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Difference Between Decontamination & Sterilization

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Hospital equipment and areas need to be cleaned on a continuous basis. This lesson will discuss the difference between decontamination and sterilization.

How Clean Does it Have to Be?

A new operating room nurse named Dan is learning all about sterile technique and how surgical equipment is stored. He asks his preceptor how he is supposed to know when sterilization is needed versus decontamination. Dan's preceptor begins explaining the difference between the two disinfection techniques.

Decontamination

Decontamination is the process of decreasing antimicrobial presence in an area or on a surface. Sterilization is actually a type of decontamination along with disinfection and antisepsis. Disinfection is not done to remove all contaminants, but instead reduces the amount of contamination. Certain surfaces cannot handle harsh cleaning over and over again so disinfection suffices. Everyday surfaces are usually disinfected, which kills some bacteria and fungi while inactivating viruses. Antisepsis is used on skin that contains microorganisms. An antimicrobial liquid is applied to skin or incision sites that are contaminated.

Microorganism that needs to be decontaminated
Microorganism that needs to be decontaminated

Dan understands that decontamination is a general cleaning that is used on various surfaces and areas. It is done many times a day to clean. For example, once a patient is discharged from the hospital their room is decontaminated. It is wiped down with a cleaning solution that reduces the number of bacteria, fungi, and viruses. However, in the operating room a more thorough decontamination is needed because a sterile environment is necessary to reduce the risk of infection during an operation.

Sterilization

Sterilization is used to kill all microorganisms, viruses, and bacterial spores. There are several types of sterilization used on different pieces of equipment and surface areas. Different methods of sterilization are heat, radiation, chemical, and filtration.

Heat Sterilization

Sterilization using heat can be done several different ways using either moist or dry heat. A high-pressure water system is used to create moist heat and is used to sterilize items that cannot be exposed to extremely high temperatures.

Examples of moist heat sterilization are:

  • Boiling at a temperature of 100 degrees Celsius can be used to sterilize small items such as surgical instruments, rubber items, and syringes.
  • Steaming is used for items that cannot be exposed to temperatures greater than 100 degrees Celsius.
  • Autoclaving uses steam as well, but the temperature is above 100 degrees Celsius, usually set for 121 degrees Celsius. The pressure in the autoclave is intense, which allows for sterilization in a short period of time.

Autoclave used for moist heat sterilization
Autoclave used for moist heat sterilization

Dry heat temperatures are at least 160 degrees Celsius.

Examples of dry heat sterilization are:

  • Red heat sterilization exposes an object to a set of heated coils.
  • Flaming simply provides a flame for an object to pass through.
  • Hot air is useful for glass equipment and objects with powder or oils on them.

Radiation Sterilization

Radiation sterilization is used on disposable equipment and surfaces that are used over and over. X-rays, gamma rays, subatomic particles, or electron beams emit the low energy radiation for the required amount of time.

Chemical Sterilization

Certain items can be damaged by heat so chemical substances are used on electronics, fiber optics, and plastics. Examples of chemicals used are bleach, hydrogen peroxide, ozone, ethylene oxide, glutaraldehyde and formaldehyde. The concentrations of these chemicals are very high compared to what is used for regular decontamination.

Sterile Filtration

Some medications or drugs that are fluids that are produced need to be sterile and cannot be exposed to heat. Therefore, the filtration process requires the fluid to be passed through a filter based on pore size.

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