Sterilization of Instruments

[Guest]

One of the issues that I see at many different hospitals is that of sterilizing wet instruments. Instruments are taken out of the washer in a tray that belongs in some type of container system, it is then "dumped" out on a table, reassembled, placed back into the tray with some type of tray liner. The instruments nor the tray have been wiped even remotely dry. Usually the tray liner becomes soaked with water from the tray and then the instruments. What is the prefered method and where is it cited in AAMI? Is once wet, always wet still applying? Please help!

[sunshine]

Ours are damp with instrument milk......by the time we have them assembled there is very little moisture.

[sleepless]

I believe that this is a gray area and is probably worth some discussion. I don't believe wet should be acceptable as it may inhibit the sterilization process by over saturation. The linen or tray liners should not be "soaked" nor should they be wet before placing instruments on them followed by sterilization. We're dealing with the theory of sterilization and I think that some testing should be done to verify that you are not ending up with wet trays or containers in this process. I myself would not be an advocate for purposely trying to sterilize anything that is wet.

[sklacik]

The AAMI "Steam sterilization and sterility assurance in health care facilities" (ST 46) specifically addresses this issue under 5.5.2.3 Instruments. The Standard states:
"Water-soluble instrument lubricants, specifically designed for compatibility with sterilization, may be used: the manufacturer's instructions for use should be followed. Instrument lubricants containing mineral oil bases should not be used except to lubricate the internal mechanism of powered instruments as specified by the manufacturer. Instruments should be carefully inspected for flaws or damage and dried before packaging or sterilization.
Section 5.6.2.9 Devices with lumens. Discusses the sterilization of lumens, stating that lumens should be flushed with distilled or demneralized water prior to packaging then immediately steam sterilized.