What is sterilization? Apparatus for sterilizing instruments and dressings
What is sterilization? How is it carried out and for what purposes? What should be the conditions for the destruction of harmful, dangerous, pathological forms of microscopic life? The most up-to-date research in this area has made it possible to create truly effective sterilization methods applied in the technique used in medical institutions. In addition, such devices are used in the workflow of dental private practices, beauty salons, manicure rooms. Any modern person should understand the importance of sterilization and apply for specific services only in a place where this question is treated responsibly and meticulously.
You can learn about sterilization in the definition of the word.The term is commonly understood as the process during which the microflora is destroyed, including spores and viruses. Various techniques are used - aggressive chemical components, physical processes, including radiative forcing. Currently, a product is considered sterile when the biological load is estimated at 10-6and below.
In accordance with the standards in force in our country, the rules for medical sterilization should be applied to all instruments that come into direct contact with human blood, the surface of the wound, and the mucous tissues of the body. If the procedure involves at least the slightest chance of injury to the site, used items must be processed before further use. Considering what sterilization is, you need to be aware of the complexity of this procedure. To achieve a successful result is possible only with the observance of technology and established rules. The peculiarities of processing medical instruments are now officially established by legal and regulatory acts adopted for the entire territory of our country.The documents are formed taking into account international requirements and recommendations in relation to the area in question.
Considering what sterilization is, the following points should be mentioned:
- thorough, effective cleaning;
- use of approved packaging materials;
- proper packaging of processed items;
- correct loading of sterilization equipment with products that need to be cleaned;
- use of a reliable sterilization material in the amount recommended by the manufacturer;
- control over the correctness of the working process of used machines.
As well as proper storage of processed tools, transportation and handling.
Step by step
Modern methods of sterilization presuppose a clearly defined sequence of actions, which is unacceptable to violate, since the final result of the measure will not be high enough. Of course, effective control techniques can reveal such a situation, but neglecting the rules leads to a waste of time and material, since you have to send the entire batch of processed items to the second round.To avoid unpleasant situations, downtime and losses, you need to strictly follow the recommendations and rules established for the chosen method of processing tools.
Briefly, the sequence of actions is as follows:
- collection of used tools;
- primary disinfection;
- mechanical cleaning;
- check on the integrity of the structure;
- thorough washing;
- processing in a special installation;
- storage subject to conditions;
If, after sterilization, the processed instruments are packaged in materials specifically designed for this, storage is possible from a day to six months (depending on the specific methods used to eliminate harmful microflora).
How do we organize?
In order to sterilize instruments to be effective, no products are overlooked, there were no losses and mistakes. In modern medical institutions, beauty salons are declared by internal documents, which all employees of the enterprise will have to follow. There are four variants of the approach to the process:
- application of power CSO.
And what in practice?
Much depends on the scale of a particular enterprise, the form of its organization (private practice, government agency), and the direction of work. For example, if we are talking about a dental office, almost always the sterilization of instruments is organized by a decentralized method. An exception to this rule may be government offices for assisting with sick teeth, but in private practice almost 100% of companies work out their workflow in a decentralized way.
The centralized option is more applicable to large polyclinics, private large-scale organizations, regional hospitals.
Advantages and disadvantages
Of course, the conditions for sterilization when applying the decentralized approach are much easier to organize, and it will cost less than an alternative option, but experts say that the technique has drawbacks that have a negative impact on performance. For example, the pretreatment procedure involves manual labor, which means little effect. It is rather difficult to organize the process of sterilization control in setting up a decentralized approach. It is not easy to ensure that the staff complies with the rules of packaging and storage.Consequently, the quality level of the procedure falls.
The centralized system is believed to give the best results, including through a streamlined sterilization control procedure. Large enterprises have more opportunities in practice to introduce the most modern devices, devices, machines, including washing. Exclusion from the production chain of manual labor allows to increase the efficiency of each stage of cleaning tools. However, process automation simplifies the work of people.
Centralized approach: organization
As a rule, such a system assumes the existence of several units, each of which is responsible for a specific stage. There are the following steps:
- separate storage.
In order for disinfection and sterilization to be carried out efficiently and effectively, it is necessary to maintain appropriate conditions in the spaces designated for this purpose. The current standards declare that the air in the rooms intended for processing and storing the instrument must be heated to the level of 18-22 degrees Celsius,humidity should be at least 30%, but not higher than 70%, and the air flow is always sent from the cleanest areas to those that are conditionally rated as more dirty.
Currently, disinfection and sterilization are organized using the following methods of influence:
- glass balls;
- infrared radiation;
- chemical solutions;
- special gases.
Modern devices for sterilizing a dressing material are often designed on the basis of the use of ozone, plasma, ethylene oxide, and formaldehyde vapor. It is necessary to select a specific option by analyzing the features of the tools to be processed: how resistant the product is to the impact that has become the foundation for a particular machine.
