Positive BI Troubleshooting Checklist

Do you know what to do when your
incubator alarms from a positive BI?

Biological indicators (BIs) play an important role in any sterility assurance program. BIs are used to validate that conditions were met to kill microorganisms in a cycle during steam and vaporized hydrogen peroxide sterilization. After the cycle is run, each BI must be incubated for a specified amount of time to determine if all endospores (typically Geobacillus stearothermophilus) have been killed. If no spores survive, and no growth is detected during incubation, the test is a pass. If growth is detected, the test is a fail and you’ll have a “positive” result on your incubator alarm.

What do I do if I get a failed (positive) Biological Indicator?

Just like a smoke detector alarming, a failed biological indicator tells sterile processing staff that action needs to be taken immediately. When a failed BI occurs, you must follow your failed spore test protocol and quickly investigate possible operator errors or equipment failures using the checklists below.

Follow These Steps after a Failed BI:

Step 1 – Inform supervisors and technicians of the BI failure.
Step 2 – Quarantine instruments processed in the failed load. Recall all instruments and packs processed back to the last passing (negative) BI following your recall procedures for sterilization.
Step 3 – Remove the sterilizer from service and inform your service/biomed group.
Step 4 – Download and use our Troubleshooting Checklist to begin the investigation.

Download the Failed BI
Troubleshooting Checklist

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SPD Technician inspecting
a Biological Indicator

If the failure cannot be attributed to any cause on the BI Failure Troubleshooting Checklist, it's time to contact your facilities, biomedical, or service provider to determine if a repair is needed. To assist, the Sterile Processing Department manager should begin the process of reviewing the preventive maintenance, repair, alarm and cycle history of the equipment.

While the bacterial spores in a BI may be small, they offer critical indication of the entire sterilization process. If a failed BI occurs in your department, it is an alarm that something is wrong but can also create a positive learning experience for your sterilization staff to stop and examine process and procedure.

Explore our Biological Indicator Solutions, Including FAST 20-min BIs for Steam & VHP