Checklist template

Instrument reprocessing and sterilization for dental practices

A ready-to-use checklist with 111 items in 6 sections, covering Cleaning, Packaging, Sterilizer operation, Monitoring, Storage, Logs. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 111 Items
  • 95 Yes / No checks
  • 6 Scored ratings
  • 125 Points

Use this template How audits work

1. Cleaning 22 items

  1. The sterilization area runs in one direction, from a marked contaminated side to a marked clean side Yes / No 1 pt
  2. Contaminated instruments arrive in a closed cassette or a covered container Yes / No 1 pt
  3. The employee cleaning instruments wears puncture-resistant utility gloves Yes / No 1 pt
  4. The employee cleaning instruments wears a mask with eye protection or a face shield Yes / No 1 pt
  5. The employee cleaning instruments wears a gown or a fluid-resistant jacket Yes / No 1 pt
  6. Instruments go through the ultrasonic cleaner or the instrument washer rather than being scrubbed by hand Yes / No 1 pt
  7. Instruments that cannot be cleaned right away are held in an enzymatic spray or holding solution Yes / No 1 pt
  8. Ultrasonic cleaner solution is changed at least daily Yes / No 1 pt
  9. The ultrasonic cleaner runs with its lid on Yes / No 1 pt
  10. The ultrasonic cycle is timed to the manufacturer's stated minutes Yes / No 1 pt
  11. Instruments sit in the basket or cassette rack, not on the bottom of the ultrasonic tank Yes / No 1 pt
  12. The ultrasonic cleaner passes a foil or cleaning-efficacy test on the schedule set by company policy Yes / No 1 pt
  13. Date of the last ultrasonic cleaner test Date
  14. Instruments are rinsed after the ultrasonic cycle Yes / No 1 pt
  15. Instruments are dry before they are packaged Yes / No 1 pt
  16. Instruments are inspected under a lighted magnifier for cement, debris and damage before packaging Yes / No 1 pt
  17. Damaged or corroded instruments are taken out of circulation Yes / No 1 pt
  18. Handpieces are cleaned and lubricated according to the manufacturer's instructions before sterilization Yes / No 1 pt
  19. Excess lubricant is expelled from the handpiece before it is pouched Yes / No 1 pt
  20. Items labeled single-use are discarded, not reprocessed Yes / No 1 pt
  21. The instrument processing sink is not used for handwashing Yes / No 1 pt
  22. Cleaning of instruments before packaging Rating
    • No visible debris on instruments checked 5 pts
    • Debris on one or two instruments 3 pts
    • Debris on many instruments 1 pt

2. Packaging 17 items

  1. Pouches are the right size: contents do not strain the seals Yes / No 1 pt
  2. Self-seal pouches are folded on the perforation with no gaps or creases in the seal Yes / No 1 pt
  3. Wrapped cassettes are closed with sterilization indicator tape Yes / No 1 pt
  4. Each package contains an internal chemical indicator, or uses a pouch with one built in Yes / No 1 pt
  5. An external indicator is visible on each package Yes / No 1 pt
  6. Each package is labeled with the sterilization date Yes / No 1 pt
  7. Each package is labeled with the sterilizer number and the load number Yes / No 1 pt
  8. Labels are written on the plastic side or on the tape, not on the paper side of the pouch Yes / No 1 pt
  9. Hinged instruments are packaged in the open position Yes / No 1 pt
  10. Sharp tips are protected so that they do not pierce the pouch Yes / No 1 pt
  11. Burs are sterilized in a bur block inside a pouch Yes / No 1 pt
  12. Handpieces are pouched individually Yes / No 1 pt
  13. Surgical and implant kits are packaged as the kit manufacturer instructs Yes / No 1 pt
  14. Packaging materials are those cleared for the type of sterilizer in use Yes / No 1 pt
  15. Pouches are used once only Yes / No 1 pt
  16. Unused pouches are kept in a closed container at the packaging station, away from splash Yes / No 1 pt
  17. Packaging of the 10 packages sampled Rating
    • All sealed, labeled and with indicators 5 pts
    • Labeling incomplete 3 pts
    • Seals open or indicators missing 1 pt

3. Sterilizer operation 19 items

  1. The manufacturer's instructions for each sterilizer are available in the sterilization area Yes / No 1 pt
  2. Each sterilizer is marked with its number Yes / No 1 pt
  3. Pouches are loaded on edge in a rack or in a single layer, as the manufacturer specifies Yes / No 1 pt
  4. Pouches in the chamber do not overlap or touch the chamber walls Yes / No 1 pt
  5. The cycle selected matches the load (wrapped, unwrapped or handpiece) Yes / No 1 pt
  6. The drying phase is completed before the door is opened Yes / No 1 pt
  7. Packages are dry when they are removed from the sterilizer Yes / No 1 pt
  8. Packages that come out wet are repackaged and sterilized again Yes / No 1 pt
  9. Packages cool on a rack before they are handled or stored Yes / No 1 pt
  10. The reservoir is filled with distilled water only Yes / No 1 pt
  11. Unwrapped (immediate-use) cycles are reserved for urgent needs, not routine loads Yes / No 1 pt
  12. A load from an aborted or failed cycle is repackaged and run again Yes / No 1 pt
  13. No load was removed before the end of its cycle during the visit Yes / No 1 pt
  14. The air removal test is run each day before the first load on pre-vacuum sterilizers Yes / No 1 pt
  15. The practice owns enough instrument sets to get through the busiest session without shortened cycles Yes / No 1 pt
  16. Sterilizers in use Number
  17. Temperature displayed during the cycle observed (°F or °C) Number
  18. Exposure time of the cycle observed (minutes) Number
  19. Loading of the sterilizer observed Rating
    • Loaded to the manufacturer's instructions 5 pts
    • Slightly overloaded 3 pts
    • Pouches stacked or crammed 1 pt

