Choice of material / Does it fit the requirements?
Certificate of quality from the manufacturer.
Choice of surface finish.
2. Storage of Instruments
Avoid any corrosive fumes / chemicals in storage area.
Avoid area of high moisture to store instruments
Brand new instruments should be cleaned / protective caps removed.
Appropriate racks / containers should be used to store instruments.
3. Usage
Clean the instruments after every use.
Avoid prolonged exposure to saline.
Sterilise used and unused instruments.
4. Preparation for Disinfection & Cleaning
Check the correctness of the delivery.
Returning of the Instruments from OT:- Dry instruments should be returned in dry condition.
Returning instruments in wet condition:- Instruments should be immersed in a non-corrosive combined with disinfecting cum cleaning solutions.
All hinges / latches of instruments should be released. Assembled instruments should be dismantled.
5. Reusing Instruments
Dismantle and immediately immerse used and soiled instruments, completely in a pre-disinfection bath.
Use containers which are hermetically sealed during the process of thermal disinfection and cleaning. It is done at 93'C for approx. 10 min. For heat-sensitive material, chemo thermal disinfection is done at 60'C for approx. 10 min.
Open the containers at 60'C or lower
6. Pre - Disinfection
Use cold water only. Water over 45'C leads to coagulation of proteins and causes cleaning problems.
Epidemic Hygiene Aspect - disinfection first followed by cleaning. General Hygiene Aspect - first cleaning followed by disinfection.
Follow exposure times / dilution parameters / concentration levels as recommended by the manufacturer for optimal cleaning / disinfection, pH value 4.5 to 9.5 is recommended for cleaning and disinfection solutions.
Ultrasonic cleaners may be used in case of stubborn stains / encrustations.
7. Washing
Periodically test water for its chloride / silicate and mineral content.
Use of enzyme based detergents is recommended and instructions for dilutions as recommended by the supplier should be followed. If powered products are being used - particles should be dissolved.
Final rinsing should be done in demineralised water.
8. Drying
Instruments should be dried immediately after rinsing / washing.
Use of air pistol is recommended where ever possible.
Use lint free paper / cloth to wipe.
9. Care of Instruments
Ensure all instruments are clean.
Check functionality of individual instruments.
Separate instruments which are not functioning correctly, showing signs of corrosion and wear & tear.
10. Maintenance for Instruments
Periodically lubricate hinged/latched instruments and instruments with joints using lubricating oil.
Inspect edges of cutting instruments and sharpen if required. Inspect instruments with carbide tips for wear and tear. Replace tips if required.
Always arrange instruments systematically in terms of size, old or new, large bulky instruments and micro delicate instruments.
11. Conditions for Sterilisation
Do not overload instruments trays with more than 10 Kgs.
Do not mix old instruments with new instruments.
Micro and delicate instruments should be placed in secure containers.
12. Sterilisation
If all necessary steps prior to sterilisation have been followed - proceed.
Use demineralised water if possible / Quality of water / steam is very important.
Excessive silicates in water cause blackening of instruments.
Excessive chlorides can set in corrosion in instruments (level of chlorides should be less than 120mg / I equiv to 200mg / I of nacl).
Optimal loading of trays prevents formation of condensates.