Today’s complex surgical instruments present unique challenges for reprocessing. Recent outbreaks of infection and death related to inadequately reprocessed surgical instruments have put instrument reprocessing front and center with health care professionals, regulatory and accrediting agencies, and the general public. Operating Room and Sterile Processing have a shared responsibility for the care of surgical instruments. The preparation for decontamination begins at the point of use (POU).
POU care and transportation of surgical instruments help to decrease risks to patients, employees, the instruments, and the facility. Healthcare facilities should ensure their policies and procedures includes these current published guidelines and standards and that they are routinely followed in both the OR and SP. Nevertheless, many organizations do not follow the current standard guidelines.
The Joint Commission surveyors have been citing facilities for not following POU care and handling of contaminated instruments and therefore are putting their patients at risk for cross-contamination. OSHA has fined organizations for violating the Blood Borne Pathogen Standard relating to POU care that puts their employees at risk. 1
We have compiled some specific quotes in this chart below from the most current guidelines/standards from the Association of perioperative Registered Nurses (AORN), the Association for the Advancement of Medical Instrumentation (AAMI), and the Association of Surgical Technologists (AST).
Sources:
- 1)United States Department of Labor. Occupational Health and Safety Administration. Inspection 974812.015 - Hallmark Health - Melrose Wakefield Hospital. https://www.osha.gov/pls/imis/establishment.inspe...
- 2)Guideline for cleaning and care of surgical instruments. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2019.
- 3)ANSI/AAMI ST79:2017 Comprehensive guide to steam sterilization and sterility assurance in health care facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2017.
AST. Standards of Practice for the Decontamination of Surgical Instruments Standard of Practice I - The cleaning of instruments should begin during the surgical procedure to prevent drying of blood, soil and debris on the surface and within lumens. Available at: http://www.ast.org/uploadedFiles/Main_Site/Content/About_Us/Standard_Decontamination_%20Surgical_Instruments_.pdf Accessed 10/6/2019