4. Monitoring 19 items

  1. The time, temperature and pressure of every cycle are checked on the printout or display before the load is released Yes / No 1 pt
  2. The employee releasing the load initials the cycle record Yes / No 1 pt
  3. The internal indicator is checked chairside when a package is opened Yes / No 1 pt
  4. A package whose indicator has not changed is returned unused to the sterilization area Yes / No 1 pt
  5. An integrating (Type 5) indicator is placed in each load where company policy requires it Yes / No 1 pt
  6. A spore test is run on each sterilizer at least weekly, or more often where local regulation requires Yes / No 1 pt
  7. A spore test is run with every load containing an implantable device Yes / No 1 pt
  8. A control vial from the same lot is processed with each in-office spore test Yes / No 1 pt
  9. In-office spore tests are read at the incubation time stated by the manufacturer Yes / No 1 pt
  10. Results of mail-in spore tests are received and checked for every week of the last 3 months Yes / No 1 pt
  11. Date of the last spore test Date
  12. Result of the last spore test Choice
    • Pass
    • Fail
    • Result pending
  13. Spore test vials or strips are within their expiry date Yes / No 1 pt
  14. The written procedure for a failed spore test is posted in the sterilization area Yes / No 1 pt
  15. The employee asked could describe the first steps after a failed spore test Yes / No 1 pt
  16. Each failed spore test of the last 12 months has a documented retest Yes / No 1 pt
  17. Instruments from loads run since the last passing test were recalled after each failed spore test Yes / No 1 pt
  18. A sterilizer returning from repair is spore tested before it is put back into service Yes / No 1 pt
  19. Sterilization monitoring over the last 3 months Rating
    • Every cycle and weekly test documented 5 pts
    • Gaps in cycle checks or tests 3 pts
    • Monitoring largely missing 1 pt

5. Storage 16 items

  1. Sterile packages are stored in closed cabinets or covered drawers Yes / No 1 pt
  2. Sterile packages are not stored under sinks or where they can be splashed Yes / No 1 pt
  3. Sterile storage is on the clean side, away from contaminated instruments Yes / No 1 pt
  4. Packages are checked for tears, moisture and broken seals before use Yes / No 1 pt
  5. A package found torn, wet or open is reprocessed Yes / No 1 pt
  6. Older packages are used first Yes / No 1 pt
  7. Drawers are not packed so tightly that pouches bend or crush Yes / No 1 pt
  8. Elastic bands are not used around pouches Yes / No 1 pt
  9. Instruments entering the mouth are not kept loose and unwrapped in operatory drawers Yes / No 1 pt
  10. Sterile packages are not stored on the floor or on the bottom shelf of an open rack Yes / No 1 pt
  11. Sterile storage drawers and shelves are wiped on the schedule set by company policy Yes / No 1 pt
  12. Sterile packages are handled with clean, dry hands Yes / No 1 pt
  13. Kits used rarely (surgical, implant) are checked monthly for package integrity Yes / No 1 pt
  14. Purchased sterile single-use items (sutures, blades) are kept in their original packaging Yes / No 1 pt
  15. Damaged or unlabeled packages found among 10 sampled from storage Number
  16. Condition of sterile storage Rating
    • Clean, dry, closed and orderly 5 pts
    • Overfilled or partly open 3 pts
    • Exposed to moisture or contamination 1 pt

6. Logs 18 items

  1. A log is kept for each sterilizer showing date, load number, cycle type, contents and operator Yes / No 1 pt
  2. The sterilizer log has an entry for every working day of the last 30 days Yes / No 1 pt
  3. Cycle printouts or data-logger downloads are kept with the log Yes / No 1 pt
  4. Spore test results are filed for the period required by local regulation or company policy Yes / No 1 pt
  5. One package picked from a drawer could be traced through its label to its load in the log Yes / No 1 pt
  6. Ultrasonic cleaner tests are recorded Yes / No 1 pt
  7. The written reprocessing procedure was reviewed within the last 12 months Yes / No 1 pt
  8. Date of the last review of the reprocessing procedure Date
  9. Manufacturer's reprocessing instructions are on file for the instruments and handpieces in use Yes / No 1 pt
  10. Training records are on file for each employee who reprocesses instruments Yes / No 1 pt
  11. A competency check of each reprocessing employee was done within the last 12 months Yes / No 1 pt
  12. New employees are trained on reprocessing before they work alone in the sterilization area Yes / No 1 pt
  13. One employee is named as responsible for the sterilization area, with a named backup Yes / No 1 pt
  14. The responsible employee or the office manager reviews and initials the sterilizer logs each month Yes / No 1 pt
  15. Corrective actions from the previous sterilization review have been completed Yes / No 1 pt
  16. Name of the employee responsible for sterilization Short text
  17. Overall control of the sterilization workflow Rating
    • Strong 5 pts
    • Partial 3 pts
    • Weak 1 pt
  18. Corrective actions required Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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