I do homecare in Ontario, Canada. For a clean drsg. change, we have the patient/ family boil or microwave plastic dressing forceps in a coffee mug for 8-10 min. If they're using a pot, it must have a lid. If they're microwaving them, the cup is covered with plastic wrap. If N.S. is needed, table salt is added to the water, using a spoon which has also been boiled.
If I don't have time for the water to cool, because the patient forgot to do the forceps before I arrived, I use a couple of 10 ml ampoules of NS, or I cut open a small IV bag (50 ml minibag if I have one.) Homecare will provide NS in bottles, but it must be discarded 3 days after being opened, so it is more cost-efficient for the patient to make their own.
This system works well, and the infection rate in the home is much lower than in hospital, which is where most of our patients acquired their wound infections in the first place! We use sterile technique for central lines only, and even with central lines, I've had patients who were allergic to the occlusive dressing. We just secure their line with a couple of steri-strips, and cover it with 4x4's and some mesh to hold it in place!