Instrument Cleaning in Practice

Instrument Cleaning in Practice

Complete Guide to Manual Cleaning and Ultrasonic Bath

You will learn

• ✔ How to correctly clean instruments.
• ✔ How to organize the process into three operational phases.
• ✔ When to use manual cleaning and the ultrasonic bath.
• ✔ How to avoid common mistakes.
• ✔ Which standards underpin each step of the procedure.

When to consult this guide?

This guide is intended for professionals who process instruments in dental offices, medical clinics, hospitals, CSDR (Central Sterile Department and Reprocessing), laboratories, podiatry, aesthetics, and other healthcare services.

If your question is “how to correctly clean an instrument before sterilization?”, this guide was developed to answer exactly that question.

Master Process Map

This article exclusively addresses the CLEANING phase of instrument processing.

INSTRUMENT USE
        │
        ▼
══════════════════════════════
PHASE 1 – RECEIPT
══════════════════════════════
• Pre-cleaning
• Sorting
        │
        ▼
══════════════════════════════
PHASE 2 – CLEANING
══════════════════════════════
• Detergent preparation
• Manual Cleaning
◇ Ultrasonic Bath Needed?
      ├── Yes → Ultrasonic Bath
      └── No → Proceed
        │
        ▼
══════════════════════════════
PHASE 3 – PREPARATION FOR STERILIZATION
══════════════════════════════
• Rinsing
• Drying
• Inspection
        │
        ▼
Instrument approved?
      ├── No → Repeat cleaning
      └── Yes → Packaging
                    │
                    ▼
Next article:
Instrument Sterilization in Practice

Category Map

Where are these products used?

• Hospitals
• Dental offices
• Medical clinics
• CSDR
• Laboratories
• Podiatry
• Aesthetics
• Veterinary clinics
• Educational institutions

Before You Begin

Do

• ✅ Use appropriate PPE.
• ✅ Consult manufacturers' IFU.
• ✅ Separate instruments by type.
• ✅ Properly prepare the enzymatic detergent.

Don't

• ❌ Do not allow residues to dry.
• ❌ Do not use household detergents.
• ❌ Do not mix incompatible materials.
• ❌ Do not send wet instruments for packaging.

Required Materials

Operational Journey

PHASE 1 – RECEIPT

Sub-step 1.1 – Pre-cleaning

Objective: Prevent organic matter from drying out and facilitate cleaning.

How to do:

• Remove gross debris immediately after use.
• Keep the instrument moistened when necessary.
• Use only recommended products.

Approval criteria:

• ☐ No dry residues.
• ☐ Instrument ready for sorting.

Tip: The shorter the time between use and cleaning, the better the result.

Attention: Never use improvised solutions.

Technical Basis: RDC ANVISA nº 15/2012 • NR-32 • Manufacturer's IFU.

Sub-step 1.2 – Sorting

Objective: Correctly separate instruments for processing.

How to do:

• Separate by type and material.
• Open articulated instruments.
• Identify delicate or incompatible items.

Approval criteria:

• ☐ Instruments correctly separated.
• ☐ Articulated instruments open.
• ☐ No risk of damage.

Tip: Sorting reduces rework and increases cleaning efficiency.

Attention: Never mix incompatible instruments in the same process.

Technical Basis: RDC ANVISA nº 15/2012 • Manufacturer's IFU.

PHASE 2 – CLEANING

Sub-step 2.1 – Detergent preparation

Objective: Properly prepare the cleaning solution.

How to do:

• Dilute according to the IFU.
• Use a clean container.
• Observe concentration and use time.

Approval criteria:

• ☐ Solution correctly prepared.
• ☐ Dilution as per manufacturer.

Tip: Prepare only the necessary quantity.

Attention: Never use expired or contaminated solution.

Technical Basis: RDC ANVISA nº 55/2012 • Detergent IFU.

Sub-step 2.2 – Manual Cleaning

Objective: Completely remove organic matter.

How to do:

• Brush all surfaces.
• Clean open articulations.
• Clean lumens when present.
• Keep the instrument fully immersed when indicated.

Approval criteria:

• ☐ No blood.
• ☐ No residues.
• ☐ No stains.

