To maintain the optimum performance of your sterilizer, maintenance schedules need to be followed explicitly. First, you need to have a copy of the manufacturer's instruction manual for each of your sterilizer models. The manufacturer usually has daily, weekly, and often quarterly procedures for maintaining the sterilizer. Tasks generally include inspection of gaskets, checking the chamber strainer, cleaning the chamber, and maintaining the casing. Periodic preventative maintenance schedules, which the manufacturer or the Biomed department usually carries out, also exist. Lack of following maintenance schedules can affect your sterilization cycles and land you in hot water with The Centers for Medicare and Medicaid Services (CMS).
General Maintenance/ Testing
Daily maintenance keeps your sterilizer functioning properly and helps to eliminate failed cycles. Clogged strainers can cause issues with air removal from the chamber, which can cause wet packs and failed integrators. Door gaskets with nicks can allow steam to escape from the door, creating a safety hazard in the department and failed cycles. Improper cleaning of the sterilizer can impede steam circulation and as staining of products within the sterilization load.
Daily testing of steam sterilizers includes Bowie-Dick (if prevacuum cycles are used) and biological indicators (if not using a parametric release of sterilization loads). Periodic (weekly) testing may also include leak testing of the sterilizer.
A Bowie-Dick test is utilized to verify that the vacuum system is functioning properly. It may also detect other sterilizer system leaks.
Biological indicators are recommended by the ANSI/AAMI ST79:2017 guidelines to be completed at least weekly but preferably daily to verify proper sterilization conditions.
Leak Testing, not to be confused with the Bowie-Dick test, is used to detect sterilizer systems failures such as plumbing and other mechanical issues.
* a warm-up cycle may be recommended by your sterilizer manufacturer before beginning the testing processes.
Routine inspections and maintenance of sterilizers are designed to prevent sterilizer failures by replacing parts before they fail. Sterilizers need periodic calibration to keep them operating correctly. The optional use of IT connectivity that allows for offsite monitoring of your reprocessing equipment helps detect small changes in your equipment functions. Early detection can help get a maintenance representative to your site earlier than planned and help reduce failures.
Occasionally, sterilizers fail and need major repairs. Major repairs include weld repairs of the pressure vessel; replacement of the chamber door, vacuum pump, or a major piping assembly; or rebuilds or upgrades of controls as described in the ANSI/AAMI ST79:2017 guidelines. Major repairs require additional testing protocols. Before placing a sterilizer back into use, three consecutive biological indicators and three consecutive Bowie-Dick tests ( for dynamic air removal sterilizers) must be completed in an empty chamber. They must pass specifications for each test before placing the sterilizer back online. These protocols are not required after preventative maintenance repairs.
As the old cliché says, pay me now, or pay me later. The saying is truly applicable to sterilizer maintenance. Lack of proper maintenance will cost you in dollars by possibly shortening the lifespan of your equipment or, more importantly, by reducing your operating efficiency when your sterilizer is down for repairs. Lost sterilizer efficiency can lengthen instrument turnaround and cost you operating room time. Lastly, CMS action plans for lack of maintenance cost time an money, which none of us have extra of.