An easy guide to CDC and ADA recommendations for sterilization monitoring

Make sure your office is meeting the standards for biological monitoring of your sterilizers with this easy walk-through of recommendations from the ADA and CDC.

Three types of monitoring (these should all be done routinely)

  1. Mechanical
  2. Chemical
  3. Biological

Mechanical – make sure you record the cycle time, temperature, and pressure displayed of each sterilization procedure you complete to check for anything out of the ordinary.

Chemical – chemical indicators, such as a color-changing strip on a sterilization pouch, indicate whether or not the instruments were exposed to a proper sterilization environment. These indicators are sterilizer specific, so make sure they match the type you are using. If the indicator doesn’t change color the sterilization has failed.

Biological – this is the most credible and thorough indicator for monitoring the sterilization process as it measures the microbial killing power of a sterilizer—not just whether or not conditions were right for sterilization.

Biological Monitoring tests consist of endospores that test the environment for the presence of resistant microorganisms that can lead to compromised health of your patients.

There are two types of spore tests:

  1. In-office incubator and spore test strips, which give results in 24 to 48 hours
  2. Mail-in spore monitoring programs, which give results in about a week but are often seen as more credible because they are completed by a third party.

With any spore testing kit you need to have a control test that you incubate with the sterilized test for proper comparison. The control test should come back positive for resistant microorganisms. You should perform biological monitoring at least once a week on sterilizing equipment and keep a log of your results.

What to do when monitoring indicates sterilization failure?

Chemical indicator failure – in this case you should review the steps of the procedure and make sure everything seems to be functioning mechanically. Then test the sterilizer with biological monitoring. If the biological indicator test result is negative you can resume use of the sterilizer.

Biological indicator failure – if you receive a positive result from a spore test you should stop use of the sterilizer until you can determine what caused the failure. Once the cause is determined and corrected the sterilizer should produce three negative results from biological monitoring before it can be put back into use.