INSTRUMENT REPROCESSING Every Day Every Patient EveryTime · 2019-10-09 · INSTRUMENT REPROCESSING...

INSTRUMENT REPROCESSINGEvery Day

Every Patient EveryTime

Volume 7 | Summer 2013

instrumentreprocessingSee pages 2–6

top ten essentiaLs for effectiveinstrumentcLeaningSee page 7

decontaminationLife cycLeSee page 10

13MS8747 Infection Control Q3-WEB_Layout 1 7/18/13 10:02 AM Page 1

IntroductionIn the past several years, much attention

has been focused on patient safety andinfection prevention. Reports of exposureto inadequately or improperly reprocessedmedical devices tell of patient risk ofexposure to infection. As information ismore freely available to the patient, theirawareness has increased. The risk ofacquiring such an infection from aninadequately reprocessed medical device isrelatively low given the number of suchmedical devices in use.1 However, outbreaksdue to exposure remain a public healthconcern.

Reusable medical devices are medicaldevices that can be reused to diagnose andtreat patients. As these devices are used,they become soiled and contaminated withorganic matter and microorganisms thatmust be removed between patients toavoid risk of cross contamination. These reusable devices are reprocessedbetween patients. Reprocessing is amultistep process that ensures reusablemedical devices can be cleaned anddisinfected without impairing itsfunction.

We will look at the key steps for theproper reprocessing of reusable medicalinstruments as it relates to cleaning,disinfection, and storage of areprocessed instrument.

Cleaning of Used InstrumentsThe most important step in instrumentreprocessing is cleaning. Studies havedemonstrated that dirty instruments cannotbe effectively disinfected.2 Cleaning is theremoval of visible soil (organic andinorganic material) from instruments and isnormally accomplished manually orautomatically using water and detergentswith or without enzymes.3

Following the use of a device, gross soil isremoved and the device is sent to thecentral processing area where cleaningwill occur. If cleaning is unavoidablydelayed, devices can be treated toprevent a hardening of the soil. The

surfaces of the instruments can be kept moist by usinga gel, spray, or foam intended for this purpose and tobegin the break down process of the soil.Alternatively, the used device can be covered with atowel that has been moistened with tap water or sterilewater. Saline solutions should not be used formoistening or soaking as it may damage devices.Keeping the soil moist is crucial for proper cleaning.Dried and hardened soil can be impossible to removeand will directly inhibit high-level disinfection orsterilization.

When choosing cleaning products or methods, alwaystake into account the special requirements of thedevice. New devices should be evaluated to ensurethat the devices can be effectively cleaned.Sometimes, even when a thorough process is used,some instruments, due to their design, can be deemedunable to be cleaned. Staff involved in instrumentreprocessing should follow the manufacturer’sinstructions and use products that are appropriate forcleaning instruments. Hand soaps, laundry, or dishdetergents should not be used to clean instruments.Follow the detergent or enzymatic detergent’smanufacturer’s instructions for proper dilution and usefor optimal cleaning.

The most common type of instrument cleaning ismanual cleaning. Manual cleaning is a more flexiblemethod of cleaning in that any type of instrument canbe cleaned manually. The down side to manualcleaning is that the consistency of cleaning can varybetween technicians and that the employees are at riskof exposure to possible contamination since they are incontact with contaminated instruments. It is for thesereasons that a health care facility establishes protocolsfor instrument cleaning and the disinfection process.A brief overview of the cleaning process is described inTable 1. These procedures should also emphasize thatappropriate personal protective equipment (PPE) beworn by the employees when performing instrumentcleaning. Additionally, proper training, qualificationand re-qualification of the cleaning process should beimplemented to ensure consistency betweentechnicians, ensuring consistent outcomes.

When the instruments are received for cleaning,technicians will take the instruments apart prior tocleaning (except when the manufacturer’s instructionssay otherwise). The instruments are disassembled,sorted, and allowed to soak. Soaking the instrumentsmakes it easier to remove soil by softening the organic and inorganic matter on the instruments.

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Table of Contents

Editorial: Instrument ReprocessingJoe Tulpinski, Director of Research and Development,Metrex Research.............................2–6

Top 10 Essentials for EffectiveInstrument Cleaning ............................7

Decontamination Products ..............8–9

Decontamination Life

Cycle Chart..........................................10

Miltex–Healthy Instrument Program ..........................11

Packaging Products ......................12–13

Sterilization Products....................16–17

Ultrasonic Cleaners & Sterilizers ......................................18

Henry Schein Brand Products ............19

Quality Assurance ........................20–21

SPSmedical Biological Indicatorsfor Steam Process ............................22

Instrument ReprocessingBy Joe Tulpinski, Director of Research and Development, Metrex Research


Sorting the instruments allows for theseparation of sharps and staging for theappropriate cleaning process. Cleaners andenzymatic detergents should be used whencompatible. The enzymatic detergents work tobreak down proteinaceous soils. Detergentsdissolve dirt and grease and break down ordissolve oils better than soaps. The detergentscontain wetting agents that allow water to flowfreely into difficult-to-clean areas like hingesand crevices. Prolonged soaking of instrumentsor devices in detergents or enzymaticdetergents can cause damage to an item orcause biofilm to form on the instrument.Always ensure that the detergent or enzymaticdetergents are approved by the devicemanufacturer.

Automated cleaning is another way toreprocess instruments. There are manydifferent types of automated cleaning methodsand types of cleaning/decontaminationequipment. They include the ultrasonic as wellas the use of different types ofwashers/disinfectors. Many of these machinesresemble household dish washers. Someautomated cleaning systems are device specific.These automated systems for cleaning regulate

and monitor the water temperature, detergentor enzymatic dosing and cleaning cycle time.Some of these automatic cleaning systemsemploy a combination of water jets andultrasonics to uniformly and thoroughly cleana soiled instrument. Regardless of theautomatic washer type or system used,instruments must be prepared for processing(i.e., sorted) before being placed into a washer.The actual preparation should be done inaccordance with the washer manufacturer’sinstructions and facilities standard operatingprocedures.

Choice of Disinfection ProcessIt is important to choose the correct method ofdisinfection for the device being reprocessed.In addition to following the devicemanufacturer’s instructions for use, facilitiescan also follow industry standards. One widelyaccepted view on the reprocessing of reusablemedical devices is a classification system firstproposed by Dr. E.H. Spaulding in the early1970’s. This is a strategy for the reprocessing ofcontaminated medical devices. This systemdivides medical devices, equipment, andsurgical materials into three categories based

www.henryschein.com/infectioncontrol incontrol 33

step procedure Why this is done

1 Disassemble used instrument according tomanufacturer’s instructions for use.

This is done to eliminate areas that aredifficult to clean. These areas can build uporganic and inorganic debris over timemaking disinfection impossible.

2 Soak the used instruments in warm water for 10minutes. (Time may vary depending on the soiltype and degree of soil drying that has takenplace.)

This step softens and loosens much of thesoil that may have dried on the instrumentbetween the time it was used and the timecleaning has started.

3 Completely brush the instrument with a medium-soft bristle brush while it is in the soak bath. To avoid damaging the instrument, followmanufacturers’ recommendations as to the typeof brushes to use for cleaning. Brushing shouldbe performed under the surface of the water to minimize aerosolization-cleaning away from the operator.

Brushing is the physical removal of the soilfrom the instrument.

Note: the insides (lumens, channels, etc.)of tubed devices, like dental handpieces or endoscopes should be brushed out as well.

4 Rinse with clean water Water can be either deionized water orreverse osmosis water from the facility.

If difficult-to-remove soil remains, another enzyme detergent soak followed by brushing and rinsingshould be done.

Table 1: Manual Cleaning of Used Instruments

References1. FDA, 2013, “Reprocessing of

Reusable Medical Devices,” U.S.Department of Health & HumanServices–Food and DrugAdministration.

2. Alfa, et al. 1998, “Comparison ofliquid chemical sterilization withperacetic acid and ethylene oxidesterilization for long narrow lumens”.American Journal of InfectionControl.

3. Rutala, 2008, CDC: “Guideline forDisinfection and Sterilization inHealthcare Facilities, 2008”

4. Spaulding, 1972, “ChemicalDisinfection and Antisepsis in theHospital”. Journal of HospitalResearch.

5. Spaulding, 1972, “The role ofchemical disinfection in theprevention of nosocomial infections”.In Brachman and Eickof, eds.Proceedings of InternationalConference on NosocomialInfections.

6. Friedmen and Petersen, 2004,“Endoscopy” in Infection Control in Ambulatory Care.

JOE TULPINSKI is Director of Research andDevelopment at Metrex/Kerr TotalCare, asubsidiary of Danaher Corporation, locatedin Anaheim, California. He holds aBachelor’s degree in Biology and a Master’sDegree in Biological Sciences fromCalifornia State Polytechnic University,Pomona. Joe has research experience informulation chemistry, microbiology, foodmicrobiology, molecular biology, and inpharmaceutical quality control. Aprofessional member of ASTM, ASM, APICand SGNA, Joe has experience in themedical device, disinfection, andreprocessing areas. Prior to joiningMetrex/Kerr TotalCare in 2005, Joe was theLaboratory Manager at N-terminus ResearchLaboratory, a research facility dedicated toboth basic and applied research in thearea of novel antimicrobial technologies.

