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What This Guide Helps With
Use this guide when instruments emerge visibly soiled, residue remains, cleaning effectiveness is poor, or retained moisture is considered abnormal for the workflow.
Step-by-Step Troubleshooting
1. Protect Processing Quality
Do not release instruments that remain visibly soiled or otherwise fail the department's cleaning acceptance criteria.
Reprocess affected instruments using a verified method.
Expected outcome: Inadequately cleaned instruments do not progress further in the reprocessing workflow.
2. Confirm the Reported Quality Problem
Determine whether the concern is visible soil, residue, retained debris in joints or lumens, spotting, excessive remaining water, or generally inconsistent cleaning results.
Identify whether the problem affects every load or only specific instruments.
Expected outcome: The complaint is narrowed to a repeatable quality issue.
3. Review Load Arrangement
Inspect how instruments are being placed into baskets or racks. Look for overloading, stacked items, closed hinged instruments, nested surfaces, or positioning that prevents fluid contact.
Expected outcome: Instruments are arranged so cleaning solution can contact the required surfaces. If correcting loading restores cleaning quality, troubleshooting can stop after verification.
4. Check for Inappropriate Instrument Selection
Confirm that the instruments being placed in the ultrasonic cleaner are suitable for the process and any required accessories are being used.
Do not attempt to clean devices in a manner contrary to their reprocessing requirements.
Expected outcome: The load is appropriate for ultrasonic cleaning.
5. Verify Chemistry Condition
Check that the correct approved chemistry is connected, available, and being delivered.
Look for incorrect product, empty container, obvious dilution error introduced externally, or tubing problems.
Expected outcome: The cleaning solution is appropriate and available to the process.
6. Inspect Chamber Solution Condition
Check for excessive visible debris, contamination, or solution conditions inconsistent with the department's established workflow.
Expected outcome: The chamber solution is suitable for continued processing or is changed according to approved workflow.
7. Verify Chamber Fill and Cycle Selection
Confirm the unit reaches a normal operating liquid level and that staff are selecting the intended cleaning cycle.
Expected outcome: The load receives the intended cycle under normal fill conditions.
8. Inspect Baskets and Accessories
Check baskets, racks, holders, and other accessories for damage, blockage, incorrect installation, or accumulated debris that could interfere with cleaning action.
Expected outcome: Accessories are clean, intact, and properly positioned.
9. Perform an Approved Cleaning-Performance Test
If poor cleaning persists, perform the department's approved process-challenge or ultrasonic-performance verification.
Do not infer ultrasonic performance solely from audible sound.
Expected outcome: The unit passes the applicable verification. If the test passes, investigate workflow or load-specific factors before assuming equipment failure.
10. Escalate Confirmed Performance Failure
If correct loading, chemistry, fluid conditions, cycle selection, and accessories are verified but cleaning remains inadequate or the performance test fails, remove the unit from service.
Expected outcome: The cleaner is withheld from use pending service evaluation and successful performance verification.
If the Problem Persists
Common workflow, loading, chemistry, chamber-condition, and accessory causes have been ruled out. Remaining causes may involve ultrasonic energy generation, circulation, temperature control, dosing, internal plumbing, or another service-level process problem.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate manufacturer documentation and approved test equipment
- Repaired or configured only by qualified personnel
Cleaning performance should be verified using the facility's approved process test before return to service.
Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Visible cleanliness and an approved process check matter more than the fact that the cycle reached its normal end screen.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Sterile Processing reported that instruments were coming out of the CaviWave Pro with visible debris remaining between hinged surfaces."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the basket was overloaded and several hinged instruments were closed during processing."
Resolution
What action was taken.
Example:
"Corrected the loading arrangement, repeated the cleaning process with instruments properly positioned, verified acceptable cleaning results, and returned the unit to normal use."
Helpful Details to Include (If Known)
- Type of cleaning defect observed
- Instruments affected
- Load size and arrangement
- Hinged or nested instrument condition
- Chemistry availability
- Chamber solution condition
- Fill level
- Cycle selected
- Basket and rack condition
- Process-challenge result
- Final device status
Final Thought
Poor cleaning results should first trigger a review of loading, chemistry, solution condition, accessories, and cycle selection. Verify equipment performance objectively before assuming an internal failure, and escalate any confirmed cleaning-performance problem.
That is successful troubleshooting.