Cleaning, Disinfection &
Sterilization of Medical Devices

Effective cleaning, disinfection and sterilization is an essential part of breaking the chain of transmission of infectious pathogens. Reusable medical equipment must be cleanable and be able to be disinfected or sterilized as appropriate for the equipment.

CLEANING

General removal of debris physical removal of dirt with running water and detergent action. Should be done for all items prior to disinfection/ sterilization.

Sterilization

Killing of all disease causing organisms. For items that penetrate sterile tissue. (e.g., surgical equipment)

HIGH - LEVEL DISINFECTION

For items that come in contact with patients non-intact skin and/or mucous membranes but does not penetrate them. HLD kills vegetative bacteria, fungi, lipid and non-lipid-viruses and mycobacteria. (e.g. laryngoscope blade)

LOW - LEVEL DISINFECTION

Removal of most of the organisms present on the surface that can cause infection. For equipment that does not touch mucous membranes and only touches intact skin (e.g., blood pressure cuff)

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RESOURCE

Reprocessing Decision Chart (publichealthontario.ca)

References

Association for the Advancement of Medical Instrumentation (AAMI). (2015). FDA proposes new criteria for surgical gowns. Retrieved from Association for the Advancement of Medical Instrumentation website: www.aami.org/newsviews/newsdetail.aspx?ItemNumber=2650

Canadian Patient Safety Institute. (n.d.). Ventilator-associated pneumonia (VAP). Retrieved from Canadian Patient Safety Institute website: www.patientsafetyinstitute.ca/en/topic/pages/ventilator-associatedpneumonia-(vap).aspx

Centers for Disease Control and Prevention. (2011). Central line-associated bloodstream infections: Resources for patients and healthcare providers. Retrieved from Centers for Disease Control and Prevention website: www.cdc.gov/HAI/bsi/CLABSI-resources.html

Critical Care Secretariat. (2012). Ventilator associated pneumonia and central line infection prevention toolkit. Retrieved from Critical Care Services Ontario website: www.criticalcareontario.ca/EN/Toolbox/Performance%20Improvement%20Collaborative/VAP%20and%2 0CLI%20Toolkit%20(2012).pdf

Immunize Canada. (2016). ImmunizeCA app. Retrieved from Immunize Canada website: http://immunize.ca/en/app.aspx

Loeb, M., Dafoe, N., Mahony J., John, M., Sarabia, A., Glavin, V., Walter, S.S. (2009). Surgical mask vs N95 respirator for preventing influenza among health care workers: A randomized trial. JAMA, 302(17), 1865- 1871. doi:10.1001/jama.2009.1466. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=184819

PIDAC. (2012a). Best practices for infection prevention and control programs in Ontario (3rd ed.). Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/BP_IPAC_Ontario_HCSettings_2012.pdf

PIDAC. (2012b). Routine practices and additional precautions in all health care settings (3rd ed.). Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/RPAP_All_HealthCare_Settings_Eng2012.pdf

PIDAC. (2013). Annex B: Best practices for prevention of transmission of acute respiratory infection in all health care settings. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/PIDAC-IPC_Annex_B_Prevention_Transmission_ARI_2013.pdf

PIDAC. (2014). Best practices for hand hygiene in all health care settings, (4th ed.). Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/2010-12%20BP%20Hand%20Hygiene.pdf

PIDAC. (2015a). Best practices for prevention, surveillance and infection control management of novel respiratory infections in all health care settings. Retrieved from Public Health Ontariowebsite: www.publichealthontario.ca/en/eRepository/Best_Practices_Novel_Respiratory_Infections.pdf

PIDAC. (2015b). Infection prevention and control for clinical office practice. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/IPAC_Clinical_Office_Practice_2013.pdf

PIDAC. (2016). Tools for preparedness: Triage, screening and patient management for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in acute care settings. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/PIDAC-IPC_Preparedness_Tools_MERS_CoV_2013.pdf

Public Health Agency of Canada. (2013). Canadian immunization guide. Retrieved from Public Health Agency of Canada website: http://phac-aspc.gc.ca/publicat/cig-gci/p03-work-travail-eng.php#a1

Public Health Agency of Canada. (2014). Canadian Tuberculosis Standards (7th ed.). Retrieved from http://www.phac-aspc.gc.ca/tbpc-latb/pubs/tb-canada-7/assets/pdf/tb-standards-tb-normes-prefeng.pdf

Public Health Agency of Canada. (2016). Summary of assessment of public health risk to Canada associated with Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Retrieved from Public Health Agency of Canada website: www.phac-aspc.gc.ca/eri-ire/coronavirus/risk_assessment-evaluation_risque-eng.php

Public Health Ontario. (n.d.a). Chain of transmission and risk assessment: Glossary of terms. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/LearningAndDevelopment/OnlineLearning/InfectiousDiseases/IPACCore/Documents/CORE_Trainers_COT_and_RA_Module_Glossary_April _2014.pdf

Public Health Ontario. (n.d.b). Risk Algorithm to Guide PPE Use. Retrieved from Public Health Ontario website: www.publichealthontario.ca/en/eRepository/IPAC_Clinical_Office_Practice_Risk_Algorithm_PPE_2013.pdf

World Health Organization. (2015). Middle East respiratory syndrome coronavirus (MERS-CoV). Retrieved from World Health Organization website: www.who.int/mediacentre/factsheets/mers-cov/en/

Cleaning, Disinfection & Sterilization of Medical Devices