Safe to drink, unsafe for instruments: water quality in sterile processing

Industry Pulse

Recent surgical delays at Mary Bridge Children's Hospital highlighted an often-overlooked issue: water quality in sterile processing.

While the hospital's drinking water remained safe, problems involving specialized water used for medical-device processing affected instrument availability and temporarily disrupted surgical schedules.

The takeaway: water can be safe to drink and still be unsuitable for medical-device processing.

Why it matters

Water quality can affect:

• Cleaning effectiveness
• Instrument staining and corrosion
• Equipment performance
• Microbial control
• Patient safety

ANSI/AAMI ST108:2023 provides guidance on water quality, treatment, storage, distribution, monitoring, and bacterial control.

ST108 at a glance

• Utility water — used during applicable early processing steps. Quality must support effective cleaning and protect against issues such as hardness and scale.
• Critical water — more extensively treated and commonly used for final rinsing of critical devices.

Clear ≠ clean enough. Water may look perfectly clear and still fail quality requirements. Appearance alone cannot confirm that water is appropriate for medical-device processing.

3 things to know about water quality

• Know your water. Tap water is not automatically appropriate for every processing step. Follow the applicable IFU and water-quality requirements.
• Know when critical water is needed. Critical water is used for important final-rinse applications where higher water quality is required.
• Know what is being monitored. Water quality may involve testing for pH, conductivity, hardness, bacteria, endotoxin, and other contaminants.

SPD check: know your water, know when to escalate

Technicians don't need to be water engineers, but they should know what water is used at each processing step, why it is required, who monitors the results, and when an abnormal result needs to be escalated. They should also understand what to do if critical water becomes unavailable.

Know your water. Know your process. Know when to escalate.

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