Nama : Samsul Maarif

Tgl Lahir : Gresik 06 Mei 1972

Status : Menikah, 1 orang Istri, 2 anak
Alamat : Jl Sampurna 74 Malang
Email : samsulmaarifmlg@yahoo.com

Pendidikan : SPK Soetomo Surabaya lulus th 1991

D3 Keperawatan Universitas Muhammadiyah Malang lulus th 2003
Sarjana Keperawatan & Ners Unibraw lulus th 2008
Saat ini menempuh pendidikan Magister Keperawatan Unibraw

Pekerjaan : Staf Perawat IBS RS Islam Aisyiyah Malang

Ketua Komite Keperawatan RS Islam Aisyiyah Malang 2014-2019
Ka Sub Bag SDI RS Islam Aisyiyah Malang
Dosen Tamu pada FIKES Universitas Muhammadiyah Malang
Dosen Tamu pada D IV Keperawatan Periop POLTEKKES Kemenkes Malang

Organisasi : Ketua Pengurus Daerah Himpunan Perawat Kamar Bedah Malang Raya 2017-2022
Bid Diklat & Pengembangan SDM Pengurus Wilayah HIPKABI Jawa Timur 2016-2021
Bid Diklat & Pengembangan SDM Pengurus Pusat HIPKABI 2018-2023
Sterilization & Disinfection

Samsul Maarif
Ojective
The Audience be Able to :
 Describe the several steps of instruments
reprocessing
 Differentiate the usage of sterilization and
disinfection
 Describe the causes of failed sterilization
process

Samsul Maarif
Introduction

 Best practice for instruments

reprocessing cycle will reduce
Failed sterilization process
 Best practices for instrument
reprocessing cycle is an
important to minimize the risk
of Infections

All contaminated Medical instruments are

potential sources of Infections

Samsul Maarif
 Attention!!

A dirty instrument cannot be effectively

sterilized, because the soil shields
bacteria and viruses from the sterilizing
agent.

As a result, bacteria and viruses may very

well survive the sterilization process and
can cross infect the next patient.

Samsul Maarif
SEVERAL STEPS OF
INSTRUMENTS REPROCESSING
1. Pre-cleaning
2. Cleaning and rinsing
3. Drying & Lubrication
4. Packaging
5. Sterilization or High-Level Disinfection
6. Storage

Samsul Maarif
 Pre-Cleaning

Removes patient’s biomaterial

from the instruments

Pre-cleaning, soak the instruments in

an enzymatic solution or a combined
detergent / disinfectant
Samsul Maarif
Cleaning

Neutral detergents with a pH of seven

that are low-foaming should be used
for cleaning instruments

Neutral pH detergents work well, low-

foaming detergents are more easily
removed during rinsing

Brush all surfaces of the instruments with soft cleaning

brushes while they are submerged in a water bath
Samsul Maarif
 Rinsing
Residual detergent may react with and inhibit the
disinfectant or sterilant solution

Rinsing of instruments under running water

Samsul Maarif
 Drying

 Elimination of moisture helps prevent rust

formation during instruments storage
 Ethylene oxyde (EO) combines with
water and create ethylene glycol which
is toxic

Drying of instruments with a jet of air.

Samsul Maarif
 Lubrication
 Lubricants should be compatible with the method of
sterilization
 Water soluble lubricants allow steam penetration during
sterilization, oil based product cannot be penetrated and
prevent the sterilant from contacting the instruments
surfaces

Samsul Maarif
Sterilization / High Level Desinfection

 High Level Disinfection is a process that destroys all

microorganisms (bacteria, viruses, fungi, and parasites)
but does not reliably kill all bacterial endospores
 Sterilization: The complete elimination of all forms of
microbial life
 The process depend on the usage of instruments
 Semi-Critical instruments
 Critical Instruments

Samsul Maarif
High level Disinfection

 The effectiveness of HLD depends on the amount

and type of microorganisms, organic material
(blood, other fluids, tissues), and other matter (such
as dirt) present on the instrument.
 Therefore it is important to decontaminate and
thoroughly clean instruments before HLD.

Samsul Maarif
High level Disinfection

 The disinfectants begin to degrade upon preparation.

