In manual cleaning, how are items cleaned or brushed?

In manual cleaning, the technique of cleaning items beneath the surface of the water is important because it helps to prevent contamination of the surrounding environment. This method allows for effective removal of soil, debris, and bioburden from medical instruments without risking splatter or recontamination, which can occur if cleaning is done above the water's surface.

Additionally, it is easier to ensure that all surfaces of the item are thoroughly cleaned when the item is submerged. When brushing items while they are under water, the bristles of the brush can effectively dislodge particles and contaminants while simultaneously washing them away. This practice is also effective in minimizing the risk of aerosolization of contaminants that could happen if items were cleaned above the surface.

While using running water can enhance the cleaning process, it is not exclusively required for effective manual cleaning, as the critical factor is the action taken during cleaning beneath the surface of the water. Thus, the focus on cleaning beneath the surface makes a strong case for why this method is considered efficient for manual cleaning in sterile processing.