_______________________________ Infection Control for Dental Professionals: The California Requirement
METHODS FOR STERILIZING AND DISINFECTING PATIENT-CARE ITEMS AND ENVIRONMENTAL SURFACES
Process
Result
Method
Examples
Patient Care Items
Environmental Surfaces
Sterilization Destroys all
Heat-automated, high temperature
Steam, dry heat, unsaturated chemical vapor
Heat-tolerant critical and semicritical Heat-sensitive critical and semicritical
NA
forms of viable micro-organisms, including bacterial spores.
Heat-automated, low temperature
Ethylene oxide gas, plasma sterilization
Liquid immersion a Glutaraldehyde,
glutaraldehydes with phenols, hydrogen peroxide, hydrogen peroxide with peracetic acid, peracetic acid
High-level disinfection
Destroys all micro- organisms, but not necessarily high numbers of bacterial spores.
Heat-automated Washer disinfector Liquid immersion a Glutaraldehyde,
Heat-sensitive semicritical
NA
glutaraldehydes with phenols, hydrogen peroxide, hydrogen peroxide with peracetic acid, ortho- phthalaldehyde EPA-registered hospital disinfectant with label claim of tuberculocidal activity (e.g., chlorine-containing products, quaternary ammonium compounds with alcohol, phenolics, bromides, iodophors, EPA- registered chlorine-based product) EPA-registered hospital disinfectant with no label claim regarding tuberculocidal activity. OSHA also requires label claim of HIV and HBV potency for use of low-level disinfectant for use on clinical contact surfaces (e.g., quaternary ammonium compounds, some phenolics, some iodophors)
Intermediate- level disinfection
Destroys vegetative bacteria and most fungi and viruses. Inactivates Mycobacterium
Liquid contact
Noncritical with visible blood
Clinical contact surfaces, blood spills on housekeeping surfaces
bovis b . Not necessarily
capable of killing bacterial spores.
Low-level disinfection
Destroys most vegetative bacteria and certain fungi and viruses. Does
Liquid contact
Noncritical without visible blood
Clinical contact surfaces, housekeeping surfaces
not inactivate Mycobacterium bovis.
a Contact time is the single critical variable distinguishing the sterilization process from high-level disinfection with FDA-cleared liquid chemical sterilants. High-level disinfection uses shorter submersion times. b Inactivation of the more resistant Mycobacterium bovis is used as a benchmark to measure germicidal potency. Source: [9; 10; 21]
Table 2
for correct use of containers, wraps, and chemical or biological indicators, should always be followed [10]. Sterilization most often fails due to overloading.
Devices being sterilized should first be cleaned, as debris interferes with the sterilization process. If an ultrasonic unit is utilized, it should be covered while actively in use. Instruments should be fully dry prior to packaging and storage.
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