[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Infection prevention and control](https://durgical.com/en/nursing/areas/infection/) › Cleaning, disinfection and sterilization of equipment

# Cleaning, disinfection and sterilization of equipment

- Fundamental

Each item is processed by the risk of its use: items entering sterile tissue are sterilized, items touching mucous membranes get high-level disinfection.

Updated Nov 5, 2026

## Key points

- Critical (sterile tissue or vessels): sterilization.
- Semicritical (mucous membranes or non-intact skin): at least high-level disinfection.
- Noncritical (intact skin): low-level disinfection.
- Always clean before disinfecting or sterilizing.
- Only sterilization kills spores.

## What it is

The Spaulding classification sorts patient-care items by the infection risk of their use. Critical items enter sterile tissue or the vascular system and are sterilized. Semicritical items touch mucous membranes or non-intact skin and need at least high-level disinfection. Noncritical items touch only intact skin, and low-level disinfection is enough. In every case cleaning comes first: organic matter left on an object stops the disinfectant or sterilant from working.

## Key points

- Cleaning: removing dirt and organic matter with water and detergent or an enzymatic cleaner, as soon as possible after use.
- Disinfection: eliminates many or all pathogenic microorganisms on inanimate objects, except bacterial spores.
- High-level disinfection: eliminates all microorganisms except small numbers of spores.
- Sterilization: destroys all forms of microbial life, including spores.
- Steam is preferred for items that tolerate heat; low-temperature methods are for heat-sensitive items.

## Components

- Pre-cleaning at the point of use or in the sterile processing department.
- Choice of process according to the Spaulding category.
- Packaging suited to the sterilization method.
- Mechanical, chemical and biological indicators.
- Storage that keeps the packaging intact; packs are checked for damage before use.

## What it is for

- Stopping equipment from carrying microorganisms from one patient to another.
- Protecting staff who handle soiled equipment.
- Making sure sterile supplies reach the patient still sterile.

## The Spaulding classification

| Category | What it contacts | Examples | Minimum process |
| --- | --- | --- | --- |
| Critical | Sterile tissue or the vascular system | Surgical instruments, urinary and cardiac catheters, implants | Sterilization |
| Semicritical | Mucous membranes or non-intact skin | Respiratory therapy and anaesthesia equipment, some endoscopes, laryngoscope blades | High-level disinfection |
| Noncritical | Intact skin | Blood pressure cuff, bedpan, crutches, bed rails, bedside table | Low-level disinfection |

## In nursing practice

- Noncritical equipment used for a patient on contact precautions is disinfected before use on another patient, or dedicated to that patient.
- Before opening a sterile pack, check it is not torn, wet or punctured; if it is, it is reprocessed.
- Mechanical and chemical indicators are checked for every load; if they suggest failure, the items are not used.
- Each pack is labelled with the sterilizer, the load number and the date.

## Common mistakes

- Disinfecting or sterilizing an item without cleaning it first.
- Using high-level disinfectants on noncritical surfaces.
- Letting blood or secretions dry on instruments before sending them for cleaning.
- Using a wet or torn sterile pack.
- Using flash sterilization for convenience or to save time.

## Test yourself

Think of the answer, then tap the question to see it.

## What minimum process does a semicritical item need under Spaulding?

High-level disinfection, because it touches mucous membranes or non-intact skin.

## Why does cleaning always come before disinfection or sterilization?

Because organic matter left on the item shields microorganisms and stops the disinfectant or sterilant from working.

## Which category does a blood pressure cuff belong to, and how is it processed?

It is noncritical, because it touches only intact skin, and it is processed with low-level disinfection.

## What separates sterilization from high-level disinfection?

Sterilization destroys all forms of microbial life, including spores; high-level disinfection may leave small numbers of spores.

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## Connections

## Related 3

- [Clean and sterile technique: medical and surgical asepsis](https://durgical.com/en/nursing/clean-and-sterile-technique-medical-and-surgical-asepsis/)
- [Standard precautions](https://durgical.com/en/nursing/standard-precautions/)
- [Transmission-based precautions: contact, droplet and airborne](https://durgical.com/en/nursing/transmission-based-precautions-contact-droplet-and-airborne/)

[← All of nursing](https://durgical.com/en/nursing/)

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [A Rational Approach to Disinfection and Sterilization (Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008)](https://www.cdc.gov/infection-control/hcp/disinfection-sterilization/rational-approach.html) (Centers for Disease Control and Prevention (CDC), 2008); [Recommendations for Disinfection and Sterilization in Healthcare Facilities (2008)](https://www.cdc.gov/infection-control/hcp/disinfection-sterilization/summary-recommendations.html) (Centers for Disease Control and Prevention (CDC), 2008); [Nursing Fundamentals, 9.6 Preventing Infection](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/09:_Infection/9.06:_Preventing_Infection) (Open RN, Wisconsin Technical College System (LibreTexts copy, CC BY 4.0), 2021).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/cleaning-disinfection-and-sterilization-of-equipment/