Disinfection and sterilization are crucial processes in infection control and prevention in healthcare settings. These methods are used to eliminate or kill microorganisms from surfaces, medical instruments, and the environment, thereby preventing Healthcare-Associated Infections (HAIs) and ensuring safe patient care.
Both disinfection and sterilization aim to reduce the microbial load, but they differ in their level of effectiveness:
Disinfection eliminates most or all pathogenic microorganisms except bacterial spores.
Sterilization eliminates all microorganisms, including bacterial spores.
The choice between disinfection and sterilization depends on the type of object, the risk of infection, and the method of use.
1. Disinfection
Definition
Disinfection is the process of reducing or eliminating microorganisms from surfaces and objects using chemical or physical agents. Unlike sterilization, disinfection does not eliminate bacterial spores.
Types of Disinfection
A. Based on Level of Disinfection
Disinfection is classified into three levels:
High-Level Disinfection (HLD)
Destroys all microorganisms, including some bacterial spores.
Used for semi-critical items (e.g., endoscopes, anesthesia equipment).
Common high-level disinfectants:
Glutaraldehyde (2%)
Peracetic acid
Hydrogen peroxide (6-7%)
Chlorine dioxide
Ortho-phthalaldehyde (OPA)
Intermediate-Level Disinfection (ILD)
Kills bacteria, most viruses, and fungi, but not bacterial spores.
Used for non-critical medical devices and surfaces (e.g., stethoscopes, thermometers, bedrails).
Used for disinfecting surfaces, spills, and water purification.
Limitations: Corrosive; must be diluted before use.
3. Glutaraldehyde (2%)
High-level disinfectant.
Used for endoscopes, respiratory equipment.
Limitations: Toxic fumes; requires activation.
4. Hydrogen Peroxide (3-7%)
Effective against bacteria, fungi, viruses, and spores.
Used for wound care, surface disinfection.
Limitations: Can degrade materials over time.
5. Phenolic Compounds
Kills bacteria, fungi, and some viruses.
Used for cleaning floors, hospital furniture.
Limitations: Toxic to tissues.
6. Quaternary Ammonium Compounds (QACs)
Kills bacteria and some viruses.
Used for environmental surface disinfection.
Limitations: Less effective against spores and mycobacteria.
2. Sterilization
Definition
Sterilization is the complete destruction or removal of all microorganisms, including bacterial spores, from medical instruments, surfaces, and biological materials.
Types of Sterilization
A. Physical Methods
Moist Heat Sterilization (Autoclaving)
Uses steam under pressure (121°C for 15-20 minutes at 15 psi).
Kills all microorganisms, including spores.
Used for: Surgical instruments, glassware, drapes, liquids.
Limitations: Not suitable for heat-sensitive materials.
Dry Heat Sterilization
Uses hot air at 160-180°C for 1-2 hours.
Used for: Glassware, powders, oils.
Limitations: Requires longer exposure time.
Radiation Sterilization
Uses ionizing radiation (gamma rays, X-rays, electron beams).
Used for: Disposable syringes, catheters, surgical implants.
Used for: Heat-sensitive instruments (e.g., endoscopes, pacemakers).
Limitations: Expensive.
Peracetic Acid Sterilization
Uses highly reactive peracetic acid solution.
Used for: Endoscopes, surgical instruments.
Limitations: Corrosive; requires careful handling.
Comparison: Disinfection vs. Sterilization
Disinfection kills most microorganisms but not spores.
Sterilization eliminates all forms of microbial life, including spores.
Disinfection is used for surfaces, non-critical instruments, and general cleaning.
Sterilization is used for surgical instruments, implants, and invasive medical devices.
Best Practices for Effective Disinfection and Sterilization
Classify medical equipment as critical, semi-critical, or non-critical before choosing the appropriate method.
Follow manufacturer guidelines for the proper use of disinfectants and sterilization techniques.
Ensure proper contact time for disinfectants to be effective.
Monitor sterilization processes using biological indicators (e.g., spore tests for autoclaves).
Store sterilized equipment properly to maintain sterility.
Disinfection and Sterilization
1. Definitions
Disinfection
Disinfection is the process of eliminating most or all pathogenic microorganisms, except bacterial spores, from inanimate objects and surfaces using chemical or physical agents. It is mainly used for medical equipment, surfaces, and environmental cleaning.
