8. Disinfection and Sterilization Procedures 8.1 CONTAMINATED surfaces can serve as reservoirs of potential pathogens that can spread via hand contact with the CONTAMINATED surface (CDC, 2019a). Nonporous surfaces in good repair can be easily cleaned, which will thus contribute to a reduction in pathogen spread. Surfaces must be cleaned prior to DISINFECTING. Cleaning is done by scrubbing with detergents and surfactants and then rinsing with water to remove organic matter, salts, and visible soils, which interfere with microbial inactivation (CDC, 2019a). If cleaning is not conducted prior to STERILIZATION or DISINFECTION, the success of these processes is compromised. All cleaning and DISINFECTING processes must be performed in accordance with the manufacturer's instructions to ensure effectiveness. OSHA’s Bloodborne Pathogens Standard states in section 1910.1030(d)(4)(ii) that “all equipment and environmental and working surfaces shall be cleaned and decontaminated after contact with blood or other potentially infectious materials” (OSHA, 2012). OSHA requires the use of U.S. Environmental Protection Agency (EPA)-registered tuberculocidal DISINFECTANTS or hypochlorite solution (diluted 1:10 or 1:100 with water) when BLOODBORNE PATHOGENS other than hepatitis B or HIV are of concern (CDC, 2019a). 8.2 SINGLE-USE barrier protective coverings, such as clip cord covers and machine covers, should be used on surfaces that will be touched with gloved hands or that might become CONTAMINATED with blood or OPIM. Barrier protective coverings are especially useful on surfaces and INSTRUMENTS that are difficult to clean. These coverings must be changed routinely between CLIENTS or when compromised (Rutala et al., 2019). Section 1910.1030(d) (4)(ii)(B) of OSHA’s Bloodborne Pathogens Standard states that protective coverings used to “cover equipment and environmental surfaces, shall be removed and replaced as soon as feasible when they become overtly contaminated” (OSHA, 2012). 8.3 EQUIPMENT must be inspected for breaks in integrity that can impair cleaning, DISINFECTION, and/or STERILIZATION. Damaged EQUIPMENT or EQUIPMENT not used for its intended purpose might introduce contaminants to the PROCEDURE AREA. EQUIPMENT that no longer functions as intended or cannot be properly cleaned, DISINFECTED, and/or STERILIZED must be discarded or repaired (CDC, 2019a). 8.4 The use of personal protective equipment (PPE) during DISINFECTION and STERILIZATION procedures is critical due to the inherent risk of exposure to blood and OPIM. Blood and OPIM can carry pathogens such as HIV, hepatitis B, and hepatitis C, which pose serious health risks (NIOSH, 2024). 8.5 To control quality, STERILIZATION of reusable INSTRUMENTS must be performed in a central room or area devoted to the task. The STERILIZATION ROOM or AREA must be set apart from PROCEDURE AREAS to prevent CONTAMINATION during the STERILIZATION process.
8.6 ACDC guidelines state that cleaning must be conducted prior to DISINFECTION or STERILIZATION, as remaining inorganic and organic materials on INSTRUMENT surfaces
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