Everything's under control!
Regardless of what method was used, it is important to monitor the effectiveness of this process. Experts agree that the stage of tracking results is the most important in the entire sequence of actions. Physical control involves checking the pressure, temperature, and compliance with the prescribed sterilization time. If there is a deviation from the standard mode, a failure of the machinery should be assumed.
The second approach to verifying the effectiveness of sterilization is chemical. For this, the toolkit is processed using specialized compositions, indicators that can change color or physical parameters. The check is carried out taking into account the specific time of exposure, selecting the method that corresponds to the carried out variant of processing products.
What to do?
The most common method of testing, applicable to a variety of sterilization regimes introduced in the enterprise, is biological. In accordance with current regulations, it is necessary to implement this at clinics at least once a week, especially if steam sterilizing installations are involved. Regular monitoring helps to prevent nosocomial epidemic, time to detect problems in the sterilizer.
Spores of Bacillus stearothermophilus most often act as biological indicators if the purification system works in air, if it is in gas, Bacillus subtilis. It is recommended that when receiving a batch of critical tools it is imperative to organize biological control, not taking into account the recommended weekly frequency.It is unacceptable to use catheters, a critical tool, until the effectiveness of the selected sterilization regimen has been confirmed by a purity test.
Keep and apply wisely
It is recommended to organize a storage area for the processed instruments in the vicinity of the room in which sterilization is performed. It is important to ensure effective protection of objects from dust, parasites, any dangerous, potentially infectious factors, including insects. A negative effect can be provoked by a change in the level of humidity and the heating of the air in the room; therefore, it is necessary to constantly maintain stable conditions. The items stored in the sterilizer are laid out for storage in such a way that the packaging does not break, does not deteriorate, does not pierce, does not squeeze - in short, any damage, even the smallest, is unacceptable.
For any modern method of sterilization, the shelf life is determined, that is, the period during which the instruments that have been processed remain their purity. For some options it is only a day or two, for others it is an indefinite period.At the same time, it must be remembered that sterility is largely determined by external conditions, so even the most reliable method will not give a tangible, durable result if the processed instruments are kept in bad conditions. When transporting products to the department where it is planned to use items, it is necessary to provide additional coverage that will allow to protect items from dust. Choose an option that can be removed quickly and easily when passing through the border of a clean zone.
Physical sterilization methods
This is a fairly extensive category, which includes different types of effects on objects. This includes the widely used in our time dry heat sterilization, the use of steam, red-hot glass balls and some other products. Most of these installations require preliminary placement of the processed tools in a specialized package, and right in it the product is placed in a machine, where, in conditions of limited closed space, the effective destruction of dangerous microscopic life forms takes place.
Special documents have been adopted in our country, which list all packaging materials permitted for use for this approach.For example, the steam technique allows for the presence of special boxes equipped with a filter or those that do not have. But the air, gas method, and sometimes steam can be organized at all without additional packaging.
The use of special compounds is important when products from unstable materials are subject to treatment, that is, they cannot be subjected to elevated temperature, steam, other measures of physical influence. As experts pay attention, the chemical approach is less desirable due to certain drawbacks: after treatment with solutions, it is necessary to wash the products in a sterile liquid (water or sodium chloride). This procedure should be carried out in strict compliance with the requirements of safety, sterility, otherwise re-infection of objects is possible after processing in the sterilization chamber.
Glass, resistant to temperature and chemical components of plastics, enameled metal is used for the working process. Solutions for sterilization are heated to 20 degrees Celsius, if they contain aldehydes, for others - 18 degrees.The exception is hydrogen peroxide and "Lizoformin 3000", for which the working conditions are declared in the instructions for the preparations - adherence to special regimes is required.
The chemical technique of sterilizing medical instruments is indispensable when it comes to a specific technique, which is particularly difficult to work with. For example, fiber, equipment for anesthesia, stimulants of the heart muscle, instruments used by dentists, require adherence to special regimes. For their processing, the most effective and modern compositions are used - glutaraldehyde, acidic compounds. Developed two approaches - classic and express. There are several drugs that are in demand in the market and are considered promising. The features of their use are clearly spelled out in the instructions; it is of utmost importance to comply with them in order to obtain a quality-based sterilization result.
Choosing a specific option, you need to take into account the price of each of the goods on the medical market, and its shelf life. As experts note, in terms of economic feasibility, the positions on the modern market differ from each other very much indeed.Planning the organization of the workflow, it will be necessary to take into account not only the characteristics of a particular substance, but also the duration of treatment (about 300 minutes in most cases). Both the high price of the components used and the time spent on the sterilization procedure are weaknesses of the chemical approach. On the other hand, with reference to a number of equipment, this option has no analogues.