JOETULPINSKI


on the potential risk of infection involved intheir use. The three categories are critical,semi-critical, and non-critical. This systemalso established three levels of germicidalactivity (high, medium, and low) fordisinfection strategies with the three classes of medical devices4, 5. Table 2 summarizes theclassification and minimum level ofdisinfection required.

Hospital or General Disinfection of Reusable Medical DevicesTypically this type of disinfection may be usedfor the decontamination process in which theused devices are deemed safe to handle by areprocessing technician. A hospitaldisinfectant is one that is EPA registered(having an EPA registration number) and iseffective against Staphylococcus aureus,Pseudomonas aeruginosa and Mycobacteriumspp. A general disinfectant will also have anEPA registration number, but does not list aclaim against Mycobacterium spp. Hospital orgeneral disinfectants do not kill spores.

A hospital or general disinfectant can be usedto reprocess non-critical medical devices suchas stethoscopes, blood pressure cuffs or othermedical device surfaces found in and around ahealth care facility.

High-Level Disinfection of ReusableMedical DevicesManual and automated methodsHigh-level disinfection is the minimumdisinfection type used for heat sensitive semi-critical medical devices. Semi-critical devices

such as anesthesia or respiratory equipment,endoscopes, and diagnostic probes, come intocontact with mucous membranes and are the types of devices that should be high-leveldisinfected. High-level disinfection destroys all microorganisms with the exception of ahigh number of bacterial spores.

Chemicals commonly used for high-leveldisinfection of medical devices are;Glutaraldehyde, ortho-Phthalaldehyde,Peracetic Acid/Hydrogen Peroxide.

GlutaraldehydeGlutaraldehyde has gained wide acceptance asa high-level disinfectant and liquid chemicalsterilant. It kills microorganisms by alteringRNA, DNA, and protein synthesis withinmicroorganisms. Glutaraldehyde has excellentbiocidal activity. It is easy to use, and does notdamage equipment. It is active in the presenceof organic matter and is non-corrosive tometals, rubbers, and plastics. Glutaraldehydecan be used in manual and automatedreprocessing protocols. The major problemassociated with glutaraldehyde is that it is aknown respiratory and dermal irritant andsensitizer, and adverse health effects may occurin exposed workers. Glutaraldehyde vapor isrequired to be monitored in the endoscopereprocessing area. Proper fume managementsystem for glutaraldehyde products is desirable.

Ortho-PhthalaldehydeOrtho-Phthalaldehyde (OPA) has shownsuperior biocidal activity (except againstbacterial spores) compared to glutaraldehyde,with a shorter contact time. OPA solutions do


classification minimum Level ofdisinfection

patient contact example of device

Critical devices Sterilization (Highactivity)

Devices come intocontact with blood ornormally sterile tissue

Surgical Retractors,Surgical Forceps orClamps

Semi-critical devices High-level disinfection(Medium activity)

Devices come intocontact with mucousmembranes

Endoscopes, Vaginal Probes

Non-critical devices Hospital or generaldisinfection (Lowactivity)

Devices come intocontact with unbroken(intact) skin

Stethoscopes,Blood Pressure Cuffs,General Surfaces

Table 2: Spaulding’s Classification of Medical Devices and required Level of disinfection

Instrument Reprocessing


not require activation. To achieve high-leveldisinfection using MetriCide OPA Plus, aminimum of 12 minutes at a minimum of 20°Cis required for manual reprocessing; and aminimum of five minutes at 25°C is requiredfor an Automated Endoscope Reprocessor(AER). Rigorous rinsing is required to removethe OPA from the surfaces of the endoscopes.OPA is contraindicated for the reprocessing ofendoscopes that will be used on patients withrecurrent bladder cancer. OPA was identifiedas the cause of serious allergic reactions insome bladder cancer patients who underwentrepeated cystoscopies. OPA vapor is notrequired to be monitored in the endoscopereprocessing area. OPA will stain protein andthis can uncover inadequate cleaningpractices. If staining occurs, the cleaningpractices should be revisited.

Peracetic Acid/Hydrogen PeroxidePeracetic acid/Hydrogen Peroxide are oxidizingagents that kill microorganisms by disruptingtheir cell-wall permeability and by denaturingproteins, enzymes, and other metabolites.Peracetic acid/Hydrogen Peroxide has a rapid,broad-spectrum antimicrobial activity.Peracetic acid (especially at elevatedtemperature) can be corrosive to some metalsbut additives and pH modifications can reducethis effect.

A high-level disinfectant (HLD) should beselected based on the follow considerations:The area and equipment available, thecomponents that make up the high-leveldisinfectant, the compatibility with the devicesin use, proper ventilation, training, andeducation of staff.

All high-level disinfectants are dangerouschemicals and need to be handled accordingly.HLDs should not be used as hard surfacedisinfectants or for routine cleaning. Whenusing a high-level disinfectant for reprocessing,fumes and vapors must be properly managed.Containers containing high-level disinfectantsshould remain closed or covered except whenplacing a device in or removing the device outof the solution. Containers must be located ina well-ventilated area or in a fumemanagement system. Fume management

systems must be routinely maintained forproper function and documented.

Another aspect to consider in the selection ofa high-level disinfecting solution, aside fromcompatibility, is the use of surfactants in thedisinfectant formulation. Surfactants can causeair bubbles that prevent the solution fromcompletely contacting the entire surface of theinstrument.6 Additionally, surfactants cancloud the lenses of lensed instruments.

To ensure that high-level disinfectants areworking properly, one must monitor for theMinimum Effective Concentration (MEC) orMinimum Recommended Concentration(MRC) required (the terminology will varydepending on product). Typically this isperformed using chemical indicating test strips appropriate for the high-leveldisinfectant used.

Perform routine testing of the liquid high-leveldisinfectant to ensure at least the minimumeffective concentration (MEC) of the activeingredient. Check the solution before each useand document the result. If the chemicalindicator shows that the concentration is lessthan the minimal effective concentration (orminimal recommended concentration), thesolution should be discarded. The liquid high-level disinfectant should be discarded at theend of its reuse life, regardless of the minimaleffective concentration or minimalrecommended concentration. Upon opening afresh bottle of test strip and at pre-definedintervals (per facility procedure), a qualityassurance test should be performed on the teststrips.

If additional liquid high-level disinfectant isadded to an AER (or basin, if manuallydisinfected), the reuse life should bedetermined by the first use/activation of theoriginal solution (i.e., the practice of “toppingoff” of a liquid high-level disinfectant pooldoes not extend its reuse life). Use only teststrips indicated for the product and documentthe test strip expiration date on the productbottle. The test strips will have two expirationdates; the date after opening and themanufactures’ expiration date.



Sterilization of Reusable Medical DevicesOverviewSteam sterilization is the gold standard whenthe reusable devices are heat and pressuretolerant. It is the most commonly used processfor sterilizing instruments, trays, and cassettes.Steam sterilization is considered safe, fast, and most cost effective when compared toother methods of sterilization. The steamsterilizers come in a variety of sizes and thesterilization cycles can vary amongmanufacturers. The cycle type depends on thetypical application or load type for sterilization.Table 3 summarizes some different cycle typesand the typical applications.

Prior to sterilizing instruments, proper andappropriate wrapping or covering must beutilized. Commonly, instruments are placed inmaterials such as pouches, wraps, or ridgedcontainers. Pouches are commonly used forsmall, lightweight instruments. Wraps arecommonly utilized for instrument trays orcassettes. Ridged containers are commonlyused for heavy or layered instrument trays.Care must be observed to ensure that sharpedges or pointed objects do not penetrate thisprotective packaging. If this occurs, the sterilityof the instrument has been compromised.

Another type of sterilization for thereprocessing of reusable medical devices arelow temperature methods of sterilization suchas gas, plasma, vapor, or liquid chemicals.These are intended for reusable devices thatcannot tolerate high temperatures or pressures.Each process has its advantages anddisadvantages. The choice about whichsterilization process the health care facilityshould choose lies with the instrumentmanufacturer as to what was validated in theirinstructions for use. For patient safety, the

process must be compatible as to not cause damage and must be efficacious to ensure sterility.

Device StorageReprocessed instruments should be stored in amanner that reduces the potential forcontamination. Sterile instruments shouldremain in their wrapping until ready for use.Sterile items are considered as such unless thepackaging is opened or damaged. Prior to use, a sterile package should be inspected forintegrity. If it is suspected that a breach mayhave occurred with a package, the items shouldnot be used and should be reprocessed.

High-level disinfected instruments such asendoscopes can be hung in appropriatecabinets so they can dry in a timely manner.Reprocessed instruments and devices should bekept clean, dry, and at a constant temperatureand out of highly traveled areas of the medicalor reprocessing facilities.

It is important that all reprocessed instrumentsbe carefully handled, ensuring that the devicesare not crushed, bent, or punctured. Wheninstruments are transported to their place ofuse, the devices should be protected fromvarious environmental contaminants.

