What is it?

  • Sterilization is a process of destroying all microorganisms including viruses, bacteria, fungi and bacterial spores
  • Thorough cleaning and sterilization reduces the risk of spreading diseases
  • All critical items must be sterilized. Critical items are those that pierce or penetrate the skin, and in some cases, those that hold sterile items. All sterile items must remain sterile until point of use.
  • Must be monitored.

Approved sterilizers are:

  • Autoclaves – must meet Canadian Standards Association specifications for use in health care or allied health facilities
    • Chemical autoclaves – must meet Canadian Standards Association specifications for use in health care or allied health facilities.
    • All autoclaves must include:
      • manufacturer’s directions on proper use of the sterilizer such as maintenance, proper use of sterilizer, packaging, and loading
      • a specified drying cycle for packaged goods
      • gauges to measure temperature and pressure
      • a timer
    • The autoclave should be equipped with a print-out that provides details of the mechanical parameters reached during each cycle.
  • Dry Heat sterilizers
    • All dry heat sterilizers must include:
      • manufacturer’s directions on proper use of the sterilizer such as maintenance, proper use of packaging, and loading
      • specified cycle for packaged goods
      • gauge to measure temperature
      • a timer

Unapproved sterilizers are:

  • Glass bead
  • Ultraviolet
  • Ultrasonic
  • Pressure cookers
  • Microwaves
  • Boiling water
  • Ovens

Steps for Proper Sterilization

  1. Clean instruments thoroughly.
  2. Package items.
  3. Load sterilizer. Do not overload. Follow manufacturer’s instructions.
  4. Monitor each cycle to verify that the sterilizer is in proper working order.
  5. Follow manufacturer’s instructions on the drying cycle. Contamination can occur if packages are handled when wet.
  6. Store sterilized items (in their packages) in clean containers with lids.

Monitoring your sterilizer properly:

1. Biological Monitoring: Spore tests must be conducted every other week

  • Spore tests use heat resistant bacterial spores to determine if the sterilizer is in proper working order.
  • Geobacillus stearothermophilus spores are used to test autoclaves (steam under pressure).
  • Bacillus atrophaeus spores are used to test dry heat sterilizers.
  • Refer to the manufacturer’s directions for proper biological challenge used to test chemiclaves.
  • Spore tests must be sent to a laboratory for testing. Test results must be negative indicating spores were destroyed, hence that the sterilization process was satisfactory.

2. Chemical Monitoring: Must be used with each load

  • Temperature sensitive tape and packaging must be placed in the sterilizer with each load.
  • Chemical monitoring is a thermal indicator that changes colour if an adequate temperature has been reached. This colour change is not indicative that sterilization has occurred.

3. Physical Monitoring: Keep daily records for at least one year on site, five years on file

  • Where appropriate, record the date, temperature, pressure and cycle length of each load.

Back-up Plans

All owners and operators must have a written back-up plan in the event of a spore test failure. The back-up plan must be reviewed annually and located on-site for inspection.

Sources: Ministry of Health and Long Term Care, Infection Prevention and Control Best Practices for Personal Services Settings, January 2009, and Toronto Public Health, Routine Practices for Personal Services Settings, 2009

January 2013