Sterilization update 2003.

Instrument processing is a key part of the office infection control program. Each step in the process must be performed correctly to help ensure patient safety. The instrument processing area must be organized so that contaminated items are not confused with sterilized items, and so that sterilized items do not accidentally become recontaminated. Instruments need to be cleaned completely of visible debris using an ultrasonic cleaner or instrument washer. The cleaned instruments are packaged before sterilization to protect them from recontamination until they are opened for use for the next patient. Processing the packaged instruments through a heat sterilizer (steam, dry heat, or unsaturated chemical vapor) kills any microbes that remain on the instruments. The sterile packages are handled and stored in a manner that preserves the integrity of the packaging material. The use and functioning of the sterilizer is monitored by mechanical, chemical, and biological means, and records are kept to document these evaluations. Sterilization failures are addressed carefully so that patient safety can be maintained.