Medical and surgical devices and supplies need to have a level of cleaning that will prevent transmission of infectious during their use. Spaulding developed a classification of devices based on their use which can help determine the type of processing required.


Spaulding device classification:

(1) critical

(2) semicritical

(2a) instrumentation

(2b) contact only

(3) noncritical


Spaulding also had a category for housekeeping.


Critical devices enter sterile tissue and/or the vasculature:

(1) implants

(2) surgical instruments

(3) needles and sutures

(4) dental instruments that penetrate oral soft tissue or bone


Semicritical (instrumentation) that touch mucous membranes with significant insertions:

(1) endoscopes

(2) laryngoscopes

(3) endotracheal tubes

(4) dental instruments no penetrating oral soft tissue or bone


Semicritical devices (contact only) that touch the mucous membranes with no or minor insertions:

(1) thermometers

(2) hydrotherapy tanks


Noncritical devices touch intact skin:

(1) stethoscopes

(2) table or countertops

(3) bedpans

Device Classification

Spaulding Process Classification

EPA Product Classification



sterilant, disinfectant

semicritical, instrumentation

high-level disinfection

sterilant, disinfectant

semicritical, contact only

intermediate level disinfection

hospital disinfectant with tuberculocidal activity


low level disinfection

hospital disinfectant without tuberculocidal activity



Spaulding Process Classification


Does Not Kill


everything, including bacterial spores


high-level disinfection

all nonspore micro-organisms

not all spores if large numbers present

intermediate level disinfection

M tuberculosis, most vegetative bacteria, most fungi

bacterial spores

low level disinfection

most bacteria, some viruses, some fungi

M tuberculosis, bacterial spores or resistant organisms


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