Sterilization
Sterilization is the complete destruction or removal of all microorganisms, including bacterial spores, from objects and surfaces. It is used for surgical instruments, implants, and medical devices that enter sterile body areas.
2. Types of Disinfection and Sterilization
A. Types of Disinfection
Disinfection is classified based on the level of microbial elimination and the method used.
1. Based on Level of Disinfection
High-Level Disinfection (HLD)
Kills all microorganisms except large numbers of bacterial spores.
Used for semi-critical medical devices (e.g., endoscopes, respiratory equipment).
Common disinfectants:
Glutaraldehyde (2%)
Ortho-phthalaldehyde (OPA)
Peracetic acid
Hydrogen peroxide (6-7%)
Chlorine dioxide
Intermediate-Level Disinfection (ILD)
Kills bacteria, most viruses, fungi, and Mycobacterium tuberculosis but not bacterial spores.
Used for non-critical medical devices and surfaces (e.g., stethoscopes, thermometers, blood pressure cuffs).
Common disinfectants:
Alcohol (70-90%)
Phenolic compounds
Chlorine compounds (e.g., hypochlorite solution at 1000 ppm)
Low-Level Disinfection (LLD)
Kills most bacteria, some viruses, and fungi, but not spores or Mycobacterium tuberculosis.
Used for environmental surfaces, floors, furniture, and some medical equipment.
Common disinfectants:
Quaternary ammonium compounds (QACs)
Diluted bleach solutions
Hydrogen peroxide (3%)
2. Based on the Method Used
Chemical Disinfection
Uses chemical agents to kill microorganisms.
Example chemicals: Alcohol, chlorine, glutaraldehyde, hydrogen peroxide, phenols, QACs.
Physical Disinfection
Uses physical processes like heat or radiation to kill microorganisms.
Examples:
Pasteurization (heat treatment for liquids).
Ultraviolet (UV) radiation for air and surface disinfection.
Boiling water (100°C for 10-30 minutes).
B. Types of Sterilization
Sterilization methods are categorized into physical and chemical techniques.
1. Physical Methods of Sterilization
Moist Heat Sterilization (Autoclaving)
Uses steam under pressure (121°C at 15 psi for 15-20 minutes).
Kills all microorganisms, including spores.
Used for: Surgical instruments, glassware, drapes, liquids.
Limitations: Not suitable for heat-sensitive materials.
Dry Heat Sterilization
Uses hot air at 160-180°C for 1-2 hours.
Used for: Glassware, powders, oils.
Limitations: Requires longer exposure time.
Radiation Sterilization
Uses ionizing radiation (gamma rays, X-rays, electron beams).
Used for: Disposable syringes, catheters, surgical implants.
Used for: Heat-sensitive instruments (e.g., endoscopes, pacemakers).
Limitations: Expensive.
Peracetic Acid Sterilization
Uses highly reactive peracetic acid solution.
Used for: Endoscopes, surgical instruments.
Limitations: Corrosive; requires careful handling.
Environmental Cleaning in Healthcare Settings
Introduction
Environmental cleaning is a critical infection control measure that prevents the spread of Healthcare-Associated Infections (HAIs) by eliminating pathogens from hospital surfaces and equipment. Proper cleaning and disinfection reduce the risk of cross-contamination and protect patients, healthcare workers, and visitors.
The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) emphasize environmental hygiene as a key strategy in infection prevention and control (IPC) programs.
1. Importance of Environmental Cleaning
Prevents the spread of infections (e.g., MRSA, C. difficile, COVID-19).
Reduces microbial contamination on high-touch surfaces.
Enhances patient safety by minimizing the risk of HAIs.
Maintains a clean and hygienic healthcare environment.
Prevents outbreaks in hospitals, nursing homes, and other healthcare facilities.
2. Principles of Environmental Cleaning
Clean from least contaminated to most contaminated areas (e.g., from patient areas to toilets).
Use proper disinfectants and cleaning techniques based on the risk level.
Ensure adequate ventilation and PPE use during cleaning.
Follow the recommended contact time for disinfectants.
Dispose of contaminated waste properly.
3. Classification of Hospital Areas Based on Risk
Environmental cleaning priorities depend on the risk level of different hospital areas:
A. High-Risk Areas (Critical Areas)
Operating rooms (OR)
Intensive care units (ICU, NICU)
Isolation rooms for infectious diseases
Laboratories and sterile processing areas
Burn units
Cleaning Protocol:
Use high-level disinfectants (e.g., chlorine 1000 ppm, hydrogen peroxide).
