Cleaning, Disinfection, and Sterilization

Chetan Jinadatha, MD, MPH

Department of Medicine, Central Texas Veterans Health Care System
Temple, TX
College of Medicine, Texas A&M Health Science Center
Bryan, TX

Angelia Bridges MPH, RNb CIC

Department of Research, Central Texas Veterans Healthcare System
Temple, TX

Revised Publication:
December 21, 2020
Original Publication:
February 22, 2018
Declarations of Conflicts of Interest:
  • Chetan Jinadatha reports that he is the principal investigator on various projects that have been funded by Xenex Disinfection Services under a cooperative research and development agreement between the Department of Veterans Affairs and Xenex Disinfection Services. He is also the inventor of record for a patent pending technology named "Methods for organizing the disinfection of one or more items contaminated with biological agents," which is owned by the Department of Veterans Affairs and has been licensed to Xenex Disinfection Services. He reports that he does not own shares, investments or partnerships in Xenex Disinfection Services or any other company relevant to the chapter. He also reports receiving funding from the National Institutes of Health/National Institute of Nursing Research, the Agency for Healthcare Research and Quality, and the Department of Veterans Affairs.
  • Angelia Bridges reports no conflicts of interest.


All invasive procedures involve contact by a medical device or surgical instrument with a patient's sterile tissue or mucous membranes. The level of disinfection or sterilization is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection, and low-level disinfection, respectively. Cleaning (the removal of foreign material) must always precede disinfection and sterilization. In addition, environmental cleaning and disinfection are also essential for maintaining a safe patient environment.