Instrument Decontamination
Methods that Prolong Instrument Life
Submerge Instruments Quickly
Instrument decontamination is easier and
more effective if soiled instruments are placed in a liquid soon after use. Blood
and tissue contain chemicals that break down the instruments' protective chromium oxide
surface. Pre-soaking procedures can be accomplished in three ways. The
following lists them in increasing order of efficiency:
 | The first suggestion is to place the
instruments in water. This method will keep the blood from drying and sticking.
However, water has neither soil suspending attributes nor the ability to loosen
soils in crevices or lumens.
|
| A better action would be to use a
water/detergent combination. Water keeps blood moist, and the detergent provides
some surfactant activity to loosen soil. Instruments will be much easier to clean
when they arrive in the central service (CS) department.
|
| The best option would be a
water/detergent/enzyme combination. Protease and lipase enzymes, which target
protein and lipids, will break down blood and fats, and literally, float them away.
Ideally, a product that is effective at room temperature should be considered since
elevated soaking temperature can result in coagulation of blood onto the medical device.
An enzyme detergent combination will penetrate tight areas and even work on
deposits in lumens and channels. Staff manual manipulation of instruments can be
reduced significantly because the cleaning solution does the work. Ultimately, this
method helps limit potential instrument damage from body fluids and also reduces personnel
exposure to contaminated instruments.
|
|
Clean Before Disinfecting
Placing soiled instruments in a disinfecting
solution without proper cleaning will not effectively reduce contamination. Even
current broad-spectrum disinfectants will not deliver dependable germicidal activity when
challenged with massive levels of organic load. 
If the
disinfectant cannot contact the organisms, it cannot kill them. blood and other
materials serve as strong barriers. With added scrubbing, these barriers can be
removed. For effective preliminary decontamination, clean instruments-- preferably
with an enzyme product-- then proceed with further decontamination.
A disinfectant presoak solution can be a
major contributor to instrument degradation. Phenolic or quaternary germicides can
also corrode the instrument surface, especially if the soak time is longer than 30
minutes. Phenolic formulations can cause permanent purple/brown staining, and
quaternary ammonium compound disinfectants can attack the instruments' chromium oxide
layer, promoting corrosion. If using a disinfectant in the manual process, there are
certain steps to follow:
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