Clean every shift and after patient discharge.
Use separate cleaning equipment for critical areas.
B. Moderate-Risk Areas (Semi-Critical Areas)
Patient wards and general hospital rooms
Emergency departments
Labor and delivery rooms
Radiology and diagnostic rooms
Cleaning Protocol:
Use intermediate-level disinfectants (e.g., alcohol-based or quaternary ammonium compounds).
Clean at least twice daily.
Focus on bedside tables, IV poles, chairs, and frequently touched surfaces.
C. Low-Risk Areas (Non-Critical Areas)
Corridors, offices, waiting rooms
Storage rooms, administrative areas
Cafeterias and hospital lobbies
Cleaning Protocol:
Use low-level disinfectants (e.g., soap and water, diluted bleach).
Clean daily or as needed.
Mop floors, clean windows, and dust surfaces regularly.
4. Types of Cleaning and Disinfection in Healthcare
A. Routine Cleaning
Performed daily in all patient care areas.
Focuses on high-touch surfaces (e.g., bedrails, door handles, light switches).
Uses hospital-grade disinfectants.
B. Terminal Cleaning
Performed after patient discharge or transfer.
Ensures complete disinfection of the patient room.
Includes deep cleaning of beds, curtains, furniture, and medical equipment.
C. Outbreak or Infection-Specific Cleaning
Applied during epidemics or outbreaks (e.g., COVID-19, norovirus, C. difficile).
Ensures extra decontamination of shared equipment and common areas.
5. Cleaning and Disinfection Procedures
A. High-Touch Surfaces (Frequently Touched by Hands)
Must be cleaned at least twice a day and after contamination. Examples:
Bedrails and patient beds
Door handles and light switches
Medical equipment (IV poles, monitors, ventilators)
Nurse station surfaces
Computer keyboards and touchscreens
B. Floors and General Surfaces
Mop with hospital-grade disinfectant solution.
Use separate mops for high-risk and low-risk areas.
Clean spills immediately to prevent contamination.
C. Patient Care Equipment
Reusable equipment (BP cuffs, stethoscopes, thermometers) should be disinfected between patients.
Use dedicated or disposable equipment for infectious patients.
D. Bathrooms and Toilets
Clean after every use in high-risk areas.
Use chlorine-based disinfectants (1000 ppm sodium hypochlorite).
Scrub surfaces with separate color-coded cleaning tools.
6. Cleaning Agents and Disinfectants Used in Hospitals
Disinfectant
Target Microorganisms
Use
Alcohol (70-90%)
Bacteria, viruses, fungi
Medical equipment, hands, surfaces
Sodium Hypochlorite (Bleach 1000 ppm)
Bacteria, viruses, spores
Floors, bathrooms, patient care areas
Hydrogen Peroxide (3-7%)
Bacteria, viruses, fungi, spores
Environmental surfaces, surgical areas
Glutaraldehyde (2%)
Bacteria, spores, viruses
Endoscopes, respiratory devices
Phenolic Compounds
Bacteria, fungi
General hospital cleaning
Quaternary Ammonium Compounds (QACs)
Bacteria, some viruses
Low-risk areas, furniture
7. Personal Protective Equipment (PPE) for Cleaning Staff
Healthcare cleaning staff must wear appropriate PPE to prevent exposure to infectious materials.
PPE for Routine Cleaning:
Gloves
Face masks
Aprons or gowns
Closed-toe shoes
PPE for High-Risk or Isolation Areas:
N95 respirator (for airborne infections)
Goggles or face shields
Disposable gowns
Double gloves
8. Waste Management in Environmental Cleaning
Proper disposal of contaminated materials is essential to prevent infection spread.
Biomedical Waste (Blood, Body Fluids, Sharps)
Dispose in color-coded waste bins (yellow for infectious waste, red for sharp objects).
Use autoclaving or incineration for medical waste.
General Waste (Paper, Food Waste)
Dispose in black bins.
Regular collection and disposal.
Reusable Cleaning Equipment
Mops, cloths, and brushes should be disinfected after each use.
Store in a clean, dry area.
9. Monitoring and Compliance in Environmental Cleaning
To ensure cleaning effectiveness, hospitals must have a structured monitoring system.
Methods of Monitoring Cleaning Efficiency:
Visual Inspections – Checking surfaces for cleanliness.
Microbiological Testing – Using swab cultures or ATP bioluminescence testing to measure microbial load.
