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FAQ - Sterilization - 2016
FAQ - Sterilization - 2016

 

 

Can sterile instruments be stored over a sterilizer? I have been told yes and no.

Ask OSAP can provide you with some general information on this topic. As requirements can vary by state, you may also wish to consider contacting your state public health agency (i.e, state health department) for further information on this matter.

The 2003 CDC guidelines for infection control in dentistry states as follows:

Instrument Processing Area

DHCP should process all instruments in a designated central processing area to more easily control quality and ensure safety (248). The central processing area should be divided into sections for 1) receiving, cleaning, and decontamination; 2) preparation and packaging; 3) sterilization; and 4) storage. Ideally, walls or partitions should separate the sections to control traffic flow and contain contaminants generated during processing. When physical separation of these sections cannot be achieved, adequate spatial separation might be satisfactory if the DHCP who process instruments are trained in work practices to prevent contamination of clean areas (248). Space should be adequate for the volume of work anticipated and the items to be stored (248).  1

And,

Sterilization

The sterilization section of the processing area should include the sterilizers and related supplies, with adequate space for loading, unloading, and cool down. The area can also include incubators for analyzing spore tests and enclosed storage for sterile items and disposable (single-use) items (260). Manufacturer and local building code specifications will determine placement and room ventilation requirements.  1

And,

Storage of Sterilized Items and Clean Dental Supplies

The storage area should contain enclosed storage for sterile items and disposable (single-use) items (173). Storage practices for wrapped sterilized instruments can be either date- or event-related. Packages containing sterile supplies should be inspected before use to verify barrier integrity and dryness. Although some health-care facilities continue to date every sterilized package and use shelf-life practices, other facilities have switched to event-related practices (243). This approach recognizes that the product should remain sterile indefinitely, unless an event causes it to become contaminated (e.g., torn or wet packaging) (284). Even for event-related packaging, minimally, the date of sterilization should be placed on the package, and if multiple sterilizers are used in the facility, the sterilizer used should be indicated on the outside of the packaging material to facilitate the retrieval of processed items in the event of a sterilization failure (247). If packaging is compromised, the instruments should be recleaned, packaged in new wrap, and sterilized again. Clean supplies and instruments should be stored in closed or covered cabinets, if possible (285). Dental supplies and instruments should not be stored under sinks or in other locations where they might become wet.  1

Practical Infection Control In Dentistry states:

Storage Of Sterilized Items And Clean Dental Supplies

The storage area should be clean and dry, and should contain enclosed storage units for sterile items and clean patient-care supplies. Closed cabinets limit dust accumulation and inadvertent contact with the sterile items. The shelves or drawers should be cleaned and disinfected on a regular basis (e.g., once a week). Sterile instruments or patient-care items should not be stored where they may become wet, such as under a sink, because even a small leak could compromise the integrity of the packaging material. Also, storage of supplies on the floor should be avoided. Shipping boxes and other cardboard cartons should not be used in sterile storage areas because they have potentially been exposed to high microbial contamination and they serve as a reservoir for dust. Packages should be handled only when absolutely necessary to avoid unnecessary contamination. By developing a stock rotation policy in the dental office, DHCP can ensure that older packages are used first and prevent waste because of expiration. This principle is sometimes referred to as “first in, first out.” Proper care and storage of packaged, sterilized instruments will help ensure that they will remain sterile until the package is opened at the time of use. 2

Infection Control and Management of Hazardous Materials for the Dental Team states:

One should store sterile packages in covered or closed cabinets in dry, enclosed, low-dust areas protected from obvious sources of contamination. One should store sterile packages away from sinks and sewer and water pipes and a few inches away from ceilings, floors, and outside walls. This prevents packages from becoming wet with splashed water, floor-cleaning products, and condensation on pipes or walls. One should also store the packages away from heat sources that may make the packaging material brittle and more susceptible to tearing or puncture. 3

The above information provides recommendations for the storage of sterilized items and clean dental supplies for compliance with the 2003 CDC guidelines for infection control in dentistry. The central processing area should include a separate storage area preferably with enclosed storage units.

Resources

1)     Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM, Centers for Disease Control and Prevention (CDC). Guidelines for infection control in dental health-care settings—2003. MMWR Recomm Rep 2003;52(RR-17):1-61. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm    Accessed on June 9, 2016

2)     Molinari JA and Harte JA. Practical Infection Control In Dentistry – Third Edition. Wolters Kluwer / Lippincott / Williams & Wilkins. Page 228.

3)     Miller CH. Infection Control and Management of Hazardous Materials for the Dental Team, 5th edition. Elsevier/Mosby Publishers. Pages 142.

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