Clinical office reprocessing

Detergents

Detergents are chemicals that help clean devices when used in a solution with water. Use medical-grade detergents intended for medical devices. Using the wrong detergent can stain the device and result in inadequate cleaning. Household products such as dish detergent can leave residue on devices and must not be used.

Some medical detergents contain one or more enzymes that are chemical substances which act on specific types of soil. Enzymatic cleaners can also be used for pre-soaking heavily soiled devices prior to the cleaning step as they dissolve dried soil without mechanical action.

Packaging

Reusable critical and semi-critical medical devices must be packaged in approved sterilization packaging.

Approved packaging is compatible with the steam process and protects medical devices from contamination after sterilization.   

Packaging both reusable semi-critical and critical medical devices ensures:

• physician offices are meeting national standards set out by the Canadian Standards Association (CSA)
• these devices are not contaminated or compromised until use

Past common practice had been for physicians to steam sterilize an unpackaged semi-critical reusable medical device (e.g. reusable vaginal speculum) and store it in an unsterile location (e.g. a drawer in the exam room) until use. This practice increases the likelihood of contamination and increases patient risk of cross-contamination.

National and provincial standards state that each package must have:

1. an externally visible chemical indicator
2. an internal chemical indicator for the purpose of differentiating between processed and unprocessed packages
3. a load control label with at least the following information:
   • name of item(s)
   • date of sterilization
   • load number if more than one load is done in a day

Reusing disposables and sterilizing consumables

Any medical device which will be reprocessed must have MIFU. These are instructions which show the device manufacturer has validated the steps necessary to reprocess a device that is safe for patient use.

How can you tell if it is a single-use disposable device?

Single-use disposable devices:

• do not have MIFUs for safe reprocessing
• must be discarded after use
• must be dedicated to only one patient
• have symbols or wording on packaging or on the device itself indicating they are single use (e.g. “Do Not Reuse/Reprocess” or “Single Use Disposable”)

Examples of inappropriate reprocessing

Single-use disposable devices that are inappropriately reprocessed include:

• skin staple removers (both plastic and metal)
• respiratory devices (e.g. aerochambers)
• humidifying masks

Consumables are single-use only

Gauze, cotton balls, and other woven fabrics do not commonly have MIFUs for steam sterilization. They cannot be successfully sterilized in a steam sterilizer.

Clinical offices must obtain individually packaged sterile consumable items which have been sterilized by the manufacturer.

Note: Manufacturers use radiation or gas sterilization, not steam, to sterilize these items.