0
Low TemperatureLow Temperature
SterilizationSterilization
Chapter 16
Objectives:Objectives:
As a result of successfully completing this
chapter, students will be able to:
Discuss basic requi...
Basic Sterilization RequirementsBasic Sterilization Requirements
Effectiveness
Safety
Monitoring
Quality Assurance
Pe...
Ethylene OxideEthylene Oxide
Used commonly in Hospitals since the
1960s
Excellent Penetration Capabilities
Kills microo...
AlkylationAlkylation
The process of destroying
microorganisms by making the cell
unable to metabolize and/or
reproduce
Ethylene Oxide ProcessEthylene Oxide Process
ParametersParameters
Time
Temperature
Concentration of
EtO
Relative Humid...
TerminologyTerminology
 Residual- The amount of EtO that remains inside of materials
after they have been sterilized
 Ae...
EtO SystemsEtO Systems
100% EtO
Gas Blends
Employee SafetyEmployee Safety
Employees should receive instruction on:
◦ Hazards of EtO
◦ Procedures to reduce employee ...
EtO SafetyEtO Safety
EtO is a Toxic Gas
EtO Sterilizers should be located in a well-
ventilated area with a room air exc...
Personnel MonitoringPersonnel Monitoring
Personal devices worn with
1 foot of the employee’s
breathing zone
◦ Provide del...
Education Should also include:Education Should also include:
Specific training
from the
manufacturers of
the gas
containe...
Aeration of EtO SterilizedAeration of EtO Sterilized
ItemsItems
Minimum recommendations for aeration:
◦ 8 hours at 1400
F...
Loading the EtO SterilizerLoading the EtO Sterilizer
 Do not overload
 When possible use metal carts
or baskets
 Do not...
Unloading the EtO SterilizerUnloading the EtO Sterilizer
 If possible aerate before
handling
 When transferring loads to...
EtO Sterilizer PerformanceEtO Sterilizer Performance
MonitorsMonitors
Physical Monitors (Charts, Printout Tapes
and Graph...
Hydrogen Peroxide (Gas Plasma)Hydrogen Peroxide (Gas Plasma)
 Popular because of its short cycle
times
 Uses H2O2 vapor ...
Staff Safety Education:Staff Safety Education:
Hazards of H2O2
MSDS Sheets
OSHA PEL
Process for changing vapor plates
...
MonitoringMonitoring
Physical Monitors (Printout)
Chemical Indicators
Biological Indicators (Geobacillus
stearothermoph...
OzoneOzone
Newest low temperature
process
No purchase of sterilant
needed. The system
generates the O3 needed
Process p...
Overview of LowOverview of Low
Temperature ProcessesTemperature Processes
A comparison
chart of the low
temperature
steri...
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Chapter 16 low temperature sterilization

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Transcript of "Chapter 16 low temperature sterilization"

  1. 1. Low TemperatureLow Temperature SterilizationSterilization Chapter 16
  2. 2. Objectives:Objectives: As a result of successfully completing this chapter, students will be able to: Discuss basic requirements important for any type of low temperature sterilization system Explain specific requirements for the three low temperature sterilization methods: ethylene oxide, hydrogen peroxide (gas plasma), and ozone Review (compare) important parameters of the three low temperature sterilization methods commonly used by health care facilities
  3. 3. Basic Sterilization RequirementsBasic Sterilization Requirements Effectiveness Safety Monitoring Quality Assurance Penetration Material Compatibility Adaptability Approval
  4. 4. Ethylene OxideEthylene Oxide Used commonly in Hospitals since the 1960s Excellent Penetration Capabilities Kills microorganisms by alkylation
  5. 5. AlkylationAlkylation The process of destroying microorganisms by making the cell unable to metabolize and/or reproduce
  6. 6. Ethylene Oxide ProcessEthylene Oxide Process ParametersParameters Time Temperature Concentration of EtO Relative Humidity
