The assessment of the central reprocessing area will focus on the consistency, predictability, organization and appropriateness of the area’s design and activities for instrument cleaning, sterilization and storage.
The physical features of the sterilization area need to be consistent with the requirements of current infection control and prevention standards. They need to allow for distinct areas to:
- hold unprocessed or dirty instruments and devices from operatories;
- clean instruments – which at a minimum requires a designated sink but may include an automated washer or an ultrasonic cleaner;
- rinse instruments – which may be done in the same sink designated for cleaning if proper protocols are established but ideally should be done in a second sink designated for the purpose. An automated washer normally has a rinse cycle appropriate for this purpose;
- inspect instruments. Regardless of the process for cleaning, all instruments must be inspected prior to sterilization;
- drying instruments. Again regardless of the process for cleaning, all instruments must be dried prior to sterilization. With manual instrument cleaning, inspection and drying may be concurrent.
- instrument or cassette packaging area. Packaging must be appropriate for the intended purpose and comply with manufacturer instructions for its use. Storage and documentation of unsterilized instrument and cassette packages must prevent unintentional use of the instruments before sterilization.
- sterilizer area. The area must be sufficient to meet manufacturer requirements for ventilation.
- storage area for sterile instruments and cassettes. If instruments are stored in the reprocessing area, it must be distinct from unsterilized instruments or packages and prevent aerosol contamination or physical damage to the packaging.
While other activities than instrument and equipment reprocessing may occur in the same room – supply storage, radiograph processing, laboratory procedures – the physical layout must allow for processes, protocols and barriers to limit risks of dental office personnel injury or instrument, supply or lab procedure contamination.
Activities in the area will be observed to ensure consistency with office protocols and current standard of practice for instrument and equipment reprocessing.
This includes:
contaminated instrument transportation; organized flow of instrument reprocessing; the use of personal protective equipment;
the impact of other activities in the area on reprocessing and
other mechanisms to prevent unintentionally using contaminated instruments in treatment and avoiding cross contamination of sterilized instruments.