Checklists and Logs – Recording cleaning schedules and procedures.
Staff Training and Audits – Conducting regular training sessions and compliance checks.
10. Challenges in Hospital Environmental Cleaning
Inadequate training of cleaning staff.
Poor compliance with cleaning protocols.
Lack of proper cleaning supplies and disinfectants.
Time constraints in high-traffic areas.
Cross-contamination due to improper technique.
Solutions:
Regular staff education and competency assessments.
Strict adherence to WHO and CDC guidelines.
Use of automated disinfection systems (e.g., UV light, hydrogen peroxide misting).
Standardized cleaning protocols and audit programs.
Equipment Cleaning in Healthcare Settings
Introduction
Equipment cleaning is an essential part of infection prevention and control (IPC) in healthcare settings. Proper cleaning, disinfection, and sterilization of medical equipment and instruments help reduce the risk of Healthcare-Associated Infections (HAIs) and cross-contamination between patients.
Medical equipment is classified based on its use and risk of infection transmission, and the cleaning method is chosen accordingly. Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines recommend specific cleaning protocols for different types of medical devices.
1. Classification of Medical Equipment Based on Infection Risk
Medical equipment is categorized into three risk levels according to Spaulding’s Classification:
A. Critical Equipment (High-Risk)
Instruments that enter sterile body areas or the bloodstream.
Must be sterilized to eliminate all microorganisms, including spores.
High-Level Disinfection (HLD) using glutaraldehyde, ortho-phthalaldehyde (OPA), peracetic acid, or hydrogen peroxide solutions.
Some items may also undergo low-temperature sterilization.
C. Non-Critical Equipment (Low-Risk)
Devices that only contact intact skin or do not touch patients directly.
Low-level or intermediate-level disinfection is required.
Examples:
Stethoscopes and blood pressure cuffs.
Thermometers.
Bedpans and commodes.
Wheelchairs and patient transport trolleys.
Cleaning Method:
Low-Level Disinfection (LLD) using alcohol (70-90%), quaternary ammonium compounds (QACs), or diluted sodium hypochlorite (bleach 1000 ppm).
2. Cleaning and Disinfection of Specific Medical Equipment
A. Surgical Instruments
Pre-clean immediately after use to remove blood and tissue residues.
Manually clean using enzymatic detergent to dissolve organic material.
Sterilize using an autoclave or chemical sterilization (ethylene oxide for heat-sensitive instruments).
B. Endoscopes (Flexible & Rigid)
Pre-clean at the bedside by flushing channels with detergent solution.
Manually clean using a soft brush and enzymatic detergent.
High-level disinfection using glutaraldehyde or peracetic acid immersion.
Rinse with sterile water and dry completely before storage.
C. Ventilators and Respiratory Equipment
Disassemble ventilator tubing, humidifiers, and masks after use.
Clean with warm soapy water and rinse thoroughly.
Disinfect using hydrogen peroxide vapor or ethylene oxide sterilization.
Change filters and single-use components regularly.
D. Dialysis Machines
Flush and disinfect internal components between patients.
Use peracetic acid or formaldehyde-based solutions.
Ensure external surfaces are wiped with disinfectant.
E. Thermometers
Digital thermometers – Wipe with 70% alcohol between uses.
Mercury thermometers – Immerse in isopropyl alcohol for 10 minutes.
Infrared thermometers – Wipe with disinfectant cloths.
F. Stethoscopes and Blood Pressure Cuffs
Stethoscope diaphragms and ear tips should be wiped with alcohol swabs after each use.
Blood pressure cuffs should be cleaned with low-level disinfectants or disposable covers used.
G. Wheelchairs and Patient Beds
Clean handles, armrests, and seat surfaces daily with disinfectant wipes.
Bed frames, rails, and mattresses should be cleaned with hospital-grade disinfectants between patient use.
3. Cleaning Methods for Medical Equipment
A. Manual Cleaning
Used for delicate instruments and pre-cleaning before disinfection.
Involves scrubbing with enzymatic detergents and soft brushes.
B. Ultrasonic Cleaning
Uses high-frequency sound waves to remove fine debris from instruments.
Ideal for delicate surgical tools.
C. High-Level Disinfection (HLD)
Chemical immersion of instruments in disinfectants (e.g., glutaraldehyde, peracetic acid).
Used for semi-critical devices like endoscopes.
D. Sterilization Methods
Autoclaving (Steam Sterilization)
Most effective for critical instruments.