ConclusionProper instrument reprocessing following thedevices’ instructions for use is an importantfactor to prevent health care associatedinfections (HAIs). Careful and thoughtfuladherence to process, procedures, and practicesensure successful outcomes. Appropriatecleaning and disinfection selections allowreusable devices to be reused with confidencefor both the patient and health care personnel.


cycle type typical application

Gravity Glassware, Unwrapped Surgical Instruments,Unwrapped Goods, Utensils

Pre-Vacuum and/or Post-Vacuum Wrapped Instruments, Packs, Cassettes

Liquids Water, Media

Flash Unwrapped Instruments

Table 3: Sterilization cycle type and applications.


incontrol 77www.henryschein.com/infectioncontrol

Millions of people each year acquire infections while receiving treatment in healthcare organizations,and some of these people never recover. According to the Centers for Disease Control and Prevention(CDC), 1.7 million infections annually are related to healthcare settings, and these infections lead to 99,000 deaths each year.

Source: APIC

Top 10 Essentials for Effective Instrument Cleaning

Each day, health care facilities’ sterile processing departments manage the preparation ofcountless surgical instruments for upcoming procedures. If devices are not properly cleanedbefore they are disinfected and sterilized, tissue, bone, or other organic material can remainin or on the instrument. This was demonstrated in the February 2013 issue of PSO MonthlyBrief which explored inadequately reprocessed devices.

Consequences of inadequate reprocessing can be relatively minor, such as a delay in surgerywhile new instruments are sought if the contamination is identified before a procedurebegins, or more significant, such as possible infection.

Healthcare staff members often mistakenly believe that sterilization alone adequatelyprepares equipment for reuse; this is simply not true. In fact, reprocessing is a multisteppractice that includes thorough cleaning as well as disinfection or sterilization. Part of theincrease in reprocessing complexity may be contributed to advances in technology. Today’sinstruments have complex, movable parts that are difficult to disassemble and cleanthoroughly, says Gail Horvath, MSN, BS, RN, CNOR, CRCST, a patient safety analyst at ECRI Institute PSO.

Facility leadership must be aware of processes and challenges within the sterile processingdepartment and view them as part of the delivery of safe patient care. Changes inequipment, personnel, or procedures can affect the organization’s ability to provide properlyreprocessed—and safe—instruments. Therefore, ECRI Institute PSO has created a list of itsTop 10 Essentials for Effective Instrument Cleaning:

1. Provide adequate trained staff, facilities, and resources for the sterile processingdepartment.

2. Standardize and simplify procedures in all areas where instruments are reprocessed.3. Monitor the quality of instrument reprocessing through postcleaning inspections.4. Seek input from reprocessing department staff on instrument and equipment purchases.5. Limit the operating room’s dependence on immediate-use sterilization.6. Establish delivery criteria for loaned instruments and prohibit immediate-use

sterilization of them.7. Require regular competency assessments of staff who reprocess instruments.8. Foster collaboration and teamwork among reprocessing department and

operating room staff.9. Recognize and respect the contribution by reprocessing staff to patient safety

and quality care.10. Encourage prompt reporting of events or near misses involving contaminated

instruments.

Source: ECRI Institute



Guidelines &RecommendationsInstrument processing functions should be performed in one central department for safety and cost-effectiveness. A. Personnel doing the reprocessing

should be capable of critical thinking.B. The supervising organization is

responsible for ensuring appropriatetraining, education, and competencyof the staff.

C. Sterilization cycles with little or nodry time are efficacious when used incompliance with validated writteninstructions provided by the devicemanufacturers, sterilizationequipment manufacturers, and (ifapplicable) container manufacturersand when done in accordance withprofessional guidelines.

D. Cleaning, decontamination, andrinsing are critical and users mustfollow and complete all requiredprocessing steps regardless of thesterilization exposure parametersbeing used.

E. Aseptic transfer from the sterilizer tothe point of use is critical to protectitems from contamination.

F. Only items sterilized and packaged in materials cleared by the FDA for maintenance of sterility can be stored.

G. The device manufacturer’s writteninstructions for reprocessing anyreusable device must be followed.The cycle parameters required toachieve sterilization are determinedby the design of an instrument, thecharacteristics of the load, thesterilizer capabilities, and thepackaging (if used).

H. Survey personnel involved inevaluating organizations that sterilizemedical items should beknowledgeable and capable ofexercising critical thinking andjudgment. The regulatory oraccrediting agency should evaluatewhether the organization’s leadersensure that training, education, andresources are provided and thecompetency of staff is validated.

I. Quality management is important toensure compliance with processesand relating those processes tooutcomes.

J. Sterilization process monitoring isessential to ensure that sterilizationpractices are efficacious.

K. Examples of process monitoring toolsare physical indicators, biologicalindicators, and chemical indicators.

L. Instrument inventories should besufficient to meet anticipated surgicalvolume and permit the time tocomplete all critical elements ofreprocessing.

Source: www.apic.org

EmPower™ FoamEnzymatic SprayFoam covers instruments,reducing splashing andmessy spills. Breaks downbioburden on instrumentsto speed up cleaningprocess. Ready to use.

24-oz Touch-n-Spray Trigger(176-9974) ..............................ea

MetriZyme®

Extra-Strength DualEnzymatic DetergentEfficiently dissolves organicsolids. Noncorrosive andlow foaming; safe forinstruments.32 oz(173-0332) ..............................ea1/2 gal(173-9446) ..............................ea1 gal(173-7048) ..............................ea

MetriCide® 282.5% Glutaraldehyde Solution28-day, long-life, high-level disinfecting andsterilizing solution with activator. Excellentcompatibility with a variety of devices.Solution is not corrosive to instruments.Rapid and broad-spectrum kill.32-oz Bottle(173-2446) ..............................ea1-gal Bottle(173-3976) ..............................ea

Benz-All® GermicidalConcentrate

Each 40-cc envelopemakes 1 gal of 1:750solution.(100-8321) .......................15/pkg

Instrument Prep Enzyme FoamIdeal for applications where instrumentcleaning is not immediately available.24-oz Bottle(953-9364) ..............................ea

ZymeX™ ConcentratedEnzymatic CleanerLow-foaming enzymatic cleaner can beused in ultrasonic cleaners, evacuationsystems, reprocessors, andwashers/sterilizers. Free-rinsing formuladoesn't leave a film. Patented formulationbreaks down 3 times more bioburden thanmarket leaders within 5 minutes.Bacteriostatic to prevent additional microbialgrowth. Corrosion inhibitor preventscorrosion on metal instruments. 1 oz makes1 gal of solution.1-qt BottleMakes 32 gallons of solution.(312-3920) ..............................ea1-gal BottleMakes 128 gallons of solution.(312-1086) ..............................ea


www.henryschein.com/infectioncontrol incontrol 99www.henryschein.com/infectioncontrol

Cidex Plus® 28-Day Solution3.4% alkaline glutaraldehyde solution withan odor suppressant. Built-in corrosion/rustinhibitor. Testable.• Rapid 20-minute soak time at 25ºC• Noncorrosive to instruments• Contains 3.4% glutaraldehyde with

odor suppressant• Effective in the presence of 2%

organic soil• Test strips available to verify minimum

effective concentration

1-qt Bottle(555-0498) ..............................ea

1-gal Bottle(555-4973) ..............................ea

ENZOL® EnzymaticDetergentLow-foaming Presoakand Cleaner

Proteolytic enzyme helps reduce the needfor manual cleaning. Fast acting–begins towork in 1 minute. Mild pH formulation.1-gal Bottle(555-1112)...............................ea

Cidex® ActivatedDialdehyde Solution Enables quick instrument turnaround tohelp maximize scheduling of dailyprocedures. With its broad kill spectrum, thisreliable, high-level disinfectant is effectiveand safe for a wide variety of medicalinstruments and devices, includingendoscopes. 2.4% alkaline-basedglutaraldehyde formula provides superiormicrobicidal and anticorrosion propertiesversus acid glutaraldehydes. Minimumeffective concentration (MEC) is easy to testusing Cidex® Activated Dialdehyde SolutionTest Strips. Activated solution can be reusedfor up to 14 days, or until otherwiseindicated by the test strip.(555-0126)........................11/4 gal

MetriClean® 2MetriClean2 is a multipurpose instrument cleaner, polisher and cart-washer agent. The alkaline pH, low-foaming, concentrated cleaner is ideal for stainlesssteel instruments and cart washers. Itenhances functionality and life of theinstruments by helping to remove stains andreduce corrosion. For use in manualcleaning systems, washer sterilizers,washer decontaminators, ultrasoniccleaners, and cart washers.#10-8100, 1 Gallon(804-5688) ..............................ea#10-8150, 5 Gallon(616-8397) ..............................ea

Wavicide-01®

High-LevelDisinfectantWavicide-01®

sterilant is a 2.65% glutaraldehyde soaking solution for use with endoscopes andstainless steel surgical instruments. It isready to use and requires no activation.With a neutral pH of 6.3, it is stable andnoncorrosive. Provides 30-day reuse. Use atroom temperature.32 oz(583-4947) ..............................ea1 Gallon(120-3619) ..............................ea

With greater attention being placed on the role of the environment in infection prevention, thereis a greater focus on sterile processing and its impact on patient safety. The Association forProfessionals in Infection Control and Epidemiology (APIC) offers disinfection and sterilizationresources to help you ensure that your facility is in compliance with guidelines and regulatorystandards for sterile processing. For more information, please visit www.apic.org.