  7. 7. TerminologyTerminology  Residual- The amount of EtO that remains inside of materials after they have been sterilized  Aeration- A process in which a device is actively subjected to moving air. For example, items that have been sterilized with EtO  Sterility Assurance Level (SAL)- The probability of a viable microorganism being present on a product after sterilization  Permissible Exposure Limits (PELs)- Limits developed by OSHA to indicate the maximum concentration of a contaminant to which an employee may be exposed over the duration assigned to that contaminant  Time Weighted Average (TWA)- The employee’s average airborne exposure in any 8-hour work shift of a 40 hour work week  Parts Per Million (PPM)- Parts Per Million (PPM) is the term used to measure the volume of gas in a vapor
  8. 8. EtO SystemsEtO Systems 100% EtO Gas Blends
  9. 9. Employee SafetyEmployee Safety Employees should receive instruction on: ◦ Hazards of EtO ◦ Procedures to reduce employee exposure ◦ Principles of EtO monitoring and interpretation of results ◦ Use of protective equipment ◦ OSHA Standards ◦ MSDS Sheets ◦ EtO Emergency Plans ◦ Processing procedures ◦ Storage and handling of EtO gas containers
  10. 10. EtO SafetyEtO Safety EtO is a Toxic Gas EtO Sterilizers should be located in a well- ventilated area with a room air exchange rate of 10 air exchanges per hour Additional information about EtO safety is included in Chapter 21, Safety, pages 405 – 408 of the text
  11. 11. Personnel MonitoringPersonnel Monitoring Personal devices worn with 1 foot of the employee’s breathing zone ◦ Provide delayed results Area monitors continuously monitor airborne EtO ◦ Provide real-time information
  12. 12. Education Should also include:Education Should also include: Specific training from the manufacturers of the gas containers and the sterilizer
  13. 13. Aeration of EtO SterilizedAeration of EtO Sterilized ItemsItems Minimum recommendations for aeration: ◦ 8 hours at 1400 F (600 C) ◦ 12 hours at 1220 F (500 C) *Some items require significantly longer aeration. Consult device manufacturer’s recommendations for specific guidelines
  14. 14. Loading the EtO SterilizerLoading the EtO Sterilizer  Do not overload  When possible use metal carts or baskets  Do not let items come in contact with chamber walls  Place peel pouches on edge  Do not stack items on top of one another
  15. 15. Unloading the EtO SterilizerUnloading the EtO Sterilizer  If possible aerate before handling  When transferring loads to the aerator, pull, don’t push the load  Follow your specific facility's safety protocols  Once a load has been placed in the aerator, new groups of sterilized items should not be added
  16. 16. EtO Sterilizer PerformanceEtO Sterilizer Performance MonitorsMonitors Physical Monitors (Charts, Printout Tapes and Graphs Chemical Indicators Biological Indicators (Bacillus atrophaeus)
  17. 17. Hydrogen Peroxide (Gas Plasma)Hydrogen Peroxide (Gas Plasma)  Popular because of its short cycle times  Uses H2O2 vapor and low temperature gas plasma doe rapid inactivation of microorganisms  Is widely compatible with different materials  Is not compatible with powders and strong absorbers like paper and linen made of cellulose  There are some restrictions regarding the sterilization of lumens (diameter and length). Consult device manufacturer recommendations for specific parameters
  18. 18. Staff Safety Education:Staff Safety Education: Hazards of H2O2 MSDS Sheets OSHA PEL Process for changing vapor plates Storage, handling and disposal of cassettes
  19. 19. MonitoringMonitoring Physical Monitors (Printout) Chemical Indicators Biological Indicators (Geobacillus stearothermophilus)
  20. 20. OzoneOzone Newest low temperature process No purchase of sterilant needed. The system generates the O3 needed Process parameters: ◦ Time ◦ Temperature ◦ O3 Concentration ◦ Relative Humidity
  21. 21. Overview of LowOverview of Low Temperature ProcessesTemperature Processes A comparison chart of the low temperature sterilization methods covered in this unit is located on page 341 of the text.
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