Uses 121-134°C steam under pressure.
Ethylene Oxide (EtO) Gas Sterilization
For heat-sensitive medical devices (e.g., catheters, plastic instruments).
Plasma Sterilization (Hydrogen Peroxide Gas)
Used for electronic and heat-sensitive instruments.
Chemical Sterilization (Peracetic Acid, Glutaraldehyde)
For instruments that cannot tolerate heat.
4. Best Practices for Equipment Cleaning
Use separate cleaning tools for different equipment types.
Follow manufacturer’s guidelines for cleaning and disinfection.
Ensure proper ventilation when using chemical disinfectants.
Perform routine maintenance and calibration for medical devices.
Document all cleaning and sterilization processes for regulatory compliance.
Train healthcare workers on proper cleaning techniques.
5. Challenges in Medical Equipment Cleaning
Inadequate training of cleaning staff.
Limited availability of proper disinfectants.
Failure to adhere to cleaning schedules.
Cross-contamination due to improper cleaning techniques.
Improper storage of sterilized equipment.
Solutions:
Implement regular staff training and hand hygiene protocols.
Conduct routine audits and compliance checks.
Ensure adequate supply of disinfectants and cleaning tools.
Use automated cleaning and disinfection systems where applicable.
6. Monitoring and Compliance
Regular microbiological testing of cleaned equipment to check for contamination.
Adherence to hospital infection control guidelines.
Use of biological indicators for sterilization validation (e.g., spore tests for autoclaves).
Routine inspection of cleaning logs and sterilization records.
Guidelines on the Use of Disinfectants in Healthcare Settings
Introduction
Disinfectants are chemical agents used to eliminate or reduce microorganisms on surfaces, medical equipment, and the environment. Proper use of disinfectants prevents Healthcare-Associated Infections (HAIs), controls the spread of pathogens, and maintains a safe healthcare environment.
The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) provide strict guidelines for the selection, preparation, application, and disposal of disinfectants to ensure effectiveness and safety.
1. Principles of Disinfectant Use
Select the appropriate disinfectant based on the type of microorganism and surface.
Follow the correct dilution and contact time to ensure microbial effectiveness.
Clean surfaces before applying disinfectants (organic matter reduces effectiveness).
Use proper protective equipment (PPE) when handling strong disinfectants.
Ensure proper ventilation when using disinfectants, especially in closed environments.
Dispose of disinfectants safely according to hospital waste management protocols.
2. Classification of Disinfectants
Disinfectants are categorized based on their ability to kill microorganisms.
A. High-Level Disinfectants (HLD)
Eliminate all microorganisms, including some bacterial spores.
Used for semi-critical medical devices (e.g., endoscopes, ventilator parts).
Common High-Level Disinfectants:
Glutaraldehyde (2%)
Ortho-phthalaldehyde (OPA)
Peracetic Acid
Hydrogen Peroxide (6-7%)
Chlorine Dioxide
B. Intermediate-Level Disinfectants (ILD)
Kill bacteria, most viruses, fungi, and Mycobacterium tuberculosis.
Do not kill bacterial spores.
Used for non-critical medical devices and surfaces (e.g., stethoscopes, BP cuffs, patient beds).
Do not kill resistant pathogens or bacterial spores.
Used for environmental surfaces, furniture, and floors.
Common Low-Level Disinfectants:
Quaternary Ammonium Compounds (QACs)
Hydrogen Peroxide (3%)
Diluted Bleach Solutions
3. Selection of Disinfectants Based on Application
Disinfectant Type
Target Microorganisms
Use
Alcohol (70-90%)
Bacteria, viruses, fungi
Skin antisepsis, small medical instruments
Sodium Hypochlorite (Bleach 1000 ppm)
Bacteria, viruses, spores
Floors, toilets, blood spill decontamination
Glutaraldehyde (2%)
Bacteria, spores, viruses
Endoscopes, surgical equipment
Hydrogen Peroxide (3-7%)
Bacteria, fungi, spores
Environmental surfaces, ventilators
Phenolic Compounds
Bacteria, fungi
General hospital cleaning
Quaternary Ammonium Compounds (QACs)
Bacteria, some viruses
Non-critical surfaces, furniture
4. Guidelines for Using Disinfectants
A. General Guidelines
Always prepare disinfectants at the correct concentration (over-dilution reduces effectiveness, while high concentrations may damage surfaces).
