Step-by-step instrument reprocessing protocol from contaminated receipt through verified sterile storage. Follows CDC, OSAP, and manufacturer IFU requirements.
Add it to Practice Flow and it becomes yours to edit, assign and schedule. It will start generating on its cadence, so the work comes back on its own.
Add this checklist Browse moreAccept used instrument containers in the dedicated dirty/receiving section of the sterilization area.
Maintaining clear separation between contaminated and sterile sides prevents cross-contamination of already-processed instruments. The workflow must always move in one direction: dirty to clean. Mixing contaminated instruments with sterile packages is an infection control breach.
1. Accept the contaminated transport container. 2. Place in the receiving (dirty) area - never on the clean side. 3. Change to utility gloves (heavy-duty, puncture-resistant). 4. Open carefully, watching for sharps. 5. Sort: discard disposables, separate sharps, group instruments by type.
Place instruments in the ultrasonic cleaning unit for the recommended cycle time to remove all bioburden.
Ultrasonic cleaning removes organic material from instrument surfaces, joints, and crevices more effectively than hand scrubbing. Bioburden left on instruments can insulate microorganisms from sterilization. The CDC states thorough cleaning must precede sterilization.
1. Open hinged instruments so surfaces are exposed. 2. Place in the ultrasonic basket - do not overload; ensure full submersion. 3. Run the cycle for the recommended time (typically 5-15 min). 4. Remove basket carefully. 5. Rinse thoroughly under running water. 6. Do NOT put handpieces in the ultrasonic.
Visually examine each instrument under adequate lighting to verify all bioburden is removed.
Visual inspection is your quality check between cleaning and packaging. If debris remains, sterilization may not reach the instrument surface. An instrument that looks dirty IS dirty - re-clean before packaging. This step also catches damaged instruments for removal.
1. Hold each instrument under bright light. 2. Inspect all surfaces: joints, serrations, grooves, lumens. 3. Look for dried blood, cement, composite, tissue. 4. Re-clean instruments with visible debris. 5. Check for damage: cracked tips, corrosion, stiff joints. 6. Remove damaged instruments from service.
Place cleaned instruments into sterilization pouches with an internal chemical indicator in every package.
Proper packaging maintains sterility after processing. The internal CI provides visual evidence that sterilization conditions were achieved inside each package. Without a CI, you cannot verify steam reached the instruments. This is a CDC requirement.
1. Select appropriate pouch size. 2. Place instruments with handles toward sealed end. 3. Insert a Type 5 internal chemical indicator strip. 4. Seal using the heat sealer with a complete, even seal. 5. For cassette wrapping, use two layers of CSR wrap secured with autoclave tape.
Write or apply a label to each package with sterilizer ID, cycle/load number, and date.
Labeling enables traceability. If a spore test fails, you must identify every package from that load for recall. Without labels, you cannot trace instruments to specific loads. Labeling is required by the CDC and most state dental boards.
1. Write on each package: sterilizer number, load/cycle number, and today's date. 2. Write on the pouch material, not the clear window. 3. Do not cover the chemical indicator area. 4. Use consistent formatting (e.g., S1-L3-03/02/26).
Load packaged instruments into the autoclave, start the cycle, and document parameters.
Proper loading is critical - overloading prevents steam from reaching all surfaces, causing sterilization failure. Recording parameters documents that the sterilizer operated within specifications. This log is reviewed during audits and required by CDC and OSHA.
1. Load packages on edges (not stacked flat) for steam circulation. 2. Leave space between packages. 3. Place pouches paper-side to plastic-side. 4. Close door securely. 5. Select correct cycle. 6. Press start. 7. Record: date, load number, contents, sterilizer ID, cycle type, temp/pressure/time.
After the cycle finishes and packages cool, check all indicators for proper color change.
The CI is your immediate verification that sterilization conditions were achieved. If the CI does not show correct color change, the contents are NOT sterile and must be reprocessed. Partial color change means failure. Releasing packages with unchanged CIs is a serious violation.
1. Allow the full cycle including drying. Do not open early. 2. Remove packages carefully. 3. Check external process indicator on each package. 4. Open one package and verify the internal CI fully changed color. 5. If ANY indicator failed, do NOT release the load. 6. Document results in the sterilization log.
Transfer verified sterile packages to the clean storage area, inspecting each for seal integrity.
Sterile instruments must be stored in a clean, dry, enclosed area. Event-related sterility means instruments stay sterile until package integrity is compromised. A torn pouch or broken seal means contamination - reprocess immediately.
1. Inspect every package: tears, punctures, open seals, moisture. 2. Reject compromised packages for reprocessing. 3. Place in clean storage (enclosed cabinet). 4. Oldest items in front (first in, first out). 5. Store away from sinks, chemicals, and high-traffic areas. 6. Re-inspect seal and indicator before each use.