For Frist year TVET Midwifery
students
By: Furade Shukri.
1/5/2026 Furade Shukri 1
Instrument processing
Ø Contents
Decontamination
Cleaning
Drying and packing
High level disinfection
Sterilization Storing
1/5/2026 Furade Shukri 2
Objectives
At the end of this session students will be able to:
ü Identify essential components of instrumental processing.
ü Define different terms related with instrument processing
ü Perform instrument processing procedure
ü List different method of disinfection as well as sterilization.
1/5/2026 Furade Shukri 3
Instrument processing
Spaulding’s category of potential infection risk
ü Non-critical: come in contact with intact skin but not
mucous membranes.
ü Semi-critical: come in contact with mucous membranes
or non-intact skin
ü Critical: come in contact with sterile areas of the body
including the vascular system
1/5/2026 Furade Shukri 4
Instrument processing
q Is process of preparing used instrument for next procedure
through various step.
q The most efficient measures are:
ü Decontamination
ü Cleaning
ü Disinfection
ü Sterilization
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Key steps in instrument
Processing
Decontaminate
Sterilize High-Level
Chemical
High-pressure Disinfect
steam Boil
Dry heat
Steam
Clean Chemical
Dry/Cool
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and Store 6
Decontamination
§ Is the process of making
cleaning.
► Inactivates highly infectious microorganisms like HBV and
HIV
► Must be done before cleaning.
► Done by soaking the equipment in 0.5% chlorine solution.
1/5/2026 Furade Shukri 7
Decontamination practices
ü Place instruments and reusable gloves in 0.5% chlorine
solution after use.
ü Soak for 10 minutes and rinse immediately.
ü Do not soak instruments in decontaminating solution for
more than 10 minutes, because it results corrosion.
ü Use plastic container with cover for decontamination .
ü How we can prepare 0.5% chlorine solution?
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Cont…….
ü Wipe surfaces (exam tables) with chlorine solution.
ü Flush syringe and needles with 0.5% chlorine solution.
ü The decontamination room should be a room that is
physically separate from areas where clean instruments,
supplies and equipment are undergoing preparation for
sterilization to prevent the risk of cross-contamination.
1/5/2026 Furade Shukri 9
Cont…….
Use three buckets by
labeling it.
ü One filled with 0.5%
chlorine solution.
ü One with soap and
water.
ü One with clean water.
1/5/2026 Furade Shukri 10
Cleaning
ü Is a process of physically removing infectious agents and
other organic matters on where they live and thrive but
does not necessarily destroy infectious agents.
ü Is an to any method of sterilization
process.
ü Is the to ensure effective disinfection
or sterilization process.
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Cont…….
begin during the
surgical procedure:
ü To prevent drying of blood, soil and debris on the
surface and within lumens.
ü The first scrub role should keep the instruments free of
debris and blood during the surgical procedure.
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Cont…….
ü All instruments that were on the sterile field, whether
used or not used, are considered contaminated, and a
possibly source of MOs that could cause an infection
ü Instruments should be disassembled and in the open
position.
ü Instruments with lumen should be thoroughly rinsed or
soaked vertically.
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Cont…….
ü All instruments should be thoroughly rinsed to remove
detergent residue.
ü Water-soluble lubricant is recommended following
decontamination.
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Cont…….
ü Instruments should never be soaked in saline or sodium
hypochlorite (bleach) solution and iodophors
.
ü The chloride ions in both solutions are highly corrosive,
causing the breakdown of the finish on instruments, as
well as the metal.
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Cont…….
instruments
Use of liquid soap is effective for cleaning.
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Cont…….
ü Low foaming
ü Easily rinsed off
ü Disperse organic soil
ü Decomposable
ü Nontoxic
ü Non abrasive
ü Effective on all types of organic soil
ü Cost-effective
ü Long shelf life
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Cont…….
ü Cleaning be performed
manually & or mechanically
Selection of the cleaning
method should be based on
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Cont…….
Ø Manual cleaning
Ø Mechanical cleaning:
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Cont…….
q Manual cleaning has 4 phases:
ü Soaking
ü Brushing
ü Rinsing
ü Drying
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ü Use PPE during cleaning to protect from
♪ Soil, debris, blood and body fluids
♪ Splashes from liquid chemical cleaning agents
ü Disassemble instruments
ü Wash with detergent, water, and a soft brush.
ü Scrub instruments under the water surface until visibly clean.
ü Thoroughly rinse with clean water.
1/5/2026 Furade Shukri 21
Disinfection
Common methods of disinfection include the use of.
ü Alcohol wipes,
ü Hexachlorophene
ü Chlorohexidine gluconate soap scrub, or
ü Povidone-iodine scrub to kill MOs on the skin.
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Cont…….
Types of disinfection
ü High Level Disinfection(HLD)
ü Intermediate Level Disinfection(ILD)
ü Low Level Disinfection(LLD)
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Introduction to Chemical Disinfectants
Commonly Used Chemical Disinfectants are;
vAlcohols
vChlorine and chlorine releasing compounds
ü Sodium hypochlorite (Chlorine bleach)
ü Calcium hypochlorite or chlorinated lime
ü Sodium dichloroisocyanurate
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Cont….
ü Glutaraldehyde
ü Formaldehyde
ü Iodine and Iodophor solutions
ü Hydrogen Peroxide
ü Orthophthalaldehyde (OPA)
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Practices Chemical Disinfection.
