Cleaning
Physical removal of soil, dust or foreign material. Chemical, thermal or mechanical aids may be used. Cleaning usually involves soap and water, detergents or enzymatic cleaners. Thorough cleaning is required before disinfection or sterilization may take place.

All reusable equipment or devices and environmental surfaces

• All reusable equipment/devices
• Oxygen tanks & cylinders

Low Level Disinfection
Level of disinfection required when processing non-critical equipment or devices or some environmental surfaces. Low level disinfectants kill most vegetative bacteria and some fungi as well as enveloped (lipid) viruses. Low level disinfectants do not kill mycobacteria or bacterial spores.

Non-critical equipment or devices and environmental surfaces

• Environmental surfaces touched by staff during procedures involving parenteral or mucous membrane contact (dental lamps, dialysis machines)
• Bedpans, urinals, commodes
• Stethoscopes
• Blood pressure cuffs
• Hydrotherapy tanks
• Baby scales
• Patient Care Devices (IV poles, wheelchairs, beds, call bells, etc)

Intermediate Level Disinfection
Level of disinfection required when processing some semi-critical devices or equipment. Intermediate-level disinfection kills mycobacteria, most viruses, and bacteria.

Some semi-critical devices or equipment and environmental surfaces

• After large environmental spills or spills of microbial cultures in the laboratory
• Hydrotherapy tanks for patients whose skin is not intact

High Level Disinfection
The level of disinfection required when processing semi-critical equipment or devices. High level disinfection destroy vegetative bacteria, mycobacteria, fungi and enveloped (non-lipid) viruses, but not necessarily bacterial spores.

Semi-Critical equipment or devices

• Flexible endoscopes that do not enter sterile cavities or tissues
• Laryngoscopes
• Respiratory therapy equipment
• Endotrachial tubes
• Specula
• Cervical caps
• Breast pump accessories
• CPR facemasks

Sterilization
The level of reprocessing required when processing critical equipment or devices which are heat stable. Heat sterilization results in the destruction of all forms of microbial life including bacteria, viruses, spores and fungi.

Chemosterilants (the use of immersion germicides capable of destroying all microbial life forms, including spores) are used as an alternative to heat sterilization for sterilization of critical heat sensitive equipment requiring sterilization.

Critical equipment or devices

• Surgical instruments
• Foot care equipment
• Implantable equipment/devices
• Fish hook cutters
• Biopsy forceps, brushes and biopsy equipment associated with endoscopy
• Eye equipment
• Dental equipment