INTRODUCTION

Autoclaves are designed to deliver heat under pressure to a chamber, with the goal of sterilizing the contents of the chamber. Sterilization is the total destruction of microorganisms that are present. This is achieved because heat damages the cell’s essential structures, rendering the cell no longer viable. This will only occur if the material is heated to a specific temperature for a given period of time. To facilitate the transfer of heat, moisture is often added.

In order to create sterilization using water it must be heated past its normal boiling point of 100 degrees Celsius. The boiling point of water is dependent on oxygen content and altitude.

Procedures, decontamination, sterilizing and monitoring are all dependent on type of autoclave used, load to be processed, Federal/Provincial regulations/guidelines, facility/health authority protocols and Registered/Licensed Nursing bodies.

The following is provided as a guideline only for the use of counter top autoclaves, ie: Prestige 21006

PREPARATION OF THE AUTOCLAVE

Read manufacturer’s instructions on care and use for your autoclave. Ensure sufficient water is in the autoclave to run the cycle. Do not use tap water. Use distilled or demineralized water only. Instruments will stain if tap water is used. Basket/tray with holes must be used inside of autoclave to ensure proper steam penetration.

PREPARATION OF THE LOAD

Items must be clean before processing. If an item is not clean it cannot reach sterility as any dirt or debris remaining following autoclaving will present a potential risk of cross infection.

Items must be thoroughly dry prior to autoclaving. Contamination may occur through micro-organisms present in the residue water being “baked on” during the sterilization cycle.

LOADING

Ensure sufficient water in load to allow steam penetration. Do not overload autoclave, as this will prevent effective steam penetration. Care should be taken to ensure instruments do not overlap and that all hinged items are opened to expose the maximum surface area possible. Instruments may be leaned on their sides against the inner basket if no instrument separation basket is available.

UNLOADING THE AUTOCLAVE

Wait until the indicator light or pressure gauge reads that the cycle is complete.

Read carefully the manufacturers recommendations for lid removal.

Open slightly to allow steam to escape.

Wait for the contents to cool.

POST STERILIZATION STORAGE

Un-wrapped solid instruments are suitable for non-sterile use later provided they are dry prior to storing.

Instruments should be stored in clean, disinfected, dry and airtight container.

CLEANING AND MAINTENANCE

Check gasket for wear.

Clean interior walls and steam line (if autoclave has one) with mild detergent once a week. Never use a strong abrasive or steel wool.

Using a stiff, nylon-bristle brush and brush the inside of the chamber.

Rinse with tap water after cleaning. Wipe thoroughly.

Remove gasket (if able to do so). Using a moist towel, wipe the gasket clean. Do not use a brush on the gasket.

Consult manual to determine other recommended procedures.

TEST STRIPS

Heat sensitive chemical indicators (those that change colour after exposure to heat) alone do not ensure adequacy of a sterilization cycle. Their use is to identify that the load has been processed through the heating cycle and to indicate that it has been processed. Test strips should be positioned in the middle of the load but not in the water.

Chemical indicators must not be used as the sole indicators of sterility.

BIOLOGIC INDICATOR (spore testing)

The definitive method of determining the efficacy of your sterilizer is to routinely challenge its ability to kill highly resistant bacterial spores. Failure to implement a weekly or monthly sport-test program can leave your clients exposed to the very real threat of biological cross-contamination.

Biological indicators are used in the efficacy testing of the autoclave process to effectively sterilize the contents being treated. Bacillus stearothermophilus spores are used, as they are the most resistant organism to steam autoclaving.

This is the standard method of validating the effectiveness of your autoclave procedures.

Biological spore testing is the only compliant testing method approved by the CDC, Federal and State Health Departments and Autoclave Manufacturers.

References: Health Canada; Alfa Medical; Spectrum Surgical; Eschmann Ltd.

www.pedicare.ca (doc.2010)