The Help Center:CDC Guidelines

APIC ANYWHERE® online courseand webinar offeringswww.apic.org/anywhere

APIC ANYWHERE® online coursesprovide convenient access toaccredited infection preventioncontinuing education. The affordable,interactive courses augment APIC’s live courses and conferences with on-demand availability.

Course Registration• Continuing the Care: Infection

Prevention in the Long-Term Care Setting

• Disinfection and Sterilization: BestPractices in Reprocessing SurgicalInstruments

• Infection Prevention CompetencyReview course

• Microbiology 101 for InfectionPreventionists

• Essentials of Infection Prevention™(EIP)

• Healthcare-Associated IP TrainingCritical Access Hospitals

• EPI Primer• Infection Prevention in Hemodialysis

Settings course

On-Demand Webinar Categories• Construction and Renovation• Disinfection and Sterilization• Emergency Preparedness &

Pandemic Planning (H1N1)• Environmental Services• Basic Infection Prevention• Clean Spaces Health Patients• Infection Prevention• IP Competency: Novice• IP Competency: Moderate• IP Competancy: Proficient• Legal, Legislative and Regulatory

Issues• Surgical Site Infection (SSI)• Surveillance• Tuberculosis


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For product support and educational in-service kits, contact your ASP Representative or visit www.aspjj.com.

AD-110413-01-US_A© Ethicon, Inc. 2012. All rights reserved.

Please read and follow the Instructions for Use for important safety information.

Fast-acting high-level disinfectant• Cost-effective• Time-saving• Proven

PROVEN PERFORMANCE

Item Code DESCRIPTION SIZE QUANTITY/CASE

555-6446 CIDEX® OPA Solution 1-Gallon (3.785 L) 4 Gallons555-2497 CIDEX® OPA Test Strips 60 Strips/Bottle 2 Bottles

The decontamination life cycle model highlights the extent to which decontamination affects the whole of anyhealthcare facility and not just those areas processing equipment. Traditionally, decontamination has been theresponsibility of the departmental heads of specialist units, for example sterile services, endoscopy units, theatresurgical suites, etc. Management arrangements within health care facilities often divided these functions andmade it difficult for a totally coordinated approach to the application of decontamination standards andpractices to be achieved.

Effective decontamination requires the attainment of acceptablestandards at all stages of the life cycle. Failure to address issues inany of these stages will result in inadequate decontamination. At allstages of reprocessing, the following issues need to be taken intoaccount:

1. The location and activities where decontamination takes place;2. Instrumetnt reprocessing facilities and equipment at each

location;3. Ensuring that equipment used is validated, maintained, and

tested in accordance with manufacturer’s guidelines andlegislation;

4. The existence of effective management arrangements;5. The existence of policies and procedures for all aspects of

decontamination work.

The aim of decontamination is to make reusable medical devicessafe for use on a patient and for staff to handle without presentingan infection hazard.

Source: Depot Health

DECONTAMINATION LIFE CYCLE

CLEANING

DISINFECTION

INSPECTION

PACKAGING

STERILIZATION

TRANSPORT

STORAGE

USE

TRANSPORT

At all stagesLocationFacilities

EquipmentManagement

Policies/Procedures

ACQUISITION1. Purchase2. Loan

DISPOSAL1. Scrap2. Return to lenderFig 1.1

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Guidelines &Recommendations

Storage Recommendations forAutoclaved Medical Instruments 1. Allow packages to dry in the autoclave

before handling to avoidcontamination.

2. Store packaged sterile instruments in aclean, dry, and dust- and lint-free area(covered or closed cabinets arerecommended.

3. Store clean and sterile materials at least8 to 10 inches above the floor, 18inches below the ceiling, and 2 inchesfrom the outside walls.

4. Keep like items together—sterile withsterile and clean with clean.

5. Rotate stock with older items beingused first.

6. Do not store sterile supplies under sinksor other locations where they maybecome wet, or on the floor,windowsills or other supply areas thandesignated shelving or cabinets.

7. Do not store sterile supplies with itemsnot intended for clinical use, e.g.,office or cleaning supplies.

8. Do not handle sterile packagesunnecessarily to avoid contamination.

9. Items stored and not used within 12months should be evaluated as to thecondition of the packaging as well asthe necessity of stocking infrequentlyused items.

Checklist for Sterility BeforeOpening Package 1. Check the expiration or

sterilization date. 2. Check for the indicator color change. 3. Check how it had been stored. 4. Check the general condition

of the wrapper. 5. Check for any holes or moisture

damage.

SOURCE:Centers for Disease Control andPrevention (CDC)

Joint Commission on the Accreditationof Healthcare Organizations (JCAHO)

Order: 1.800.772.4346 8am – 9pm, et | Fax: 1.800.329.9109 24 hours1212 incontrol

KimGuard One-StepSterilization WrapStrength: KC200

KC200 is the second of six strength levels in the KimGuard One-Step line. It is often used to packagelinen towels, packs and gowns, light basinsets, and single instruments. One-Step ismade of two sheets of SMS fabric bondedtogether on the edges, enabling users towrap and open packages in about half thetime of sequential wrap. The SMS fabricdelivers barrier and strength properties thathelp prevent contamination aftersterilization.• Simultaneous (nonsequential) wrap • One application equivalent to 2 sheets of

wrap • Low-lint SMS fabric • Steam- and EO-compatible • Latex-free • Non-sterile#68018, 18" x 18"(643-0529)..................1000/case

#62024, 24" x 24"(943-9024) ...................240/case

#68024, 24" x 24"(643-2451) ...................500/case#62030, 30" x 30"(608-5474)....................144/case#68030, 30" x 30"(643-4934) .....................300/pkg#62036, 36" x 36" (761-5652) ....................144/case#62048, 48" x 48" (812-1222)......................48/caseSterile#62018, 18" x 18"(806-8305) ...................480/case#68036, 36" x 36"(643-8345) ...................300/case#62248, 48" x 48"(303-4845) .....................24/case#62654, 54" x 54"(613-6497) .....................24/case#62645, 45" x 45"(627-3565)......................48/case

Bio-Shield II CSR WrapsComplete sterilization wrap systems innonwoven, low-linting fabrics. Excellentantimicrobial barrier.#401212" x 12"(153-2942)..................1000/case15" x 15"(153-4867) ...................500/case20" x 20"(153-9442) ...................500/case

24" x 24"(153-8657) ...................500/case

30" x 30"(153-0701)....................250/case

CSR WrapsA comprehensive, single-use wrappingsystem that is unparalleled for quality,versatility, and cost-effectiveness. BusseCSR wrap offers superior barrier propertiesagainst both air- and water-borne bacteria,combined with excellent water repellencyand high wet or dry tensile strength.Standard PacksAn economical wrap ideally suited forgeneral purpose use in hospitals,physician's offices, clinics, etc.#851, 15" x 15"(788-7835) ...................500/case#852, 20" x 20"(788-6238) ...................500/case

#853, 24"x 24"(788-7325) ...................500/case#855, 36" x 36"(788-9877) ...................250/case#856, 40" x 40"(715-6566) ...................250/case#857, 45" x 45"(990-2859) ...................250/case#858, 54" x 54"(788-5387)....................100/case

Physician Convenience PacksEach pack contains 100 sheets. Availablein the four most commonly used sizes.#845, 12" x 12"(788-1865)......................100/pkg#843, 15" x 15"(990-1220)......................100/pkg#846, 18" x 18"(788-9718)......................100/pkg#847, 24" x 24"(788-9701)......................100/pkg


www.henryschein.com/infectioncontrol

The Help Center:CDC Guidelines

Joint Commission Resources• Webinars: exclusive monthly

video training sessions delivered to you online.

• E-News: receive the most up-to-dateinformation all by e-mail. Enjoysspecial offers, promotions, anddiscounts offered exclusively to e-mail subscribers.www.jcrinc.com

Association of PerioperativeRegistered Nurses (AORN)Perioperative Standards & Recommended PracticesThe 2013 edition introduces the firstever evidence-rated recommendedpractices with new and significantlyrevised content on: • Prevention of Transmissible Infections• Safe Environment of Care• Sterile Technique• Sterilization

www.aorn.org

SPSmedical has developed a series ofeducational CD-ROMs on a variety ofInfection Control topics that can beused for group or individual training.Each program is presented in a slidepresentation and utilizes an abundanceof pictures to provide viewers a betterunderstanding of the subject beingcovered. Accredited through multipleorganizations, test questions and a CEUCertificate are included with eachprogram.• Cleaning, Packaging & Sterilization

of Instruments; CEUs 1.0 – 1.5• Decontamination, You & Biofilms;

CEU 1.5• Selection & Use of Packaging

Systems; CEU 1.0• Steam Sterilization: The Process

of Choice; CEUs 1.0 – 1.5

Visit the SPS Medical website for moreinformation and a full listing of programswww.spsmedical.com/education

incontrol

All healthcare facilities should choose either an event-related or date-related policy for managing the process of“shelf-lives” for the autoclaving of medical instruments. Each health care facility should have a written policythat addresses the shelf-life of packaged sterile items based on the quality of the wrapped material, storageconditions, conditions during transport, and the amount of handling. The processing of instruments requirescare be taken to avoid contamination of the instrument(s) during storage; instruments need to be stored in away to preserve the package; and packages must be examined before use to ensure integrity and dryness.

