When contaminated instruments arrive in Sterile Processing, our primary goal is starting soil removal with various types of detergents.
The timing and correct selection of chemicals in the “dirty” decontamination side becomes more confusing if killing germs is a consideration when items cannot go through washer thermal disinfection. Device instructions must be followed but often tell us to use alcohol to “clean” the device. Selecting a chemical that will do the job, meet device instructions and not cause damage is tricky.
Two things that Sterile Processing must understand in this chemical dilemma: detergents cannot claim to kill germs unless EPA registered and disinfectants are not tested for cleaning action by the EPA. Disinfectants must have chemicals to kill germs with alcohols, peroxides or ammoniums as frequently used active agents. But those same chemicals may interfere with cleaning or cause corrosion.
If device instructions recommend avoiding alcohol during processing, a water-based disinfectant may be useful. Water-based disinfectants with cleaning surfactants and alcohol content below 5 % alcohol are available with EPA registration to meet device instructions. The disinfectant label should state that it is a cleaner and disinfectant.
Check chemical instructions for the need to rinse or wipe off residues of chemicals between steps and before heat sterilization. Valuable resources include Annex E of AAMI ST79:2017 and AAMI TIR68:2018. Both documents explain how to select and use disinfectants in Sterile Processing.
The bottom line is: read chemical labels and check label for EPA registration if disinfection is needed.