Cleaning the Sterile Processing Department

A Comprehensive Guide to Cleaning Hospital Sterile Processing Departments

Cleaning the Sterile Processing Department (SPD) in a hospital is a critical task that ensures the integrity of sterilized medical instruments and safeguards patient safety. The standards set by the Association of periOperative Registered Nurses (AORN), The Healthcare Sterile Processing Association (HSPA), and the Office of Health Systems Oversight (OHSO) outline stringent guidelines for maintaining cleanliness, minimizing contamination risks, and ensuring compliance with regulatory requirements. This guide provides detailed steps and best practices for cleaning SPDs effectively.

1. Importance of Proper Cleaning in the SPD • Patient Safety: Preventing surgical site infections (SSIs) by maintaining the sterility of surgical instruments.
   • Compliance: Meeting state, federal, and accrediting body regulations, including those from the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC).
   • Operational Efficiency: Minimizing equipment downtime and ensuring proper instrument functionality.
2. Regulatory Standards and Guidelines • AORN: Recommends evidence-based practices for sterilization, decontamination, and environmental cleaning.
   • HSPA: Provides detailed protocols for the disinfection, inspection, and sterilization processes.
   • OHSO: Enforces compliance with sanitation and safety regulations in healthcare facilities.
3. Key Areas in the SPD
   1. Decontamination Area: Where soiled instruments are received and cleaned.
   2. Preparation and Packaging Area: For inspection, assembly, and wrapping of instruments.
   3. Sterilization Area: Houses sterilizers and facilitates the sterilization process.
   4. Storage Area: Sterile instruments are stored in clean and controlled environments.
   5. Administrative Area: Houses workstations for documentation and inventory management.
4. Cleaning Procedures for Each Area

A. Decontamination Area

•   Frequency: Clean at least daily and as needed.
•   Steps:
1.  Pre-Cleaning: Remove visible debris using enzymatic detergents and water.
2.  Surface Cleaning:
•   Use hospital-grade disinfectants approved for medical use.
•   Focus on high-touch areas (e.g., counters, sinks, transport carts).
3.  Drain Maintenance:
•   Regularly flush drains with enzymatic cleaners to prevent biofilm buildup.
4.  Equipment Cleaning:
•   Decontamination sinks and ultrasonic cleaners should be cleaned daily following manufacturer guidelines.
5.  Floor Cleaning:
•   Mop with a low-lint mop and a disinfectant designed for healthcare environments.

B. Preparation and Packaging Area

•   Frequency: Clean daily and between shifts.
•   Steps:
1.  Surface Cleaning:
•   Wipe down countertops and workstations with a lint-free cloth and hospital-grade disinfectant.
2.  Environmental Controls:
•   Ensure temperature and humidity levels are within prescribed ranges (typically 68-73°F and 30-60% humidity).
3.  Dust Control:
•   Use HEPA-filtered vacuums to remove dust and particulate matter.
4.  Instrument Cleaning:
•   Inspect and clean instruments using magnification tools to ensure no residual debris.

C. Sterilization Area

•   Frequency: At least daily and after contamination events.
•   Steps:
1.  Sterilizer Maintenance:
•   Follow the manufacturer’s cleaning protocols for sterilizers, including chamber cleaning and gasket inspections.
2.  Environmental Cleaning:
•   Wipe down surfaces and sterilizer exteriors with approved disinfectants.
3.  Air Quality Monitoring:
•   Ensure HEPA filters are regularly inspected and replaced.
4.  Cleaning Logs:
•   Maintain detailed logs for cleaning activities, sterilizer maintenance, and biological indicator tests.

D. Storage Area

•   Frequency: Weekly for deep cleaning; daily for spot cleaning.
•   Steps:
1.  Shelf Cleaning:
•   Wipe shelves with disinfectant and ensure they are dry before placing instruments.
2.  Environmental Controls:
•   Monitor and document temperature and humidity levels.
3.  Inventory Rotation:
•   Use a first-in, first-out (FIFO) system to prevent expired items from remaining in storage.

E. Administrative Area

•   Frequency: Daily.
•   Steps:
1.  Surface Cleaning:
•   Disinfect keyboards, phones, desks, and other high-touch areas.
2.  Waste Management:
•   Dispose of paper and packaging waste according to facility protocols.

5. General Best Practices

A. Staff Training

•   Provide annual training on infection control, cleaning protocols, and the proper use of cleaning agents.
•   Reinforce the importance of adhering to personal protective equipment (PPE) guidelines.

B. PPE Compliance

•   Always wear appropriate PPE, including gloves, gowns, face shields, and shoe covers, during cleaning activities.

C. Environmental Monitoring

•   Perform regular environmental testing for microbial contamination in critical areas.
•   Conduct air quality assessments to ensure compliance with regulatory standards.

D. Use of Approved Cleaning Agents

•   Only use EPA-registered disinfectants and detergents compatible with medical equipment and surfaces.
•   Follow dilution and contact time guidelines provided by manufacturers.

E. Documentation

•   Maintain detailed records of cleaning schedules, environmental monitoring results, and staff training.
•   Use digital systems when possible for real-time tracking and compliance reporting.

6. Additional Considerations • Incident Response: Establish protocols for responding to spills, contamination, or equipment malfunctions.
   • Audits: Schedule routine audits to assess adherence to cleaning protocols and identify areas for improvement.
   • Continuous Education: Stay updated on emerging best practices, new cleaning technologies, and changes in regulatory requirements.
7. References and Resources • AORN Guidelines for Perioperative Practice
   • HSPA’s Best Practices Manual
   • CDC Guidelines for Environmental Infection Control
   • Manufacturer’s Instructions for Use (IFUs) for Equipment

By adhering to these guidelines and leveraging the latest evidence-based practices, hospital Sterile Processing Departments can maintain a safe and compliant environment, ensuring the highest standards of patient care and safety.