Source: Centers for Disease Control and Prevention (CDC). Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)

1313

KimGuard One-Step KC500Sterilization Wrap• Simltaneous (nonsequential) wrap• One application equivalent to 2 sheets

of wrap• SMS fabric

CSR Wrap

#62118, 18" x 18"(451-0741) ....................288/case#62124, 24" x 24"(876-0028) ...................120/case#62130, 30" x 30"(928-6012)....................120/case#62136, 36" x 36"(181-3907)......................72/case#62145, 45" x 45"(181-3909)......................48/case#62148, 48" x 48"(102-2483)......................24/case#62154, 54" x 54"(181-3910) ......................24/case#62160, 60" x 60"(791-5301)......................24/case

Highly permeable sterilization wrap.Outstanding liquid repellancy against water,alcohol, iodine. For use with EtO, steam,gamma radiation, E-beam sterilizationtechnologies. Exceptionally strong.12" x 12"(107-1428) ..................1000/case15" x 15"(107-8142) ....................500/case18" x 18"(108-9992)....................500/case20" x 20"(107-7093) ....................500/case24" x 24"(108-0896)....................500/case30" x 30"(108-0898)....................250/case

3M™ Comply™ Lead Free Steam IndicatorTapeDesigned to seal packs and provide visualevidence that packs have been exposed tothe steam sterilization process. Indicatortapes are Class 1 process indicators usedfor exposure monitoring, which assures theoperator handling the processed items thatthe pack has been exposed to thesterilization process without the need toopen the pack or check load controlrecords. #1322-12MM(777-0445) ..............................ea#1322-18MM(777-0447) ..............................ea#1322-24MM(777-0446) ..............................ea#1322-48MM(777-0451) ..............................ea

STERILIZERINDICATOR TAPE60-yd RollsIndividually wrapped. Seals autoclave bags,tubing, pouches, and CSR wraps, indicatingthat sterile conditions have been attained onpackages that have been sterilizedby steam.1/2"(104-8181) ..............................ea3/4"(104-6133) ..............................ea1"(104-8993) ..............................ea

Sterilization TapeLead-Free, Latex-FreeConsistent with 2008 AORN Latex Guidelines, and because latex cannegatively affect both healthcare workersand patients, this steam indicator tape islatex-free as well as lead-free. Lead is notbiodegradable, so it is difficult to removeonce it enters the environment.Also provides:• Immediate identification of processed

items while securing sterilization packs• Color-change indicator to verify

sterilization exposure(112-6361) ..............................ea



ITEM # DESCRIPTIONQTY/CASE

8950019DuraWick Towel 3 ply/poly+ 13x18 Blue

100

1003347Sterilization Wrap 12x12 Blue

100


100


100


100


100

ITEM # DESCRIPTIONQTY/CASE


100


500


500


500


500

SUPERIOR INSTRUMENT

REPROCESSING PRODUCTS Sterilization Wrap and Durawick™ Towels

Sterilization Wrap Durable, water-repellent material allows penetration for various sterilization methods.

Durawick™ Barrier Towels

DuraWick™ towels were specially created to be used to last through several rounds of tools being placed on them from your ultrasonic cleaning. The top layer of material wicks away moisture, which is then absorbed into the middle layer of the product, keeping your sterilization area clean and sanitary.

www.tidiproducts.com / 1.800.521.1314COPYRIGHT © 2013 TIDI PRODUCTS, LLC. ALL RIGHTS RESERVED.

To order call Henry Schein: 800-772-4346

Is Your Autoclave Really Sterilizing?ProSure® Sterilization Monitoring ServiceHelping Ensure Sterility For You And Your Patients

Why Wait? Get Your Results

in 24 Hours Instead of 48 Hours

ProTest Fits* the 3M™ Attest™ Incubator**

(*Fits 3M™ - 1261, 1261P, 1262 & 1262P)

**3M™ and Attest™ are registered trademarks of the 3M Corporation

(436-4128) ProSure® 12 tests/box(991-3994) ProSure® 26 tests/box(331-2136) ProSure® 52 tests/box(780-3685) ProTest Steam BI 25 tests/box(335-0392) ProTest Steam BI 100 tests/box

Visit us at www.hlk.cc ©2013 Clorox Professional Products Company 1221 Broadway, Oakland, CA 94612. Always use products as directed.



(777-0154)

BECAUSE YOU CAN’T SEE STERILE

Patent Pending

5+1OF SAME FREE!

SHIPPED WITH ORDER

Internal/external multi-parameter chemical indicators only change color when all 3 criteria for sterilization have been met... Time / Temperature / Steam

Sure-Check®Sterilization PouchesEVERY LOAD.

SteamPlus™Class 5 Integrators

100/pack 613-4050

2+1FREE!

SHIPPED WITH ORDER

For the best in sterility assurance include a Class 5 Integrator at least once daily.

Use with your steam sterilization cycles to receive a distinct pass/fail result - allowing you to release non-implant loads before receiving spore test results. PROCESSED

UNPROCESSED

EVERY DAY.

A breakthrough in biological monitoring... final results in just 10 hours!

Meet CDC biological monitoring guide-lines for steam sterilizers in less than half the time.

Mail-in service also available.

Buy 2 Boxes of 25 Indicators,

receive an incubator FREE! ($300.00 value) (See below for details)

ConFirm®10 Hour In-O#ce Biological Monitoring System

EVERY WEEK.

774-0124 | ConFirm 10 Biological Indicators 25/box

991-0035 ConFirm 10 Incubator (special order item)* |

Products manufactured by or for Crosstex.

Buyer’s price may constitute a ‘discount or other reduction in price’ under 42 U.S.C. § 1320a-7b(b) and 42 C.F.R. 1001.952(h). Buyer is solely responsible for (i) accurately reporting all discounts and price reductions claimed or charged to any Federal or State health care program, and (ii) determining whether to report or pass on savings or discounts to payors.

3.5 X 9 112-00885.25 X 10 110-95307.5 X 13 110-5122

*To take advantage of the ConFirm 10 Promotional Package, order Henry Schein Item 774-0124 (2 boxes of biological indicators). Free incubator shipped directly from Crosstex with proof of purchase (Henry Schein invoice). E-mail invoice to: [email protected]

10 X 15 774-011612 X 18 110-5115ADDITIONAL SIZES AVAILABLE

Use promo code UAEto receive free goods.


Guidelines &RecommendationsThe manufacturer’s written instructionsshould be used to determine how to replicate the validated cleaning and processing methods. Themanufacturer’s written instructionsshould identify requirements related to • Utilities (e.g., type of water,

compressed air) • Cleaning equipment

accessories (e.g., adaptors) forcreating a proper connectionbetween the instruments andequipment, utilities, and cleaningequipment

• Accessories for cleaning lumens,ports, and internal parts

• Cleaning agents • Lubricants• Processing methods

Instruments should bedecontaminated in an areaseparated from locations whereclean activities are performed.Cleaning soiled instruments in a scrubsink can contaminate the sink andfaucet, which also may be used forclean activities (e.g., hand washing,surgical hand antisepsis). Thedecontamination area should bephysically separate from clean areasand include a door. This area shouldcontain, but not be limited to thefollowing equipment: • Sinks to manually clean instruments • Hand washing facilities • Eye wash station• Automated equipment consistent

with the types of instruments to bedecontaminated

• Adaptors and accessories toconnect instruments with cleaningequipment and utilities

• Compressed air supply

The design of the decontaminationarea facilitates the appropriatedecontamination of instruments.Having equipment and utilities in placefacilitates desired infection controlpractices.

SOURCE: AORN Recommended Practices Committee

Order: 1.800.772.4346 8am – 9pm, et | Fax: 1.800.329.9109 24 hours1616 incontrol

Chex-All® InstantSealing PouchesSelf-sealing, see-through pouch provides a hermetic seal. Sterilization indicators are on inside and outside of pouch.3" x 8"(141-7290)......................250/box31/2" x 24"(141-1372) ....................500/case5" x 10"(141-9031)......................250/box5" x 15"(141-3809)......................250/box7" x 12"(141-2723)......................250/box

8" x 16"(141-3608)......................125/box9" x 16"(600-7348) ...................500/case12" x 18"(141-3347)......................125/box

Duo-Check™ Sterilization PouchesSelf-sealing sterilization pouches with color-changing dual indicators. Easy-to-read,blue-tinted, medical grade paper. Offerstriple seals, chevron safety seal at base ofpouch for added protection, and a thumbnotch for easy opening. For use in steamand EtO sterilization. Made in the USA.Latex-free.

