STERILIZATION GUIDELINES – International Committee of the Red Cross

All hospitals need to sterilize their equipment and supplies. Even the smallest hospital requires sterile surgical instruments for minor procedures, and sterile dressing materials. If a hospital has a full surgical unit, the sterilization of surgical instruments and linen, together with dressing materials for the wards and operating theatre, plays a key role in infection control.
In medical facilities supported by the ICRC, care must therefore be taken to provide safe, sterile surgical material and safe blood for transfusion. This is all the more important when the ICRC is working in a general hospital setting where elective or semi‑elective surgery is a routine part of the workload.

Processing potentially infected materials also presents a hazard to medical staff.
The procedures for cleaning and disinfecting these materials should therefore include protective measures for those who handle them. Correct handling and safe processing of surgical materials are part of the standard precautions that should be taken in any medical facility, including those supported by the ICRC.
In 2004 a workshop was held for experienced ICRC operating theatre (OT) nurses and experts from Médecins Sans Frontières to discuss the main problems relating to sterilization in the context of humanitarian operations. This workshop led to the drafting of the first edition of the Sterilization Guidelines.
Ten years later, it was time to review the Guidelines in light of recent scientific discoveries, new sterilization procedures and technological developments.
While the systems and procedures outlined in the Guidelines may be difficult to fully implement in all ICRC‑supported medical facilities, they represent good practice and set the standard to achieve in order to ensure a basic level of safety. This will sometimes involve an investment in infrastructure, equipment and training, all of which requires planning and budgeting.
The Guidelines are intended for use by OT nurses working in ICRC‑supported medical facilities. While they do not cover all aspects of infection control and sterilization in detail (for more information, see the publications selected as resource material under “Reference”), they should help OT nurses in various hospitals, facing different challenges, to set up safe and simple systems for processing the entire range of surgical materials requiring sterilization.
The Guidelines can be applied in situations where resources are limited and may be used to provide essential training for OT nurses and for anyone involved in sterilization.