ü For HLD, a 0.1% chlorine solution shall be prepared
from boiled water.
ü Decontaminate, clean, rinse and dry instruments,
ü Cover all items completely with disinfectant,
ü Soak for 20 minutes,
ü Rinse thoroughly with boiled water three times.
ü Air-dry before use and storage.
ü Remove items using HLD or sterile forceps/gloves.
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Cont…….
Note:
Ø Chemical disinfectants should be stored in a cool, dark
area,
Never store chemicals:
ü In direct sunlight or
ü In excessive heat
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Cont…….
Chemicals used for disifection
Ø Chlorine solution 0.1%
ü Safe for stainless and plated instruments
ü Concentrated solutions >0.5% can
Ø Glutaraldehyde 2-4%
ü Less irritating but still needs to be in well ventilated
area
1/5/2026 Furade Shukri 28
Cont…….
Characteristics of a Good Disinfectants
activity
(does not precipitate)
products
• Non-toxic, non-corrosive
• Odorless
• Surface compatibility
• Cost effective
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STERILIZATION
ü Used for instruments and other items that come in direct
contact with the blood stream or tissue under the skin.
ü Can ensure the safe use of invasive medical devices.
ü All items to be sterilized should be
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Cont…….
q Wrapping materials should
ü Be ,
ü Be free of ,
ü Be resistant to bacteria,
ü Allow
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Cont…….
Characteristics of a Sterilizing Agent
microbicidal
ü Bactericidal: killing bacteria
ü Sporicidal: killing spore
ü Tuberculocidal: killing TB
ü Fungicidal
ü Viricidal
Strong penetrability
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Cont…….
METHODS(TYPES) OF STERILIZATION
ü Steam sterilization,
ü Dry heat sterilization,
ü Chemical Sterilization,
ü Gas sterilization using
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STEAM STERILIZATION
ü Also called an .
ü Steam, especially .
ü Certain contaminants, such as grease or oil materials, can
protect the effects of steam, we
should have clean thoroughly.
1/5/2026 Furade Shukri 34
Cont…….
The & combination for
is:
v 121°C (250°F) at 106 kPa pressure for
ü 20 minutes for unwrapped items
ü 30 minutes for wrapped items
v 132°C (270°F), pressure of 206 kPa
ü 15 minutes for wrapped items.
ü10 minutes for unwrapped items.
1/5/2026 Furade Shukri 35
Cont…….
Sterilization depends on
ü Routine maintenance
ü Preparing items to be sterilized
ü Packing and wrapping
ü Operating
ü Unloading the sterilizer
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Cont. …….
Techniques for packing instruments for the
autoclave
ü Envelope wrap
ü Square wrap
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DRY HEAT STERILIZATION
ü Also called Oven.
ü Accomplished by thermal (heat) conduction.
ü Initially, heat is absorbed by the exterior surface of an
item and then passed to the next layer.
ü MOs die as their proteins are slowly destroyed.
ü Takes longer time than steam sterilization because the
steam speeds up the penetration of the heat.
1/5/2026 Furade Shukri 38
Cont…….
Conditions: long exposure time, high temperature
System: heat oven
Requirements:
ü Adequate temperature
ü Correct time
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Cont…….
Recommended temperature/time ratios for oven
ü 180°C (356°F) for 30 minutes
ü 170°C (340°F) for 60 minutes
ü 160°C (320°F) for 120 minutes
ü 150°C (300°F) for 150 minutes
ü 140°C (285°F) for 180 minutes
ü 121°C (250°F) for overnight
1/5/2026 Furade Shukri 40
Chemical Sterilization
ü Is an alternative for items that would be damaged if
subjected to steam or dry heat sterilization.
ü Sterilization takes place by soaking.
ü Rinse with sterile water.
ü Is powerful enough to destroy germs
1/5/2026 Furade Shukri 41
Cont…….
When handling these products:
ü Wear gloves to avoid skin contact.
ü Wear protective eyewear to protect from splashes.
ü Limit exposure time.
ü Be in a well-ventilated area
1/5/2026 Furade Shukri 42
Cont…….
Allow items to soak
ü For 10 hours in 2–4% solution or
ü For 24 hours in 8% .
1/5/2026 Furade Shukri 43
STERILIZATION CONTROL/MONITORING
It is essential quality assessment procedure for infection
control.
ü Physical monitoring
ü Biological monitoring
ü Chemical monitoring
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STERILE MATERIAL STORAGE
The sterile material storage should follow optimal
conditions:
ü Relative humidity: 40% – 60%.
ü Temperature: 15 ºC – 25 ºC.
ü Ventilation: 6 air exchanges/h.
Sterile material packages need to be stored
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Cont…….
ü At a minimum height of 25 cm above the ground and 40
cm from the ceiling,
ü On wire shelving, to avoid dust accumulation and
humidity condensation.
ü Where packaging is not crushed, bent, compressed, or
punctured.
1/5/2026 Furade Shukri 46
QUIZ 1
1. List three type of sterilization monitoring(2%)
2. Write four essential steps of manual cleaning(2%)
3. Write at least four ideal characteristics of cleanin agent(2%)
4. Write the temperature, pressure & time combination for
steam sterilization(2%)
5. Least four types of sterilization(2%)
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