Cleaning

While decontamination makes items safer to handle, cleaning, the second step in processing, removes organic material, dirt, and foreign matter that can interfere with sterilization or HLD. Cleaning also drastically reduces the number of microorganisms, including bacterial endospores, on instruments and other items.

Cleaning refers to scrubbing with a brush, detergent, and water and is a crucial step in processing. If items have not first been cleaned, further processing might not be effective because:

• Microorganisms trapped in organic material may be protected and survive further processing
• Organic material and dirt can make the chemicals used in some processing techniques less effective.

Use of detergents in cleaning

Detergent is important for effective cleaning, since water alone will not remove protein, oils, and grease:

• When detergent is dissolved in water, it breaks up and dissolves or suspends grease, oil, and other foreign matter, making them easy to remove by cleaning.
• Do not use hand soap for cleaning instruments and other items, because the fatty acids contained in the soap will react with the minerals of hard water, leaving a residue or scum that is difficult to remove.
• Avoid using steel wool or abrasive cleansers such as Vim or Comet. These products can scratch or pit metal or stainless steel, resulting in grooves that can become a nesting place for microorganisms. This also increases the potential for corrosion of the instruments and other items.

Thorough cleaning drastically reduces the number of bacterial endospores on items and helps minimize the risk of infections due to bacterial endospores, which can survive some further processing methods.

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