Do not overload the sterilizer chamber.  This will cause the sterilizer to take much longer to heat to a temperature sufficient for sterilization resulting in inadequately sterilized goods.

Do not stack instruments.  Place packs or packages on edge to facilitate sterilant penetration of packaging materials and place unwrapped instruments in a single layer to allow the sterilant (steam, chemical vapor, dry heat, etc.) to contact all surfaces.

Allow items to dry completely before removal from the sterilizer.  Wet or damp packs must be considered contaminated as microorganisms readily migrate through damp packaging.

Items should not be removed from the sterilizer until they have cooled.  Hot instruments will form condensation inside the package when they hit the colder room air.  Again, packages will be wet and must be considered contaminated.  Additionally, when hot packages cool, the air in them contracts, forming a vacuum, which will draw microorganisms through the packaging to the contents and contaminate them.

Refer to the sterilizer manufacturer's written instructions for recommended load size and loading procedure.

Instrument sets - Mesh-bottom or perforated trays containing instruments should be placed flat on the sterilizer shelf.  Metal items should be placed on a separate shelf below packages containing textiles.  If a sterilization container or cassette system is used, the manufacturer's recommendations for loading should be followed.

Packs containing textiles - Textile packs (e.g., gauze, towels, etc.) should be loosely wrapped and placed on edge so that all the fabric layers are perpendicular to the shelf.

Utensils and glassware - Items capable of holding water, such as basins and trays, should be positioned tilted over on edge and oriented in the same direction to prevent pooling of condensate.

Paper/poly, paper or nylon pouches - Do not over-fill pouches.   Instruments should be able to lie flat in a single layer.  Pouches should be positioned standing on edge, paper to plastic, to facilitate circulation of the sterilant around items.  Pouch holders, or loading racks/baskets may be used and are designed for this purpose.  Lining the tray or basket with a surgical or paper towel will aid in removal of condensate.

In a steam sterilizer, if paper/poly packages must be placed flat in a single layer, place them paper side down and use an absorbent, such as surgical or paper towel, to line the tray to facilitate wicking moisture away from the packaging.  Placing paper/poly packaging plastic side down may cause condensate to pool inside the pouch resulting in a wet pack, which must then be considered contaminated.

Solutions - Facilities or offices using tabletop steam sterilizers should avoid sterilizing solutions, such as saline and water, unless appropriate equipment and procedures are in place.

Facilities having appropriate steam sterilization equipment/cycles and procedures in place should sterilize solutions separately from all other items and must process them in flasks with closures specifically designed for this purpose.  Never use screw caps or rubber stoppers with crimped seals.  Never use vacuum cycles or processes other than steam.