The Principles of the Decontamination Area in the Sterile Process

The decontamination area of a hospital is one of the most important for surgical patient safety. In this area, the vital first steps to providing safe and sterile surgical instruments are taken. Instruments and equipment are cleaned -- reducing harmful microorganisms -- so that the items are safe to handle in the sterile processing room. Specific decontamination principles must be followed to keep yourself safe and produce properly decontaminated instruments.

Attire

• The decontamination area is considered a dirty room. This doesn't mean messy or soiled. It means anything entering the area is considered to be potentially contaminated with harmful microorganisms (germs). These little bugs might cause surgical site infections in patients or make you sick. To protect yourself and others, you need to wear Personal Protective Equipment, or PPE, anytime you enter the decontamination area. The required PPE varies by facility, but generally surgical scrubs, disposable booties, hair covering, waterproof gown, rubber gloves and face protection are required.

Environment

• Decontamination areas are designed with the control of germ spread and growth in mind. The room should have more air evacuated from it than is pushed into it. This creates a negative air flow to keep germs from blowing out of the decontamination area around doors or windows. The temperature in the decontamination area should be fairly low, around 60 to 65 F. The lower temperature not only helps keep you cool in your layers of PPE but also retards the grown of some germs hiding in the area. Germs also tend to thrive in humidity, so the humidity of the area should be kept low, between 30 and 60 percent.

Work Flow

• The decontamination area is one step in the dirty to clean one-way workflow. Items should never move backwards in the process, as they may be exposed to environmental contaminations. In decontamination, dirty items should enter on one side of the room, be cleaned in the middle and then exit on the opposite side of the room. This helps keep clean items separate from dirty items.

Manual Cleaning

• Each item entering the decontamination area should be inspected for contamination and damage. If an item is visibly soiled, scrubbing should be done under the surface of the water to prevent forming germ-laden aerosols. If an item has a lumen, or a channel, it should be brushed and flushed to remove any hidden debris. Expose all surfaces to cleaning detergents, and allow the detergent to remain in contact for the manufacturer's recommended amount of time. After rinsing with clean or sterile water, the cleaned item may be passed through to the sterile processing room or placed in a washer for additional mechanical cleaning.

Mechanical Cleaning

• Ultrasonic baths, washer-decontaminators and other specialized washers may be available in the decontamination area. All instruments and equipment should go through a mechanical cleaning process, if compatible, because manual cleaning may not reach all surfaces. Some delicate items or power equipment should only be manually cleaned and passed to the sterile processing room to prevent damage.