Run Surgical Instrument Sterilization Verification — Free

Load Identification and Traceability

Sterilization load ID matches documentation critical (required)

Confirm the load identifier on the tray or package matches the sterilizer log and release record.

Yes No N/A

Cycle date and time are recorded critical (required)

Verify the sterilization cycle date, start time, and completion time are documented.

Yes No N/A

Operator and reviewer are identified

Confirm the sterilizer operator and the person releasing the load are documented.

Yes No N/A

Instrument set or tray name is correct critical (required)

Verify the tray contents correspond to the intended surgical procedure or instrument set.

Yes No N/A

Autoclave Cycle Parameters

Cycle type matches load requirements critical (required)

Confirm the selected cycle is appropriate for the instrument type and packaging used.

Exposure temperature is within validated range critical (required)

Verify the recorded temperature meets the validated sterilization parameters.

Exposure time is within validated range critical (required)

Verify the recorded exposure time meets the validated sterilization parameters.

Pressure or cycle readings are documented

Confirm pressure or other required cycle readings are recorded according to the sterilizer's validation requirements.

Yes No N/A

Cycle printout or digital record is available critical (required)

Verify the sterilization record is complete and available for review.

Yes No N/A

Biological and Chemical Indicator Verification

Biological indicator was used as required critical (required)

Verify a biological indicator was included according to policy, load type, or monitoring schedule.

Yes No N/A

Biological indicator result is negative critical (required)

Confirm the biological indicator passed and no growth was detected.

Yes No N/A

Chemical indicator changed appropriately critical (required)

Verify internal and/or external chemical indicators show the expected color or state change.

Yes No N/A

Indicator placement was correct

Confirm indicators were placed in the most challenging location within the tray or package as required.

Yes No N/A

Load release was held until indicator criteria were met critical (required)

Verify the load was not released for use until all required indicator results were acceptable.

Yes No N/A

Instrument Tray Contents and Packaging

Tray or package is intact and dry critical (required)

Verify the tray, wrap, peel pack, or container is not torn, wet, or compromised.

Yes No N/A

Instrument count matches the set list critical (required)

Confirm all required instruments are present and the count matches the tray checklist.

Yes No N/A

Instruments are clean and free of visible soil critical (required)

Verify no visible debris, residue, or bioburden remains on instruments or tray surfaces.

Yes No N/A

Release, Documentation, and Sign-off

Any exceptions or failed items are documented critical (required)

Record any deviations, failed indicators, or missing documentation discovered during review.

Yes No N/A

Corrective actions are assigned when needed

Confirm corrective actions were documented for any failed or nonconforming items.

Yes No N/A

Inspector signature completed critical (required)

Capture the inspector's sign-off confirming the review is complete.

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Run: Surgical Instrument Sterilization Verification

Load Identification and Traceability

Autoclave Cycle Parameters

Biological and Chemical Indicator Verification

Instrument Tray Contents and Packaging

Release, Documentation, and Sign-off

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