MIcrobiology and Sterile Technique Part 2

Hopefully by now you all understand why it's our number one priority in the operating room to make sure all our equipment and supplies are free of microorganisms. And if you are ever a patient in the O.R. you'll really appreciate the work we do to ensure your safety. In this post I'd like to share with you the many processes we go through to ensure sterility.

Let's start with all the work that gets done in the Central Sterile department. Obviously when we get the instruments they've been sterilized already. We use them on a patient and send the now dirty instruments to Central Sterile (C.S.). The first step in the journey back up to the O.R. is obvious.....the instruments need to be cleaned. So they go straight to decontamination.

In decontamination each instrument is thoroughly cleaned using FDA approved cleaners, brushes, and specialized equipment like an Ultrasonic Washer. This is the most important step because if even one instrument isn't properly cleaned and there is bioburden (dried blood, bone, ect) stuck in a crack or crevice and it is put in a set and sterilized...the entire set is contaminated. If it isn't caught and that set is used on a patient, we are exposing that patient to all those nasty bugs we talked about.

This is an Ultrasonic Washer. It's filled with water and a detergent is added. When the washer is turned on it sends shockwaves through the water. This causes bubbles to form on the surface on the instruments and the bubbles lift the bioburden off the instruments.

After the instruments are hand cleaned they are put through a washer sterilizer. It's basically a big dishwasher and it cleans the instruments enough that they are safe to handle without gloves. From here, they go to processing.

This is a washer sterilizer.

In processing the instruments are double checked to ensure that they are 100% free of bioburden. After they've been checked, they get reassembled and put together as a set. They are either put into an instrument tray, peel packed, or wrapped. Then those packages are sterilized.

This is an example of an instrument tray.

This shows supplies being wrapped.

It's important to note that not everything can be sterilized the same way. Depending on the type of instrument, material, and other factors it may require steam, gas, or chemical sterilization. It is the responsibility of the people who work in C.S. to know which sterilization process is required.

Those are wrapped instruments that are being loaded into a sterilizer.

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After the sets have been sterilized they are stored until they need to be used again.

There are usually at least five people who handle the instruments along this journey back to the O.R. Don’t let this post fool you, it takes a good amount of time to get things through these process and the people who do it go through a lot of training to ensure that everything is done correctly. Chances are patients never see these people and they never think of what goes on behind the scenes. But I’m here to tell you, we would never be able to do what we do in the O.R. if it wasn’t for the work being done in Central Sterile.



I know I orginally said this would be a two part post but after I started writing this part I realized how much I had left to talk about. So there will be one more post to follow in order to finish up.