After a surgery is complete, surgical instruments are cleaned according to the manufacturer’s instructions. Above, Kim MacKenzie, Sterile Processing Technician, loads surgical instruments into an ultrasonic washer. Disinfectors and manual cleaning techniques can also be used to clean instruments, depending on the manufacturer’s instructions.
Photo essay: Behind the scenes - Sterile Processing Department
Verifying the cycle
Once the ultrasonic washer is started, a technician initials a print-out to verify the correct cycle was used. Upon cycle completion, the printout is reviewed again to verify all of the cycle parameters were met.
Inspecting the instruments
Ronial Fraser, Sterile Processing Technician, inspects an ophthalmology surgical set.
When surgical instruments comes from the decontamination room, they are inspected for cleanliness as well as damage and functionality. If a piece of equipment is damaged, it will be removed from the set and replaced.
By the book
Technicians follow reference books during instrument inspections to ensure the proper type and number of surgical instruments are included. Kevin Boutilier, Sterile Processing Technician, inspects a chest surgical tray.
Chemical indicators are placed in every instrument set prior to sterilization. The indicator changes colour to indicate to the user that it has been exposed to a sterilization cycle. If the indicator does not change colour, the user will notify the Sterile Processing Department and a recall will be initiated.
Let’s wrap it up
Once the instruments have been checked for cleanliness, damage and functionality, they are placed into their respective containers and wrapped in preparation for sterilization. Here, technician Sarah Alexander wraps and instrument set. She leaves a tab so nurses can later open it without contaminating the contents. She will then seal the set using a tape designed for sterilization.
Instrument sets are labelled with the operating room they belong to and a technician initials the set. The lighter diagonal lines on the tape will change colour after the tape has been subjected to the sterilization process. This is another visual quality check that lets the SPD Technician know the instruments have been subjected to a sterilizing process. The tape is referred to as an external chemical indicator. If for any reason the set is compromised, the technician who initialled it takes accountability as the person who performed the quality checks.
Ready for sterilization
Wrapped instruments waiting to be sterilized.
Once the sets and instruments are wrapped, they are placed on a sterilizer cart. The cart allows the Sterile Processing Technician to put multiple instruments and sets into the sterilizer. There are many different sterilization cycles, thus the SPD Technician must choose the correct cycle for the items to be sterilized.
In they go
A full cart of trays and instruments are being pushed into the sterilizer.
Once the sterilizer cart is full, it is loaded into a sterilizer and the appropriate cycle is selected. Technicians initial a printout from the sterilizer to show that they chose the correct cycle.
Out they come
A sterilized cart filled with instruments and trays is removed from the sterilizer.
Once the cycle is complete, the load is removed and technicians look to see if the tape changed colour. This is the first visual indicator that the load has been subjected to a sterilization process.
Nice point quality checks are completed on each cycle print-out. Technicians circle the date and time, underline when the cycle started, when it stopped and how long it took, place a sticker with the sterilizer number and load number at the start of the cycle time, underline the type of cycle the instruments were subjected to and sign their initials.
Ready for surgery
Once the sterilized instruments have come out of the sterilization machine, they are then cooled and transferred to the corresponding shelves. This is where surgical packages will stay until they are used and then brought back to the decontamination room.