OSHA Standard Disinfection and Sterilization
According to OSHA standards, disinfection and sterilization procedures should be used for all reusable instruments, devices and other items that are contaminated with blood and/or other potentially infectious materials (OPIM).
Your practice should use the following definitions as guidelines for appropriate sterilization and/or disinfection procedures:
Disinfection levels and sterilization
High level disinfection:
Must be used on all semi-critical care items that could be damaged by heat sterilization. Use a product labeled “disinfectant/sterilant” and leave the items immersed for the shorter time recommended by the manufacturer. (The longer time is used for “cold sterilization”.)
Intermediate level disinfection:
Must not be used on semi-critical care items. Use it for disinfection of non-critical care items that are contaminated with blood or OPIM. A bleach solution (1 part bleach to 10 parts water) is strong enough but must be mixed fresh daily. Wipe the item to be cleaned with the bleach solution (or a commercial disinfectant) and allow it to air dry.
Low level disinfection:
Not necessary for non-critical care items that have not been contaminated with blood or OPIM. Proper cleaning is usually sufficient. To use a low-level disinfection, wipe or spray an EPA registered disinfectant on the surfaces of the cleaned items and let them air dry.
Destroys all microorganisms (including viruses) and their spores. Sterilization can be accomplished by the use of steam (steam autoclave), dry heat, chemicals under pressure (chemical autoclave) or an EPA registered product that is labeled “disinfectant/sterilant” (sometimes referred to as “cold sterilization”).
Critical Care Items
Critical care items:
All instruments and/or devices that are introduced directly into the bloodstream. They touch bone or penetrate tissue. All of these items must be sterilized.
Semi-critical care items:
Instruments that touch mucous membranes but do not touch bone or penetrate tissue. Sterilize them or, if the items are damaged by heat, use a high-level disinfection process following the manufacturer’s guidelines.
Non-critical care items:
Equipment and environmental surfaces that will come into contact with intact skin only. Floors, exam tables, crutches, and countertops are examples of non-critical care items. Use intermediate-level disinfection for non-critical care items. (Cleaning alone is sufficient unless the items are visibly contaminated with blood.)
Biological monitoring is a “spore test” and is the only way to ensure that heat sterilization is effectively killing all types of microorganisms. Check with the manufacturer of sterilizer for the proper spore test. Mail the exposed test spores to an appropriate microbiology lab for testing or check them in a special incubator designed for that purpose.