The Most Common Mistakes in Steam Sterilization

Steam sterilization process failures are the result of a series of unfortunate events. Steam sterilization process failures are identified by observing the available monitoring tools. These include both the physical monitors on the steam sterilizer and the results of various types of indicators such as the Bowie-Dick (BD) tests, external chemical indicators. Most mistakes regarding the programming and operation of typical steam sterilizers are related to the basic principles of steam sterilization.

SOME OF THE COMMON ERRORS THAT CAN LEAD TO STERILIZATION FAILURE:

1. Improper cleaning of instruments- Cleaning is the basic, critical step in instrument processing because it involves removal of contaminating debris and organic material from an instrument before sterilization. If blood, saliva, and other contamination remain, they can shield adherent microorganisms and potentially compromise the sterilization process.
2. Improper packaging- Wrong type of packaging material for method of sterilization, placing too many instruments in a package, and wrapping items in excessive amounts of packing wrap can lead to failure in sterilisation. If the material used to package instruments is not compatible or excessive wrap is used, the sterilizing agent (i.e., moist heat under pressure, dry heat, and unsaturated chemical vapour under pressure) may not be able to appropriately contact instrument surfaces, thereby resulting in a sterilization failure.
3. Overloading the sterilizer- Overloading the chamber can result in prolonged warm up times needed to reach sterilization conditions, and may also prevent thorough contact of the sterilizing agent with all items in the unit. Not spacing wrapped instrument packages adequately is a common problem observed with sterilization failures.
4. Inappropriate sterilization time, temperature, and/or pressure- Issues to consider here include use of inadequate temperature or time during the sterilization cycle and interrupting the total cycle. Human error plays a role here if the sterilizer door is opened during the cycle or timers are incorrectly set, thereby resulting in incomplete sterilization.
5. Inadequate maintenance of sterilization equipment- Routine maintenance as recommended by the manufacturer is critical to the whole instrument processing protocol.
6. Use of improper equipment for sterilization- Use only FDA-cleared medical devices for sterilization and follow the manufacturer’s instructions for correct use.