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Point of Use Care and Transportation of Surgical Instruments

Care and handling of surgical instruments is a shared responsibility between the operating room (OR) and sterile processing (SP) personnel. Research has proven that preparation for decontamination must begin at the point of use (POU); however, many facilities are not following the guidelines. Surveyors from accreditation organizations such as The Joint Commission are citing facilities for not following POU care and handling of surgical instruments, which can put patients at risk. In addition, facilities have been fined by OSHA for Blood Borne Pathogen Standard violation relating to skipping POU care and handling that puts employees at risk.1

The following are excerpts from current guidelines and standards relating to POU care of surgical instruments from the Association of periOperative Registered Nurses (AORN), the Association for the Advancement of Medical Instrumentation (AAMI), and the Association of Surgical Technologists (AST).Click to view or download table. 

Appropriate POU care and transportation of surgical instruments can help decrease risks to patients, employees, and the instruments. Healthcare facilities should ensure their policies and procedures for care and handling of surgical instruments includes detailed information on POU care and transportation following current published guidelines and standards. 


  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.inspection_detail?id=974812.015
  2. Guideline for cleaning and care of surgical instruments. In:Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2018.
  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.
  4. 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_.pdfAccessed 4/17/2018

Rose Seavey, MBA, BS, RN, CNOR, CRCST, CSPDT, is president/CEO of Seavey Healthcare Consulting and formerly the director of the SPD at The Children’s Hospital of Denver. Rose served on the AORN board of directors and is a past president ASHCSP. She received numerous awards and was named as one of the Who’s Who in Infection Prevention by Infection Control Today. Ms. Seavey is the author of Sterile Processing In Healthcare Facilities: Preparing for Accreditation Surveys, published by AAMI. She serves on several AAMI committees helping to write national standards.

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