Docfan Academy

Some devices are made for one use. Others are reusable, but only if you clean them and then disinfect or sterilise them correctly between patients. The IFU tells you which is which, and how.

The Spaulding idea

Choose the process by where the item goes:

• Critical items enter sterile tissue or the bloodstream, such as surgical instruments. They must be sterilised.
• Semi-critical items touch mucous membranes or broken skin, such as a vaginal speculum. They need at least high-level disinfection; sterilisation is better where possible.
• Non-critical items touch only intact skin, such as a blood pressure cuff, a stethoscope or a bed rail. Cleaning with low- or intermediate-level disinfection is enough.

Clean first, then disinfect

Blood and dirt shield germs, and a disinfectant cannot work through them. Wear gloves and an apron, and brush the item under water to avoid splashes. Rinse and dry it. Only then disinfect or sterilise.

A disinfectant needs the right dilution and the right contact time: how long the item must stay wet with it. Read the label. Mix it fresh, write the date on the container, and never top up old solution. For chlorine, standard WHO guidance is 0.5% for blood spills and 0.1% for general surfaces.

Sterilise, store, track

• Sterilisation usually means a steam autoclave run on the correct cycle. Boiling is not sterilisation.
• Wrap or pouch the items, do not overload the autoclave, and check the indicator after each run. An indicator shows that the load was exposed to the process. It does not on its own prove that every item is sterile.
• Store sterile packs in a clean, dry, closed cupboard, off the floor, oldest first. A pack that is torn, wet or dropped goes back for reprocessing.
• Keep a log of each cycle: date, load, cycle settings, operator and indicator result. Label packs so you can trace them to a load if something fails.