Preventing infections in patients undergoing surgical procedures is a primary goal for all members of the healthcare team. This is especially important in today’s dynamic healthcare environment, in the face of newly recognized pathogens, well-known microorganisms that have become resistant to treatment modalities, and the economic pressures to reduce healthcare-associated infections. A key infection control practice for reducing the likelihood of a surgical site infection is proper reprocessing of surgical instruments. However, effective reprocessing of instrumentation can only take place after thorough cleaning, as any disinfection or sterilization process is adversely affected by the presence of bioburden. The detergent or disinfectant agent used to clean surgical instruments is a key factor in instrument reprocessing, as well as safe patient care. Because there are various types of detergents available today, all personnel involved in the care and cleaning of surgical instruments must be knowledgeable about these agents and the proper instrument cleaning process.
This continuing education activity will provide a review of the key considerations related to the selection and use of detergents and disinfectants for instrument cleaning. It will outline the steps of the instrument cleaning process. The characteristics of the various types of detergents and high-level disinfectants will be described. Troubleshooting steps for the cleaning process and mechanical equipment will be presented. Finally, the applicable regulations and standards related to instrument care and cleaning will be reviewed.