Autoclaving is a crucial sterilization method that helps ensure the safety and sterility of medical instruments and equipment. These devices use pressurized steam to kill microorganisms.
Proper use of autoclaves is necessary to prevent healthcare-associated infections. Use these seven autoclave tips for healthcare professionals to maintain your facility’s standards, provide quality patient care, and protect patients and healthcare workers.
1. Understand Autoclave Basics
Medical devices and instruments are sterilized in a variety of ways, but one of the most prominent methods is by exposing items to pressurized steam in an autoclave. Autoclaves are essential sterilization devices used in laboratories, hospitals, biohazard waste treatment facilities, and other applications that require or benefit from moist heat sterilization.
Autoclaves kill microorganisms by heat denaturation. The heat from the steam cycle vibrates molecules in microorganisms, breaking the hydrogen bonds and causing proteins to lose their structure. This process kills bacteria, viruses, fungi, and spores.
2. Select the Right Cycle Type
Not all types of loads can be sterilized with the same autoclave cycle type. The three standard types of steam sterilization cycles are gravity, prevacuum, and steam flush pressure pulse (SFPP).
Cycle development is important for choosing the right cycle type to sterilize the load without destroying it. Considering factors such as the presence of liquid, container flexibility, and restrictions on air removal can help you determine the best cycle type. Users can follow a cycle development protocol to systematically determine the correct parameters and process requirements for each load.
Gravity, Prevacuum, and SFPP Cycles
The gravity cycle displaces the air in the chamber with steam, then uses gravity’s force to cause the air to exit the chamber. This is the most basic cycle, and it is used for glassware, utensils, and unwrapped goods.
The prevacuum cycle uses a mechanical vacuum system, resulting in more efficient air removal compared to the gravity cycle. The prevacuum cycle is typically used for wrapped goods and packs.
The SFPP cycle applies a series of controlled pressurizations and steam flushes to remove air. Since this method doesn’t rely on a vacuum, the pressure in the chamber doesn’t drop below the ambient air pressure, ultimately reducing the chances of load recontamination.
3. Clean Items Before Autoclaving
Debris can prevent steam from contacting an item’s entire surface, so be sure to clean visible material off instruments before autoclaving. Cleaning helps remove organic and inorganic material.
Do not autoclave combustible, corrosive, flammable, reactive, toxic, or radioactive items. Items typically suitable for autoclaving include surgical instruments, glassware, centrifuge tubes, and pipette tips.
Cleaning Techniques
Two common cleaning techniques are ultrasonic cleaning and automated instrument washers. Ultrasonic cleaners use sound waves and are effective at reaching small crevices without damaging devices. Automated instrument washers eliminate the need for manual rinsing and drying.
Use the cleaning products and techniques that are compatible with your instruments. Also, consider the kind of organic material you’re removing so you can apply an effective detergent or enzymatic product.
Dry the instruments thoroughly before autoclaving. Wet instruments will increase the risk of contamination.
4. Load the Chamber Properly
Another essential autoclave tip for healthcare professionals is to load the chamber properly. Overloading is one of the most common causes of steam sterilization failure.
The correct loading technique is essential for allowing the steam to circulate adequately and touch the entire surface of every item. Overloading can also increase the device’s warm-up time.
Ensure there’s enough space between individual items to facilitate steam penetration and thorough sterilization. Proper spacing will also prevent porous goods from retaining water.
Do not front- or rear-load the autoclave, but instead spread the load evenly. Heavier items should be on the bottom and lighter items on the top. Items should not touch the chamber walls or autoclave door.
Tip: Always Follow the Manufacturer’s Instructions
Always follow the autoclave manufacturer’s instructions for correct and safe loading. Do not use the same loading process across all devices without checking the manufacturer’s instructions for each one.
In busy settings, operators are sometimes tempted to wait to run the autoclave until they have a full load. However, this can lead to workflow backups and increase the risk of overloading. You can—and should—run the autoclave before it is full.
5. Determine Temperature and Time
After selecting the cycle type, determine the required steam sterilization temperature and duration. Autoclaves typically use temperatures between 121°C (250°F) and 132°C (270°F).
Different materials require different cycle durations. Packaging and load amount can also affect time requirements.
Learn about the temperature and time requirements for each cycle type. You can reference an autoclave temperature, time, and pressure chart to determine the parameters for your load type.
6. Unload Carefully
Follow the manufacturer’s instructions when unloading the autoclave to mitigate the risks of heat and steam burns and hot fluid scalding. Do not open the autoclave when the chamber is pressurized.
Wear heat-resistant gloves when opening the door. Wait 5 minutes to remove dry glassware and 10 minutes to remove autoclaved liquids.
Wear personal protective equipment (PPE) when unloading the autoclave. This can include heat- and liquid-resistant gloves, a rubber apron, arm protectors, eye protection, and face protection.
Remove the load and let the glassware cool for at least 15 minutes before handling without gloves. Liquid loads should be placed in a secure, out-of-the-way area for a full hour before touching without gloves.
7. Validate the Autoclave
At least once annually, perform an autoclave validation to verify the device’s effectiveness. Simple validations can be performed weekly, monthly, or every six months.
You can use chemical indicators for a quick visual reference to show that the autoclave has reached a certain temperature. Biological indicators (BIs) take longer to read but provide more information. They measure the growth or inhibition of bacterial spores to demonstrate the process’s effectiveness. Follow the biological indicator’s manufacturer’s instructions to correctly place the BI and interpret results.
By understanding the fundamental principles of autoclaving, properly preparing loads, applying the correct autoclaving parameters, and validating the autoclave, operators make their healthcare facilities safer. Workers can protect themselves by using the machine as intended, unloading carefully, and wearing PPE.
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