recomm Rep. 2003; 52:1-61.
- Kelkar U, Bal AM, Kulkarni S. Monitoring of steam sterilization process by biologic indicators—a necessary surveillance tool. Am J Infect Control. 2004;32:512-513
- Guidelines for Disinfection and Sterilization in Health Care Settings, 2008. Available at: www.…
- Kohn WG, Collins AS, Cleveland JL, et al. Guidelines for infection control in dental healthcare settings—2003. MMWR Recomm Rep. 2003; 52:1-61.
- Kelkar U, Bal AM, Kulkarni S. Monitoring of steam sterilization process by biologic indicators—a necessary surveillance tool. Am J Infect Control. 2004;32:512-513
- Guidelines for Disinfection and Sterilization in Health Care Settings, 2008. Available at: www.cdc.gov/ncidod/dhqp/pdf/guidelines/Disinfection_Nov_2008.pdf. Accessed February 6, 2009.
- Staat RH. Sterilizer monitoring: rationale for using biological indicators. Dentistry Today. Available at: www.dentistrytoday.com. Accessed March 3, 2009.