Sterilization Pouches21/4" x 4"(774-0098) .....................200/box

23/4" x 9"(774-0099) .....................200/box

31/4" x 51/4"(774-0100)......................200/box

31/2" x 9"(774-0101) ......................200/box

51/4" x 10"(774-0104) ......................200/box

71/2" x 13"(774-0102) ......................200/box

12" x 18"(774-0103) ......................100/box

Assure Plus® PouchSelf-sealing sterilization pouch with uniquepeel-off internal indicator. Class IV indicatormeets CDC recommendations and ensuresthat the pouch's contents have undergonethe sterilization process. Quality, medical-grade paper allows steam and gas topenetrate. Lead-free inks and solid seals foradded strength and confidence.

31/4" x 61/2"(312-8361) .....................200/box

23/4" x 10"(312-0686) .....................200/box

31/2" x 10"(312-1228) .....................200/box

51/4" x 71/2"(312-9506) .....................200/box

51/2" x 11"(312-1817)......................200/box

7" x 13"(312-2815) .....................200/box

10" x 15"(312-3236) .....................200/box

11" x 16"(312-0636)......................100/box



The Help Center:

Guide to Selecting and UsingMetricide OPA Plus – YouTube Video This video outlines protocols whenusing MetriCide OPA Plus solution, sothat you can protect your patients, yourstaff, and yourself.http://www.youtube.com/watch?v=71uu9Uw9H6o

Cleaning Instruments – Educational Articles View a listing on various topics ofinstrument reprocessing andsterilization.http://www.spsmedical.com/education/educationarticles.html

Guideline for the Use of High LevelDisinfectants and Sterilants forReprocessing of FlexibleGastrointestinal Endoscopes (2011)http://www.sgna.org/Portals/0/HLD.pdf

Standard of Infection Control inReprocessing of FlexibleGastrointestinal Endoscopes (2012)http://www.sgna.org/Portals/0/sgna_stand_of_infection_control_0712_FINAL.pdf

Reprocessing of Single-Use Devices- U.S. Food & Drug Administration(FDA) free e-mail subscriptionservice.http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/ReprocessingofSingle-UseDevices/

Steam Sterilization Process RiskAssessment – Webinar CDA comprehensive guide to steamsterilization and sterility assurance inhealth care facilities.http://www.aami.org/meetings/webinars/webinar.cds/030311.steamsterilization.html

Surgical Instrument ReprocessingGuidelines – FREE Posterhttp://www.surgicalinstruments.com/instrument-reprocessing-guidelines-poster-1003-299.html

incontrol

In the United States, there are more than 46 million surgical procedures, and 5 million gastrointestinalendoscopies performed every year. Unfortunately for many patients, procedures too often result in healthcare-associated infections. The reasons? Inadequate cleaning of instruments and devices, improper selection of adisinfecting agent, and failure to follow recommended cleaning and disinfection guidelines procedures.

Source: Metrex.com

1717

Self-Seal Sterilization PouchesPackaging products are manufactured usingheavy-gauge, medical-grade paper.Balanced seal strengths facilitate ease ofopening while preventing “blowouts” duringsterilization. Products are also approved forEO gas and chemical vapor processes.Each pouch features a perforated adhesiveseal to minimize errors associated withsealing, a thumb notch for ease of opening,clear poly film for ease of viewing contents,and chemical indicators to show processinghas occurred. Self-Seal Pouches#SSP-380-1, 31/2" x 51/4"(120-1889)......................100/box#SSP-380, 31/2" x 51/4"(960-1590)......................10/case#SSP-381-1, 31/2" x 9"(120-9767)......................100/box#SSP-381, 31/2" x 9"(120-2039) .....................200/box

#SSP-390, 5" x 15"(218-6862) .....................200/box

#SSP-382 , 51/4" x 10"(120-6578) .....................200/box#SSP-383-1, 71/2" x 13"(120-8321)......................100/box#SSP-383, 71/2" x 13"(120-6392) .....................200/box#SSP-387, 8" x 16"(257-2327)......................200/box#SSP-388-1, 10" x 15"(120-0440)......................100/box#SSP-389-1, 12" x 15"(120-0441)......................100/box#SSP-391-1, 12" x 18"(120-0442)......................100/box

Chex-All® Tubes100' RollsHeat-sealable tubes are premium-quality,sterile packaging products designed toreduce the cost of sterilization processingby including independent indicatorsimprinted on both the inside and outside ofevery tube. While external indicators serveas process indicators, the internal indicatorsmonitor the penetration of steam andethylene-oxide gas on the inside of thepackage. Not having to add separateindicator strips in the pouches is a costsaving. Made of premium-quality, high-resistance, 2.5-mil plastic and triple-bonded, 75-g medical-grade papers, whichguarantees the integrity of the packaging inprevacuum and gravity sterilizations cycles,even with heavy instruments.2"(141-2630) ..............................ea3"(141-3312) ..............................ea4"(141-3627) ..............................ea6"(141-4058) ..............................ea

Roll Stock TubingDesigned to be cut to any length prior to packaging and then mechanically sealed or taped closed. All tubing is individually packaged in 100' rolls.

#RST-002, 2" Roll(608-5573) ..............................ea#RST-003, 3" Roll(120-3191).......................10 rl/ca#RST-004, 4" Roll(120-5596) ..............................ea#RST-006, 6" Roll(608-5515) ..............................ea#RST-008, 8" Roll(966-5352) ..............................ea

Sani-Roll® SterilizationPaper/Plastic Tubing100' RollsSee-through, medical-grade tubing witheasy-to-read color-changing indicators foruse in steam, chemical vapor, or EtOsterilization. Extra-thick, medical-gradepaper with triple seals for added protection.Blue-tinted plastic aids in the detection ofpuncture holes. Made in the US. Latex-free.2", 5 cm(107-1782)...............................ea3", 8 cm(107-0694) ..............................ea4", 10 cm(107-6496) ..............................ea6", 15 cm(107-4915)...............................ea



Ultrasonic cleaning is usually one in a multi-step process that begins with manual cleaning to remove grossdebris. This step is performed immediately after the instrument's use to prevent patient soil from drying. Oncemanually cleaned, the instrument is then placed in the ultrasonic cleaner. This cleaning step is particularlyimportant for removing fine debris that may not have been removed during manual cleaning.

Source: Infection Control Today

M9 UltraClave®

& SterilizerThis reliable and efficient sterilizer featuresa sleek look, quiet-door operation, andpulse-air-removal technology. Front fill-and-drain tube feature means you never have tomove it to maintain or drain the water. Loadit, set it, and forget it.• Press “Start” and M9 fills with correct

amount of water• When cycle is complete, door opens

automatically and quietly for fastdrying time

M9 Ultra Clave(386-7984) ..............................ea

M250 Soniclean®

Ultrasonic Cleaner#M150, Tank Capacity: 11/2 gal; Tank Size: 12" x 6" x 6"*(102-5893) ..............................ea#M250, Tank Capacity: 21/2 gal; Tank Size:111/2" x 91/2" x 6"*(386-0250) ..............................ea#M550, Tank Capacity: 51/2 gal; Tank Size:191/2" x 111/2" x 6"*(102-5896) ..............................eaAccessory Kit with Half Basket(386-2836) ..............................ea*Required safety basket sold separately.

MAXITABS®

• Provide safe and effective cleaning properties in multiple cleaning cycles throughout the day

• Does not leave a residue on instruments or inside tank

• 1 tablet makes 1 gallon of solution• 1 box makes 32 gallonsGeneral Purpose Cleaner(900-4088) .......................32/boxTartar and Stain Remover(900-4089) .......................32/box

Ritter M11 UltraClave®

Automatic SterilizerLike the Ritter M9, this unit also contains an automatic opening door. Unique chambersize gives it the most sterilizing capacity ofany standard countertop sterilizer on themarket. Featuring a modern look, quiet dooroperation, and pulse air-removal technology,this sterilizer couldn't be easier, moreefficient, or more reliable. You load it, set it,and forget it.• Door opens automatically• UL listed and CSA/ASME certified• Chamber size: 11" x 18"• Weight: 99 lb(386-8917) ..............................eaDoor and Dam Gasket Kit, M11(386-7195) ..............................ea

ULTRASONIC CLEANERWITH TOUCH PADOne-touch, press-set digital pad timer in beige, vinyl-clad housing. Solid-state circuitry.Stainless steel drain with reversible right orleft hookup. 43 kHz of cleaning power.Includes an FCC-approved EMI filter and a60-minute timer with infinity hold.• Tank dimensions: 93/8" x 53/8" x 4"• Tank capacity: 33/8 qt• 21/2-year warranty

110-V Unit(104-4057) ..............................eaAccessory Package(100-7900) ..............................eaContains: 1 stainless steel solid-side basket,1 bur tray, 1 positioning cover, 2–600-mLbeakers, 2 beaker covers & 2 beaker bands.