The addition of any debris or solution, such as water, will
reduce the effective concentration.
 Therefore, it is recommended that the minimum effective
concentration (MEC) must be tested prior to each use
according to the manufacturer’s instructions.
 High Level Disinfection is followed by rinsing and drying
before the instruments are stored / used to minimize
adverse tissue reaction (chemical tissue irritation)

Samsul Maarif
Sterilization Methood

 Steam sterilization
 Dry Heat Sterilization
 Ethylene Oxide Sterilization
 Hydrogen Peroxide Gas Plasma

Samsul Maarif
 Steam Sterilization
 Saturated steam under pressure is the oldest and most widely
used, economical, effective and reliable method of sterilization
 Steam kills microorganisms by coagulating and denaturing the
cell protein
 Recommended minimum sterilization times : 120⁰C 30 min
exposure; 45 min drying time
 Due to the high temperatures and moisture associated with
steam sterilization it may only be used with heat and moisture
stable medical devices, instruments and compatible materials
 The sterilizer chamber must be free of any air entrapment to
ensure direct contact of the steam to all surfaces to be sterilized

Samsul Maarif
 Dry Heat Sterilization
 Dry heat sterilization should be used to sterilize anhydrous
(waterless) items that can withstand high temperatures
 The destruction of organisms occurs by oxidation, which is
a slow burning
 Recommended sterilization time : 6 hours exposure at
120°C
 It is generally to sterilize talcum powder for surgical
procedures, sharp/pointed instruments, such as burrs and
reusable needles that would be damaged by the moisture
of steam

Samsul Maarif
Storage

 Instruments should be stored in a clean, dry, and

well ventilated area to minimize the possibility of
recontamination.
 Temperature and humidity the area should be
controlled
 The sterility life time depend on : The sterilization
methood, packing, and storage place

Samsul Maarif
Failure of Medical Instrument Reprocessing

 Incomplete of Instruments Reprocessing cycle

 The usage of Inadequate Cleaning Agent
 The Usage of Inappropriate Lubricants
 Inappropriate packing materials or technique
 Sterilization process failure
 Inadequate of sterile instruments storage

Samsul Maarif
Incomplete of Instruments Reprocessing cycle

The First & Most Important Step in Instruments

Reprocessing Cycle is Cleaning
If not done immediately, instruments should be
submerged in a neutral PH detergent or
Enzymatic Solution

A dirty instrument cannot be

effectively sterilized, because the
soil shields bacteria and viruses
from the sterilizing agent.

As a result, bacteria and viruses

may very well survive the
sterilization process and can cross
infect the next patient.
Samsul Maarif
The Use of Inadequate Cleaning Agent

Neutral detergents with a pH of seven

that are low-foaming should be used
for cleaning instruments

Neutral pH detergents work well, low- XXXX

foaming detergents are more easily
removed during rinsing
XXX

Samsul Maarif
The Use of Inappropriate Lubricants

Lubricants should be compatible with the

method of sterilization

Water soluble lubricants allow steam

penetration during sterilization, oil based xxxx
product cannot be penetrated and
prevent the sterilant from contacting the
instruments surfaces

Samsul Maarif
Inappropriate packing materials or technique

Packaging for sterilization should be

suitable for the sterilization method used to
ensure that the packaging material can be
penetrated by the sterilizing agent.

The packaging also provides protection

from microbiological recontamination
during transport and storage.

Samsul Maarif
 Packaging Material
Sterilization Method Requirements
Steam autoclave •Should allow steam to
penetrate
Dry heat •Should not insulate items from
heat
•Should not be destroyed by
temperature used
Unsaturated chemical vapor •Vapors should be allowed to
precipitate on contents
•Vapors should not react with
packaging material
•Plastics should not contact
sides of sterilizer
Acceptable Materials
•Paper
•Plastic
•Cloth
•Paper/plastic peel packages
•Wrapped perforated cassettes
•Paper bags
•Aluminum foil
•Polyfilm plastic tubing
•Wrapped perforated cassettes
•Wrapped perforated cassettes
•Paper
•Paper/plastic peel packages
Samsul Maarif
Sterilization process failure

 Malfunctioning Sterilizer
 User Errors
 Sterilizer Loading Errors

Chemical indicators should be used in combination with

mechanical monitors and biological indicators as part of
the quality assurance sterilization program.

Samsul Maarif
Inadequate of sterile instruments storage

 Store sterile surgical instruments on shelving

that is at least 8 to 10 inches from the floor, 18
inches from the ceiling, and 2 inches from
outside walls.
 Humidity should not exceed 65% and the
temperature should not exceed 22°C.
 Minimize over handling and unnecessary
traffic in the sterile storage area.

Samsul Maarif
Samsul Maarif