This chapter discusses sterile processing standards and practices in different healthcare facilities. It provides an overview of sterile processing in ambulatory surgical centers, including their history, regulatory standards, and personnel. Standards and practices for dental facilities, including environmental and instrument processing procedures, are also examined. The chapter describes sterile processing in Veterans Affairs facilities and differences from other facilities. Finally, it emphasizes that the core science of cleaning, sterilization and handling sterile items is consistent, regardless of facility type.

1. Chapter 23

2. As a result of successfully completing this
chapter, students will be able to:
 Review basic similarities and some differences
between sterile processing in hospitals and other
healthcare facilities
 Explain basic standards and practices used for
sterile processing in ambulatory surgical centers:
 Overview and History
 Ownership and Regulatory Standards
 ASC Processing Personnel
 Processing Environment

3.  Explain basic standards and practices used for
sterile processing in dental facilities:
 Environmental Issues
 Instrument Processing Procedures
 Provide an overview of Veterans’ Administration
(VA) facilities, and list sterile processing
differences between VA and other healthcare
facilities

4.  Even though the type of facility may vary,
the science of cleaning, decontamination,
inspection, packaging, sterilization and
sterile product handling does not change

5.  A healthcare facility
that allows patients
to have selected
surgical and
procedural services
performed that do
not require hospital
admission

6.  Cosmetic
 Facial Plastic and
Reconstructive
 Gastroenterology
 General
 OB/GYN
 Opthalomological
 Oral/Maxillofacial
 Orthopedic
 Podiatry
 Urology
 Cardiovascular/Vascular

7.  ASCs came into being in the 1970s.
Prior to that, all surgical procedures
were performed in the hospital
 ASCs must have at least 1
dedicated operating room
 Physicians are involved in the
ownership of the majority of ASCs

8.  A voluntary process by which an
organization measures the quality of its
services and performance against
nationally recognized standards
◦ Joint Commission
◦ Accreditation Association of Ambulatory
Health Care (AAAHC)
◦ American Association of Accreditation of
Ambulatory Surgery Centers (AAAASF)

9.  Fast-paced
 Tight instrument
turnover timelines

10.  Cleaning/Decontamination
 Instrument Assembly
 Sterilization
 Sterile Storage

11.  Require:
◦ Cleaning and Decontamination
◦ Preparation and Packaging
◦ Sterilization
◦ Inventory Management and
Storage

12.  Clinical Contact Surfaces (infection control)
◦ - Surfaces that can be directly contaminated during patient care;
examples are: contamination from sprays, splatters, or direct contact
with a dental professional’s gloved hand
 Housekeeping Surfaces (infection control)
◦ - Surfaces such as floors, walls, and sinks that pose a risk of
disease transmission
 Environmental Surfaces (infection control)
◦ - Surfaces or equipment that do not contact the patient directly, but
may become contaminated during patient acre; examples are: light
and power unit switches and drawer knobs

13.  Transport
 Cleaning/Decontamination
 Inspection
 Assembly
 Packaging
 Sterilization
 Sterilization Quality
Assurance
 Storage and Handling

14.  Central Service Departments are called
Supply, Processing, and Distribution (SPD)
Departments
 Has its own certification program and
continuing education requirements
 Follows directives that set guidelines for
sterile processing

15.  Clinics
 Veterinary Hospitals
 Third Party
Reprocessing
Facilities
 Manufacturers