Basket Only, Solid Side, Perforated Bottom(101-1667)...............................eaCover(900-4354)..............................ea

DRy HEATSTERILIZERS“Heat and hold” capability for continuous use. Rapid heating for fast operation, automatic timer. Will not dull sharpinstruments. All stainless steel. 60 minutessterilization set at 320°F or 160°C.#200 UnitDimensions: outside: 151/2"W x 101/2"H x91/2"D; inside (useful space): 121/2"W x 5"Hx 71/2"D; no. of trays: 2; weight: 17 lb(100-5400) ..............................ea#300 UnitDimensions: outside: 19"W x 141/2"H x11"D; inside (useful space): 15"W x 71/2" Hx 9"D; no. of trays: 3; weight: 27 lb(100-7250) ..............................ea

SUPERCONCENTRATEDULTRASONICCLEANING SOLUTIONSFast-acting solutions clean quickly and effectively. Nontoxic and noncorrosive. In small, easy-to-store,16-oz bottles, which are less expensive toship, handle, and stock. Metered-dosedispenser top ensures exact dose. To use:loosen cap 1/2 turn, squeeze to 1-oz mark,and remove cap and pour into glass beaker.Available in 3 formulas.Metered Dose Bottles .............eaSpecify:General Purpose Cleaner(Makes 16 gal) Used for very fastcleaning of blood, mucus, andtissue. .......................................... (101-4412)Tartar and Stain Remover(Makes 96 oz) Its citric acidformula is noncorrosive andcleans quickly. ............................. (101-0827)Enzymatic Cleaning Solution(Makes 16 gal) Effective againstblood, tissue, and mucus foundon instruments.............................(102-6472)Crosszyme

Ultrasonic SolutionsNeutral pH formula will not damage or harm instruments. Contains no harsh alkaline components—noncorrosive. Safe for use on plastics,stainless steel, glass and aluminum.Contains rust inhibitors. Enhances thedissolving of organic materials. Balanceddetergent system for effective cleaning andeasy rinsing over a wide range ofconcentrations and temperatures.Powerfully chelated to improve performancein hard water conditions. May be used as anUltrasonic Cleaning Solution or anInstrument Presoak.

Gallon(107-0064) ..............................ea

EZ-Zyme™

All-PurposeEnzyme Cleaners

Easy-to-use, neutral pH, multienzyme concentrate for use as a surgical and dentalinstrument/apparatus presoak and as anultrasonic and evacuation system cleaner.Each 3/4-oz packet makes 1 gal; 1-gal refillmakes 170 gal. Economical shipping andconvenient storage.3/4-oz Unit Dose(953-2961) .......................32/box Call1-gal Bottle Refill with Dispenser Pump

(953-8528) ..............................ea Call



MAXIMA®

MULTIPARAMETER SELF-SEAL STERILIZATIONPOUCHES WITH SURE-CHECK® TECHNOLOGy

23/4" x 9"(900-4602) .......................................200/box31/2" x 51/4"(900-4604) .......................................200/box31/2" x 9"(900-4601) .......................................200/box51/4" x 10"(900-4603) .......................................200/box71/2" x 13"(900-4782) .......................................200/box12" x 18"(900-4783) .......................................100/box

SURGICAL MILKSuper ConcentratedRust inhibitor and lubricantwith bacteriostatic action forsurgical instruments. Dilute1 part milk to 5 parts water.Makes 51/2 gal of dip bath.64-fl-oz Bottle(102-5539) .................................................ea

GERMICIDETRAySDimensions:10" x 4" x 23/4"Stainless Cover.........................................eaSpecify:Beige.................................. (100-8193)Blue.................................... (100-7778)White .................................. (100-8485)Mauve ................................ (101-8195)

Plastic CoverOpaque Smoke.........................................eaSpecify:White .................................. (100-2937)Beige.................................. (100-6126)Blue.................................... (100-7564)Mauve ................................ (101-8196)

SELF-SEALSTERILIZATIONPOUCHES WITH DUALINDICATORSSuperior quality pouch with dual indicatorsthat comply with the recommendations ofthe CDC for effective sterilization. Preprintedinternal and external indicators changecolor when processed with steam and EtO. 23/4" x 9"(112-4856) .................................200 per Box31/2" x 9"(112-4853) .................................200 per Box51/4" x 10"(112-4854) .................................200 per Box71/2" x 13"(112-4858) .................................200 per Box101/2" x 17"(112-4862) .................................100 per Box13" x 20"(112-4865) .................................100 per Box

MAXICIDE® NS SOLUTION2.6% AlkalineGlutaraldehyde SolutionReusable sterilizing and high-level disinfecting 14-day solution.Broad-spectrum kill of pathogenicmicroorganisms. Specificallydesigned for scopes andultrasound transducers. Contains no surfactants.1-gal Bottle

(102-2866) ................................................ea

MAXIZyME®

Dual Enzymatic Detergent• Contains 2 gold-standard

proteolytic enzymes for moreeffective cleaning

• Dissolves and releases bloodand tissue: minimizes handling and scrubbing ofcontaminated items

1-gal Bottle(101-9031).................................................ea

Henry Schein BrandOur Henry Schein Brand is a perfect match for health carefacilities looking for products that are cost-effective withexceptional value. Our instrument reprocessing product linewill help reduce costs and promote better outcomes…Every Day, Every Patient, Every Time!

DUAL-PURPOSE NyLON STERILIZATION TUBING100' Rolls

Continuous Clear, 2"(101-2224).................................................ea

Continuous Clear, 3"(101-2225).................................................eaContinuous Clear, 4"(101-2226).................................................ea

Continuous Clear, 6"(101-2227).................................................ea

Continuous with Indicator, 2"(101-1111)..................................................ea

Continuous with Indicator, 3"(101-1110)..................................................ea

Continuous with Indicator, 4"(101-2222).................................................ea

Continuous with Indicator, 6"(101-2223).................................................ea

12-Test Package(101-5830).................................................eaContains: 12 packets, each containing 2 teststrips & 1 control strip.

48-Test Package(101-1253).................................................eaContains: 48 packets, each containing 2 teststrips & 1 control strip.Not for export.

Biological SterilizationMonitoring Service:MaxiTest includes testsets, culturing service, laboratory reports,all postage and handling, and any deviceconcerning sterilization procedures; the labcultures are completed in 7 days; however,if any test strip cultures positive (sporegrowth indicating sterilization failure), theoffice will be telephoned immediately; if thetest strips do not culture positive, the officewill receive a laboratory report inapproximately 2 weeks, indicatingsterilization was achieved.

MAXITEST®

MAXITEST® VALUE TEST PACKBiological Monitoring SystemUsed to test steam, dry heat, chemical vapor, and EtOprocesses. Mail-in service with results reported quarterly.Immediate and confidential notification of test failures. Testresults available electronically. Postage not included.(101-4715).................................................eaContains: 52 test packets, each containing 1 teststrip & 1 control strip.Not for export.

MAXICIDE® PLUS3.4% Glutaraldehyde Solution with Activator• Sterilization in 10 hours• 28-day reuse life after

activation• Clear color before activation;

turns blue after activation• Activated solution contains

anticorrosion andantioxidant ingredients

• Rapid and effective broad-spectrum kill

• Pleasant pine scent1-qt Bottle(102-5796) ................................................ea1-gal Refill Bottle(102-2865) ................................................ea

EZ-Zyme™


incontrol Order: 1.800.772.4346 8am – 9pm, et | Fax: 1.800.329.9109 24 hours

Guidelines &Recommendations

Understanding Proper Instrument StorageThe correct storage of processedinstruments is important to protect themfrom environmental contamination. Themajor source of environmentalcontamination is airborne bacteria andviruses that settle on instruments andequipment. Critical instruments that mustbe sterile at the time of use must be storedbagged/wrapped until use. However, anefficient way to protect all sterilizationcritical instruments from environmentalcontamination is to bag them prior tosterilization and store them in theunopened bag/wrap. Critical instruments/items must be stored in a way thatmaintains the integrity of packs andprevents contamination from any source.Items required to remain sterile must notbe stored in ultraviolet cabinets ordisinfectants as these processes willcompromise sterility. It is important thatcritical wrapped instruments are stored in a clean dry area and are subjected tominimal handling before use.

During storage, packs can be contaminated by:• over-handling – this can happen through

excessive transferring from one place toanother or during rotation of instrumentpacks from over-stocking storage areasor from bundling packs together usingrubber bands;

• moisture – if the pack is placed on awet bench top, splashed with water,other liquids or aerosols; or

• penetration – if instruments breakthrough the surface of the pack.

A package is considered to be nonsterile when it:• is damaged or open;• comes out of the steam sterilizer wet

or is placed on a wet surface; or• is dropped or placed on a dirty surface.

Storage areas must be dedicated for thatpurpose only and be free of dust, insects,and vermin. For open shelving, all itemsmust be stored above floor level by at least250 mm, from ceiling fixtures by at least400 mm, and protected from directsunlight. This will facilitate environmentalcleaning and allow unrestricted airflow andprevent heating and degradation of thepackaging material.

2020

MAXITEST® IN-OFFICE BIOLOGICALMONITORING SySTEMIn-office system for monitoring steamsterilizers. Easy to use and interpret.Results in 24–48 hours.Starter Kit(102-6076) ................................................eaContains: 1 of each: box of 25 indicators,incubator, crusher & record keeper.