Tip: Brushes of different sizes facilitate cleaning.

Attention: Do not use abrasive sponges or metallic brushes.

Technical Basis: RDC ANVISA nº 15/2012 • Instrument IFU.

Sub-step 2.3 – Ultrasonic Bath

Objective: Supplement cleaning using cavitation.

How to do:

• Position instruments without overlapping.
• Open articulated instruments.
• Perform the cycle according to the IFU.
• Remove immediately after completion.

Approval criteria:

• ☐ Cycle completed.
• ☐ Instruments intact.
• ☐ No visible residues.

Tip: Perform solution degassing when recommended.

Attention: The ultrasonic bath does not sterilize instruments.

Technical Basis: RDC ANVISA nº 15/2012 • Ultrasonic bath IFU.

PHASE 3 – PREPARATION FOR STERILIZATION

Sub-step 3.1 – Rinsing

Objective: Completely remove detergent residues.

How to do:

• Rinse all surfaces carefully.
• Pay special attention to articulations and lumens.

Approval criteria:

• ☐ No foam.
• ☐ No detergent residues.

Technical Basis: RDC ANVISA nº 15/2012.

Sub-step 3.2 – Drying

Objective: Completely eliminate moisture.

How to do:

• Use a lint-free cloth or filtered compressed air when indicated.
• Dry all surfaces and articulations.

Approval criteria:

• ☐ Instrument completely dry.

Attention: Never send wet instruments for packaging.

Technical Basis: RDC ANVISA nº 15/2012.

Sub-step 3.3 – Inspection

Objective: Confirm that the instrument is clean and suitable for packaging.

How to do:

• Perform visual inspection under good lighting.
• Check cleanliness, integrity, and functionality.

Approval criteria:

• ☐ Clean.
• ☐ Intact.
• ☐ Functioning correctly.

Tip: When in doubt, repeat the cleaning.

Technical Basis: RDC ANVISA nº 15/2012 • Manufacturer's IFU.

Operational Checklist

• ☐ Pre-cleaning performed.
• ☐ Sorting completed.
• ☐ Detergent correctly prepared.
• ☐ Manual cleaning performed.
• ☐ Ultrasonic bath used when indicated.
• ☐ Complete rinsing.
• ☐ Drying performed.
• ☐ Inspection approved.

Most Common Mistakes

Frequently Asked Questions

Does the ultrasonic bath replace manual cleaning?

No. It complements cleaning when indicated.

Can I use household detergent?

No. Only use enzymatic detergent appropriate for medical devices.

Does the ultrasonic bath sterilize?

No. It only aids in cleaning through cavitation.

Should all instruments go through the bath?

No. It depends on compatibility and the manufacturer's IFU.

Can I package a wet instrument?

No. Complete drying is mandatory.

What is the most common mistake?

Allowing organic matter to dry before cleaning.

Continue Exploring

• ➡ Instrument Sterilization in Practice.
• ➡ Distilled water or Deionized water: which one to use?
• ➡ How to choose the ideal enzymatic detergent?
• ➡ Technical Standards: Cleaning and Disinfection.
• ➡ Complete Guide to Processing Medical Devices.

Conclusion

Instrument cleaning is the step that establishes the quality of all subsequent processing. A well-executed procedure reduces the risk of cross-infection, preserves the lifespan of instruments, and increases patient and staff safety.

By organizing the process into three phases — Receipt, Cleaning, and Preparation for Sterilization —, professionals can standardize routines, reduce failures, and comply with recommended best practices for healthcare services.

An instrument is only ready for sterilization when all inspection criteria are met.

Technical Basis

Legislation

• RDC ANVISA nº 15/2012 – Good practices for processing medical devices.
• RDC ANVISA nº 55/2012 – Requirements for enzymatic detergents intended for processing medical devices.
• NR-32 – Safety and Health at Work in Healthcare Services.

Scientific Societies

• SOBECC – Recommended Practices for the Processing of Medical Devices (current edition).

Manufacturers

• Instructions for Use (IFU) of instruments, enzymatic detergents, and ultrasonic baths.

See all Cleaning and Disinfection products →