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Point-of-Use Instrument Care in OR Vital for Effective Device Processing

Photo: Courtesy of National Cancer Institute

Sterile Processing (SP) professionals must deliver clean, sterilized, well-functioning devices that are ready for patient use in the operating room and other patient care areas — but those in the OR and Endoscopy departments also play a critical role in that process.

Per industry standards and guidelines — including those from the Association of periOperative Registered Nurses (AORN), the Association for the Advancement of  Medical Instrumentation (AAMI) and the Association of Surgical Technologists (AST) — the OR and other end user departments should routinely practice proper POU care. Unfortunately, this vital step is not occurring as it should in many facilities.

Protecting patient safety

Proper POU care involves wiping off blood and bioburden during the procedure, keeping instruments covered with a water-moistened towel or sprayed with an approved enzymatic product or wetting agent, and ensuring the devices are transported to the decontamination area as quickly as possible post-procedure. Each step is essential because bioburden and fluids that are allowed to dry on devices make cleaning and reprocessing in the Sterile Processing department more difficult (which, in turn, increases the risk for instrument damage and the possibility of a contaminated device being used on a future patient).

Proper POU care

AAMI, AORN and AST recommendations also state that instruments designed to be disassembled and opened should be done so at the POU. Sharps should be kept separate from non-sharps, performed by personnel who understand the risk for injury, and the instruments should be transported in a puncture-resistant container. POU care for endoscopes involves suctioning and wiping down surfaces to aid the removal and breakdown of bioburden. Endoscopes should also be transported to the decontamination area and processed as soon as possible following their use. Some manufacturers’ instructions for use state that if reprocessing doesn’t begin with 60 minutes of use, extensive reprocessing will be required. All used/contaminated devices, regardless of type, should be covered for transport to the decontamination area and marked as “biohazardous.” This is true even if the surgical suite or procedure area is located near the decontamination area in the SPD.

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