Indicator Refill(102-5804)..........................................25/box

ProSure™ MailersKits for Steam or Dry-Heat Sterilization(436-4128)..........................................12/box(991-3994)..........................................26/box(331-2136)..........................................52/box

ProSpore2™

Indicator with Crusher(833-9786) .........................................50/box

Comply® SteriGage™ IntegratorDesigned to monitor exposure to steam orEO conditions in a pack. Provides a visualaccept/reject readout to determine that thesterilant has penetrated to the point ofplacement in the pack and confirms thatsufficient exposure conditions occurred.(220-1989) 2 x .75............................100/box

3M™ Attest™ 1291 Rapid ReadoutBiological IndicatorsSelf-contained biological indicator for270°F/132°C gravity steam cyclesconsisting of a Geobacillusstearothermophilus spore strip; sealedglass ampule with growth medium and dualindicator system; blue color-coded cap withholes for sterilant penetration and ahydrophobic filter as a bacterial barrier; anda chemical indicator on the label thatchanges from rose to brown whenprocessed. After sterilization, the vial is"crushed" to join the growth media with theprocessed spore strip. The BI is incubatedfor 1 hour in the 3M™ Attest™ 290 seriesauto-reader for a fluorescent reading. A redlight indicates a positive result orsterilization failure.(777-3276) ..........................................50/box

3M™ Comply™ (SteriGage™) ChemicalIntegrator 1243AAn ANSI/AAMI/ISO 11140-1:2005 Class 5Integrating Indicator for use in determiningwhether the sterilization process conditionswere met inside each pack. Can be used inall 250°F-275°F sterilization cycles.(777-9032)........................................500/pkg

Biological Test Pack and CultureService ProgramAllows clinics and medical offices to monitora steam, dry heat, or ethylene oxide gassterilizer's performance on a regular basis.

• Tests are reproducible andtherefore reliable

• Test packs are ready to use • Preaddressed envelopes are provided for

culture service• Provides permanent record of test results• Provides for detection of a faulty sterilizer• 2-day incubation(141-3829) ..........................................10/boxNot for export.


incontrol 2121

To ensure that instruments and supplies are sterile when used, monitoring of the sterilization process is essentialand requires administrative monitoring. Work practices must be supervised. Written policies and procedures mustbe strictly followed by all personnel responsible and accountable for sterilizing and disinfecting items, and forhandling sterile supplies. If sterility cannot be achieved or maintained, the system has failed.


The Help Center:

Administrative MonitoringWork practices must be supervised. Written policies and procedures must be strictly followed by all personnelresponsible and accountable for sterilizingand disinfecting items, and for handlingsterile supplies. If sterility cannot beachieved or maintained, the system hasfailed. Policies and procedures pertain to:1. Decontaminating, terminally sterilizing,

and cleaning all reusable items;disposing of disposable items.

2. Packaging and labeling of items. 3. Loading and unloading the sterilizer. 4. Operating the sterilizer. 5. Monitoring and maintaining records

of each cycle. 6. Adhering to safety precautions and

preventive maintenance protocol. 7. Storing of sterile items. 8. Handling sterile items ready for use. 9. Making sterile transfer to a sterile field.

Helpful Tips for Instrument Processing Areas

• Every designated health careprofessional should have a personal setof heavy-duty utility gloves, disinfectedand evaluated for cracks and integritydaily. This will help with complianceand guard against sharps injuries.

• To prevent having to change gloves,keep a spare set of clean cotton forceps or a set of tongs to open andtake things out of drawers andcupboards.

• Keep sterilization pouches in an open,easy-to-access location to eliminate the risk of cross contamination fromopening drawers and cupboards.

• Having the sterilizer divide the roombetween clean and dirty (one side isthe dirty side, one side is the cleanside) is a simple way to help everyoneunderstand the concept.

• An instrument-management system that includes procedure tubs andcassettes is the most efficient andorganized way to manage instrumentsand consumable products, and saves time.

• Procedure tubs and cassettes limit exposure to pathogens and sharps injuries.

Source: University of Rochester University Medical Center

3M™ Attest™

Biological IndicatorsFor use in steam sterilization. Will monitorand indicate the effectiveness of steamsterilization conditions.#1261(777-9599) ........................................100/box#1262(777-5692) ........................................100/box#1262P(777-4656)..........................................25/box#1261P(777-2331)..........................................25/box

PassPort® Plus Mail-in SystemMail-In spore-test system, certified for use with steam, chemical vapor, EtO, and dry-heat sterilizers. Simply place the spore strip and integrator togetherinside an instrument tray or peel pouch.Steam customers receive immediate “peaceof mind” with our integrator, and theirbiological results after just 24 hoursincubation time in the SPS lab. Prepaidmailers, educational CD-ROM in every box,reports with every test, and access to yourresults on-line.(613-4434)..........................................12/box(120-5685) .........................................52/box

ProTest Steam BI• 24-hour results, instead of 48 hours• Intended for steam sterilization 121°C

gravity displacement and 121°C–135°Cprevacuum cycles

• Not to be stored frozen or refrigeratedProTest Starter Kit(437-0028) ................................................eaContains: 1–25-pack of ProTest BiologicalIndicator Ampoules & 1–100-pack ProPackIntegrator.(780-3685).................................25 tests/box(335-0392) ...............................100 tests/box

SporView® Self-Contained Biological IndicatorsAn in-office biological indicator (BI) systemcertified for use with all steam sterilizationcycles. This system gives clear, easy-to-interpret results for monitoring theeffectiveness of the sterilization process.Final results are known after only 24 hoursof incubation in any compatible dry-blockincubator operating at 55–60°C. For user'sconvenience, SPSmedical offers acalibrated 60°C dry-block incubator thatcomes with 15 wells and a lifetime warranty.

#SCS-025, SporView® BI System(120-2516)..........................................25/box#SCS-100 SporView® BI System(120-1432)........................................100/box#SK-116, SporView® Starter Kit(896-3663) ................................................ea#NDB-037, 37°C Dry Block Incubator,11 mm(120-6065) ................................................ea

3M™ Comply™ Bowie-Dick Test Pack1233LFConsists of a chemical indicator sheetpositioned inside porous materials andsealed inside a disposable outer wrap. The3M™ Comply™ Bowie-Dick Internal SteamIndicator Sheets are large-sized test sheetsused for health-care facility prepared,reusable towel Bowie-Dick test packs.(777-0288) ................................................ea

INDICATOR STRIPSFor steam and chemical sterilizers. Indicatorink changes from white to black, indicatingsterilization process has been completed.(102-6332)........................................250/box





OPALIT - Rev. 0 - 2/13 ©

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To Order or Contact your Sales Consultant for more information:Phone: 1(800) P-SCHEIN / 1(800) 772-4346 8am-9pm (EST)Fax: 1(800)329-9109 24 hours or Visit: http://www.henryschein.com/opa28Please Mention Promotion Code DAV to Ensure Free Good; All o!ers expire: 09/28/2013

Description Quantity HSI Code

Rapicide® OPA 28 DP ay HLDAlso Available:Rapicide® OPA A Test Stest Strips

1-Gallon Bottle

50 strips/bottle

337-7961

337-7962

High-level disinfefef cts devices manually in just 10 minutes at room temperature (20ºC minimum), to achieve bactericidal, fungicidaland tuberculocidal kills. Studies indicate Rapicide OPA/2PA/2P 8

It's important for heafor heaf lthcare providers to manage budgets carefully while still delivering high-quality patient care. Rapicide OPA/28 hPA/28 hP as been tested to provide 84 reuse cycles† along with a reuse period of up to 28 days – twice the reuse period of other OPAPAP brands.

MRSA • VRE • TBHepatitis Viruses • HIV

OPAPAP 's faster manual disinfeection allowsyou to reprocess one extra scope

foor every disinfeection cycle!

† Minimum recommended concentration

WORKS FASTER LASTS LONGERTake quicker actionagainst microorganisms

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USe pRoMo CoDe DAV To ReCeIVe

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9/28/2013


Call:1-800-P-SCHEIN

(1-800-772-4346)8am–9pm (et)

Fax:1-800-329-9109

24 Hours


13MS8747

© 2012 Metrex Research. MetriCide and EmPower are registered trademarks of Metrex Research.

Together, a winning combination of cleaning and high-level disinfection.

(640-8231) OPA Plus Solution Gallon(640-5822) EmPower Enzymatic Solution Gallon

The Perfect Handoff.

Start your cleaning process off with EmPower® dual enzymatic detergent then hand off the instrument to MetriCide® OPA Plus high-level disinfectant. This powerful combination has been engineered to work safely together to maximize instrument reprocessing performance.

Learn more about EmPower ®

and MetriCide® OPA Plus – Metrex.com/Schein

Due to manufacturer price increases, prices are subject to change without notification. Offervalid on our full array of products. Upon any request by Medicare, Medicaid, Tricare or otherpayer, you must report the value of any benefit received from a discount program (e.g., pointsredemptions, gifts or other special awards). ©2013 Henry Schein, Inc. No copying withoutpermission. Not responsible for typographical errors. No adjustments from prior sales. Offer notto be combined with other promotions and/or special contract pricing. Void where prohibited.Local regulatory requirements may apply to use or installation of certain products. It is yourresponsibility to understand and comply with any such requirements prior to purchase, use orinstallation of products. †For informational purposes only. Source: ReimbursementCodes.comand/or www.cms.gov. Customer is responsible for verification of billing/coding in accordancewith applicable specific circumstances.


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