Follow manufacturer instructions for use and storage.
Apply disinfectants using appropriate methods (e.g., wiping, spraying, immersion).
Allow proper contact time for the disinfectant to work effectively.
B. Specific Guidelines for Common Disinfectants
1. Alcohol-Based Disinfectants (70-90%)
Used for: Small medical instruments (stethoscopes, thermometers), hands (hand rubs).
Application: Wipe surfaces with an alcohol-soaked cloth; let air dry.
Precautions: Flammable—store in cool, ventilated areas.
2. Sodium Hypochlorite (Bleach 1000 ppm)
Used for: Surface disinfection (floors, toilets, blood spills).
Application:Dilute bleach (1:10 ratio of 5% bleach to water) and apply using mops or cloths.
Precautions: Corrosive—avoid using on metals and electronics.
3. Glutaraldehyde (2%)
Used for: High-level disinfection of endoscopes, surgical tools.
Application: Immerse instruments for 20-30 minutes, then rinse with sterile water.
Precautions: Toxic fumes—use in well-ventilated areas.
4. Hydrogen Peroxide (3-7%)
Used for: Disinfecting environmental surfaces, wound care.
Application: Spray or wipe onto surfaces; allow 10 minutes of contact time.
Precautions: Can cause skin irritation—wear gloves when handling.
5. Quaternary Ammonium Compounds (QACs)
Used for: Disinfecting furniture, walls, and medical equipment.
Application: Mix with water as per guidelines; apply with a cloth or mop.
Precautions: Inactivated by organic matter—clean surfaces before application.
5. Disinfectant Preparation and Contact Time
A. Dilution of Common Disinfectants
Disinfectant
Stock Concentration
Dilution Ratio
Final Concentration
Use
Sodium Hypochlorite (Bleach)
5%
1:10
1000 ppm
Blood spills, floors
Glutaraldehyde
2%
Undiluted
2%
Endoscopes, surgical tools
Alcohol
90%
1:1 with water
70%
Small medical instruments
Hydrogen Peroxide
30%
1:5 with water
6%
Environmental disinfection
B. Required Contact Time for Disinfection
Disinfectant
Contact Time
Microbial Effect
Alcohol (70%)
30 seconds – 1 min
Kills bacteria and viruses
Bleach (1000 ppm)
10 minutes
Kills bacteria, viruses, spores
Glutaraldehyde (2%)
20-30 minutes
High-level disinfection
Hydrogen Peroxide (6%)
10-15 minutes
Kills spores, fungi, bacteria
6. Safety Measures for Handling Disinfectants
Wear appropriate PPE (gloves, masks, goggles) when handling strong disinfectants.
Never mix disinfectants, as chemical reactions may produce toxic gases.
Label all disinfectant containers clearly to prevent misuse.
Store disinfectants in a cool, dry, and ventilated area.
Dispose of used disinfectants safely, following hospital waste management policies.
7. Challenges in Disinfectant Use
Common Issues:
Overuse or misuse of disinfectants leading to antimicrobial resistance.
Failure to follow proper dilution ratios reducing effectiveness.
Inadequate contact time, leading to incomplete disinfection.
Skin irritation and respiratory issues among cleaning staff due to improper handling.
Solutions:
Regular training for healthcare workers on proper disinfectant use.
Use of standardized protocols and checklists for disinfection.
Routine monitoring of cleaning effectiveness using microbiological testing.
Spaulding’s Principle: Classification of Medical Equipment for Disinfection and Sterilization
Introduction
Spaulding’s Classification System is a widely used framework in infection control and medical device reprocessing. Developed by Dr. Earle H. Spaulding in 1968, it categorizes medical instruments and equipment based on the risk of infection transmission and recommends the appropriate level of cleaning, disinfection, or sterilization.
This system ensures safe and effective reprocessing of medical devices, reducing the risk of Healthcare-Associated Infections (HAIs) and cross-contamination in healthcare settings.
Spaulding’s Classification System
Medical equipment and devices are classified into three categories based on their intended use and potential for transmitting infections:
Critical Items (High-Risk)
Semi-Critical Items (Moderate-Risk)
Non-Critical Items (Low-Risk)
Each category determines whether an item requires sterilization, high-level disinfection, or low/intermediate-level disinfection.
1. Critical Items (High-Risk)
Definition:
Critical items are medical instruments that enter sterile body tissues or the vascular system.
These items must be sterile, as any contamination could lead to serious infections.