PROCEDURE GUIDE: ETO Sterilizers
PROCESS TYPE / PROCESS CATEGORY
JOB
STEP / DESCRIPTION OF
JOB CONTENT / Tools or Supplies to be Used During Job Step / Key Quality and Safety Points
1.  / Prepare items to be sterilized. / Appropriate size wrappers, green sterilant tape, set count sheets. / Ensure all pieces are completely dry. Cold water mixed with the ethylene oxide will turn into ethylene glycol (antifreeze).
2.  / All loads must have a BI included, and a control with the same lot # must be placed in the ETO incubator. / BI tests and controls are located on the sterilizing workstation. / The control must be labeled, crushed and tapped before placement in the incubator. The BI must be placed in the approximate center of the load, “the challenge area”.
3.  / Identify the next load # in the sterilizer book, and label all pieces for the intended load with the label gun. Place an extra sticker in the book for future reference. / Label gun and extra stickers are located in the incubator area. / Each item, including the BI, must be labeled with the proper load #, date, sterilizer #, and sterility disclaimer.
4.  / Scan all items into the SPM computer system: verify the number of items on the load, and print. / The print out of the load contents is to be placed into the sterilizer book for proper record keeping.
5.  / Load the baskets so that trays are laid flat, or stood on their edge, tape side down. / Sets cannot be stacked. Peel pouches are to be paper to plastic.
6.  / Insert an ETO canister into the ring holder inside the sterilizer chamber, and then load the baskets. / ETO canisters are located in the fireproof box in the gas room.
7.  / Check the distilled water reservoir and fill if necessary. / Gallon jugs of distilled water are located in the chamber below the aerator. / Distilled water is necessary to carry the ETO throughout the sterilizer chamber.
8.  / Determine which cycle is to be run, with or without aeration, and start cycle. / Check with supervisor if unsure of which cycle to use. / Cycle #1 includes 12-hour aeration. Cycle #2 has no aeration time and must be transferred to an aerator.
9.  / With aeration: Cycle will be complete in 15 hours. Sterilizer will alarm. Skip to step 15.
10.  / Without aeration: Cycle will be complete in 3 hours. Sterilizer will alarm. Tear off sterilizer print out and attach to SPM printout. / DO NOT OPEN DOOR.
Verify parameters on print out.
11.  / Check the graph on the aerator to ensure proper temperature, and open aerator door. / 140*F is necessary for shortened aeration.
12.  / Put on protective gear, open sterilizer, move baskets to aerator (including the BI and empty ETO canister). Remove gear, place into aerator and close door. / Butyl rubber gloves are located in the bottom drawer of cabinet in gas room. / Be sure to pull all items behind you, or step backwards. DO NOT PUSH, or carry items in front of you, as the ETO vapors will be traveling directly into you.
13.  / Wash your hands.
14.  / Document on aerator door the time of transfer. / Aeration will last at least 8 hours.
15.  / Unload items. Tear off sterilizer print out and attach to SPM printout. / Verify parameters have been met on printout, including 12 hour aeration temperature of 120*F.
16.  / Release items in SPM to Cooling Area, and take to sterile storage.
17.  / Remove the BI, from the test pack and prepare for placement into incubator. / The BI must be labeled, crushed and tapped before putting into the incubator.
18.  / Get an ETO load paper and record load #, incubator well #, and time. Hang paper on clip for ETO loads. / Load papers are located on sterilizer workstation.
19.  / 1st reading of BI is done 24 hours later.
Read the BI results and record on load paper. / If negative, proceed.
If positive, notify Team Leader and institute recall procedures.
20.  / Read BI results again 24 hours later (total of 48 hours) and record on test paper. / If negative, items are safe for use.
If positive, notify Team Leader and institute recall procedures.
21.  / Test paper is to be matched up with SPM and sterilizer printouts. / Sterilizer records are located in the stock room.