Why Washer-Disinfectors Should Not Be Loaded by Habit

A washer-disinfector may run the correct cycle and still produce an unacceptable result if the wrong rack is selected or the rack is loaded incorrectly.

Loading should be based on the instruments being processed, the washer manufacturer’s instructions for use, and the medical device manufacturer’s IFU—not simply on how the department has always done it.

Washer/Disinfector in a Sterile Processing Department

Five loading decisions can directly affect cleaning:

1. Select the Correct Rack

The loading rack is part of the washer-disinfector’s cleaning system. It positions devices so that water and detergent can reach the surfaces that require cleaning.

Before selecting a rack, confirm:

• The rack is approved and compatible with that washer model

• The rack is intended for the devices being processed

• The selected cycle is appropriate for the rack and load

• The rack connects correctly to the washer’s water-delivery system

• Required inserts, adapters, connectors, and hold-down screens are present

• The load will remain within the manufacturer’s weight and configuration limits

Different loads may require different rack designs:

• General-instrument racks for open, nonlumened instruments

• Multi-level racks for properly positioned trays and baskets

• Container racks for sterilization containers and larger components

• Anesthesia or specialty racks for applicable reusable devices

• Minimally invasive surgery racks with irrigation connections

• Lumen racks or manifolds that deliver water through internal channels

A rack should also be inspected before use. Look for blocked or damaged spray nozzles, missing caps, worn seals, damaged connectors, clogged screens, and spray arms that do not rotate freely.

A rack that fits inside the chamber is not automatically the correct rack for the load.

2. Protect Spray-Arm Access

Confirm that every spray arm rotates freely. Tall instruments, trays, misplaced baskets, or loose devices can block rotation and reduce water and detergent contact.

3. Position Instruments Correctly

Open hinged instruments and arrange devices so all surfaces are exposed. Avoid nesting, stacking, or positioning items where they shield one another from the cleaning action.

4. Connect Lumened Devices Properly

Connect lumened instruments to the correct irrigation ports using the required adapters. Confirm that connections are secure and that unused ports are managed according to the washer and rack IFUs.

A device placed on a lumen rack without being properly connected may appear processed even though its internal channel was not effectively flushed.

5. Avoid Overloading

Adding more instruments may appear to improve productivity, but overcrowding can restrict spray contact, interfere with mechanical action, and prevent effective drainage. A full rack is not necessarily an efficient rack.

Before starting the cycle, ask:

• Is this the correct rack for the washer, cycle, and devices?

• Is the rack properly connected to the water-delivery system?

• Are all required adapters and accessories present?

• Can the spray arms rotate freely?

• Are all instrument surfaces exposed?

• Are lumens properly connected?

• Is the rack overloaded?

Consistent rack selection and loading practices improve cleaning reliability and make results less dependent on who happens to be operating the washer.

Habit is not a loading standard. The IFUs and a clearly defined process should be.

Evolved Sterile Processing Consulting LLC

Real Experience. Proven Solutions.