 Terminal decontamination, disinfection & sterilization are the

procedures carried out to destroy pathogens on items after their use on

patients during surgery
 process by which chemical or physical agents are used to clean
Inanimate, noncritical surfaces
 a specific contact time is not specified
 a low level disinfectant is commonly used for this purpose

 chemical or physical process of destroying most forms of pathogenic

microorganisms except bacterial spores
 used for inanimate objects but not on tissue
 the degree of disinfection depends primarily on the strength of the
agent, the nature of the contamination and the purpose for the process
 performed in a designated area, not in the operating room immediately
after completion of the surgical procedure
 decontamination begins by wiping instruments as they are used on the
sterile field & then prerinsing, washing, rinsing and disinfecting /sterilizing
for safe handling in the processing department
 decontamination combines mechanical cleaning and a physical or
chemical microbicidal process to make instruments safe for handling
A. Prerinsing / Presoaking
B. Manual Cleaning
C. Washer-Sterilizer / Washer-Decontaminator
D. Ultrasonic Cleaning
E. Lubricating
F. Inspecting & Testing
 Earle H. Spaulding developed a classification system in 1968 to
determine the appropriate processing method to attain the desired level
of disinfection required for patient care items
• Critical items
• Semicritical items
• Noncritical items
LEVELS OF DISINFECTION
1. High level disinfection: process that destroys all microorganisms
except high numbers or bacterial spores
2. Intermediate-level disinfection: process that inactivates vegetative
bacteria, including M. tuberculosis & most fungi & viruses but does not kill
bacterial spores
3. Low- level disinfection: process that kills most bacteria, some viruses
& some fungi but does not destroy resistant microorganisms
•Manual wiping with a chemical-impregnated cloth or sponge
•Soaking by total immersion
•Processing by flush-through machinery
TYPES OF DISINFECTANTS:

1. Chemical Disinfectants (Table 17-1)

2. Physical Disinfectants
• Boiling water
• Pasteurization
• Ultraviolet Irradiation
  process by which all pathogenic & nonpathogenic microorganisms,
including spores are killed
 refers only to process capable of destroying all forms of microbial life
including spores
 it utilizes a sterilizer – a piece of equipment used to attain either
physical or chemical sterilization

1. Thermal (Physical): Steam under pressure / moist heat ; Hot air /

dry heat
2. Chemical:ethylene oxide gas; formaldehyde gas & solution; hydrogen
Peroxide plasma/vapor;ozone gas, acetic acid solution;glutaldehyde
Solution;peracetic acid 0.2% solution; hypochlorous acid
3. Radiation: microwave (nonionizing); x-ray (ionizing)