2.5 Principle IV: Make Instruments and Equipment Safe

Instrument Sterilization Fundamentals

biohazard--soaking The instrument-processing area should be divided into two separate zones: a "dirty zone" for intake, cleaning, and packaging of contaminated items and a "clean zone" for sterilizing instruments, removing packaged items from the sterilizer, cooling them, and storing them. PPE and utility gloves should be worn when handling and cleaning contaminated instruments.

Programs do not usually clean instruments immediately after use. Soaking instruments in detergent, disinfectant/detergent, or enzymatic cleaner immediately after use in a puncture-resistant container prevents patient matter from drying and makes cleaning easier.2 If instruments are to be transported off-site, they should be transported in a securely closed, appropriately labeled, and puncture-proof container.

Instruments should be cleaned (either manually and/or with an ultrasonic cleaner) before being placed in bags or pouches for sterilization. Bags or pouches should be sealed with heat-sensitive tape. A chemical indicator should be placed in the middle of each bag or pouch and on the outside if the first indicator is not visible through the bag or pouch material. If the indicator tape does not change color, this may indicate that there was a problem during sterilization. Bags or pouches should be clearly labeled with the date, so that the first instruments sterilized will be the first instruments used.2

OOH-funded school-based dental sealant programs should store packaged instruments in clearly and appropriately labeled puncture-proof and secured containers. Containers should be labeled "sterilized instruments," "contaminated instruments," and "scrubbed instruments." Containers with contaminated instruments also should have a biohazard symbol.2 Containers should be disinfected before and after use. Brushes used to clean instruments should be disinfected and stored in a labeled container.

Sterilized bagAfter appropriate sterilization, a bag or pouch is considered sterile unless it is compromised (e.g., torn, wet, dropped on floor). If a bag or pouch is compromised, the instruments should be cleaned, placed in a new bag or pouch, and sterilized again.2