Leaving Instruments Overnight

Practices will need to perform a risk assessment and determine if the risk of leaving instruments overnight is greater than the risk of having a potential lone worker in the practice whilst the final ‘reprocessing cycles’ take place and also review the financial implications.

Leaving Instruments Overnight

According to HTM 01-05, research suggests that instruments cleaned as soon as possible after use are more easily cleaned than those left for a number of hours before reprocessing. Therefore it is recommended that instruments are transferred from the surgery to the decontamination area as soon as possible and that instruments are kept moist until the cleaning and reprocessing can take place.

It is a requirement that sterilisers are emptied of water at the end of every day and not left with water in the chamber overnight as a result of which instruments cannot be left in a running steriliser at the end of the day.

Likewise instruments should be sterilised as soon as possible after cleaning to avoid air drying which can result in microbial growth and potentially corrosion, which means instruments cannot be left in an ultrasonic or washer disinfector cycle overnight.

Consequently this can sometimes leave practices with an issue about what to do with the final instruments of the day, many practices don’t stay open long enough at the end of the day for a full washer disinfector and sterilisation cycle to take place.

Practices will need to perform a risk assessment and determine if the risk of leaving instruments overnight is greater than the risk of having a potential lone worker in the practice whilst the final ‘reprocessing cycles’ take place and also review the financial implications.

If it is determined that instruments are to be left overnight there are two ways in which this can be done

1) Instruments are kept in a suitable solution (Check manufacturers COSHH guidance for the length of time before corrosion may occur etc.) in a clearly labelled ‘contaminated’ lockable-lidded secure box, preferably in a decontamination room that is also locked. A policy is in place which all staff are aware of, particularly the practice cleaner who may be required to perform some tasks in the decontamination room. This policy should clearly state that instruments in the ‘contaminated’ box are still to be reprocessed and should not be touched by anyone other than those authorised to do so.

2) The alternative way would be for a practice to clean the instruments first, either manually, in the ultrasonic or through the washer disinfector, leave them overnight in a labelled box that makes it clear that the instruments haven’t been through the sterilisation cycle. The next morning the instruments would have the cleaning process repeated and then go through the steriliser as normal.

The lowest risk to a practice is to clean and reprocess instruments as soon as possible and not leave them overnight. In the instances where practices find this impossible then the above can be followed providing strict procedures/protocols are implemented and documented.