Sterilization and Cleaning (Instruments, Reusable Goods) for Certified Perioperative Nurse (CNOR)

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Study Tools For Sterilization and Cleaning (Instruments, Reusable Goods) for Certified Perioperative Nurse (CNOR)

Sterilization & Cleaning (Cheatsheet)

Perioperative personnel perform surgical instrument cleaning and sterilization to reduce the risk of surgical site infections (SSIs)
- Cleaning = removes microorganisms
- Decontamination = renders microorganisms noninfectious
- Sterilization = kills microorganisms and spores
Cleaning, disinfection, and sterilization processes build upon each other and should be performed sequentially for maximum efficacy

Successful instrument sterilization requires thorough instrument cleaning and disinfection
- Includes removal of organic and inorganic material and microbial contaminants that can inactivate the sterilant or prevent it from contacting all surfaces of the instruments
- Refer to the manufacturer’s instructions for use (IFU) for information on cleaning, decontamination, and sterilizing instruments and using any associated equipment
Immediate-use steam sterilization
- A sterilization method that involves the shortest possible time between a sterilized item’s removal from the sterilizer and its aseptic transfer to the sterile field
- A sterilized item intended for immediate use is not stored for future use not held from one surgical procedure to another
Reusable semi critical items
- Some items cannot be sterilized or mechanically processed
- May be processed using manual methods when that is the only processing method recommended by the manufacturer
- If manufacturer validated for sterilization, then sterilize
- Follow the manufacturer’s IFU

The Spaulding Classification:
- Strategies the risk of infection transmission based on the patient tissue the device will contact during use. The device classification determines the level of disinfection/sterilization required.
Critical: Device contacts sterile tissue or the bloodstream. Requires sterilization. Example, surgical instruments
Semi-Critical: Device contacts mucous membranes or non-intact skin. Requires high level disinfection. Example, flexible endoscopes, vaginal specula, anesthetic equipment
Non-critical: Device only contacts intact skin. Requires intermediate or low level disinfection. Example: non-critical ultrasound probes, BP cuffs, environmental surfaces.

Surgical instrument cleaning, decontamination, and sterilization is done to reduce the risk of SSIs
Cleaning, decontamination, and sterilization should be performed sequentially
Cleaning and decontamination begins at the point of use
Follow the manufacturer’s IFU

When you start a FREE trial you gain access to the full outline as well as:

Association for the Advancement of Medical Instrumentation. ANSI/AAMI ST79:2017 Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities .
Arlington, VA: AAMI; 2017.
Global Guidelines for the Prevention of Surgical Site Infection. Geneva: World Health Organization; 2018. Table 3.3.3, Spaulding classification of equipment decontamination.
https://www.ncbi.nlm.nih.gov/books/NBK536426/table/ch3.tab7/
Guideline for care and cleaning of surgical instruments. In: Guidelines for Perioperative
Practice . Denver, CO: AORN, Inc; 2022:417- 456.
Guideline for sterilization. In: Guidelines for Perioperative Practice . Denver, CO: AORN, Inc;
2022:1059- 1088.
Link, T. (2021). Guidelines in practice: Instrument cleaning. AORN Journal, 114(3), 241-251.
https://doi.org/10.1002/aorn.13495