Guidelines in Practice: Instrument Cleaning

Care of surgical instruments and devices is a multifaceted process that begins with an interdisciplinary team's prepurchase determination that the facility has the resources to correctly process the items. Processing encompasses point-of use removal of organic and inorganic material, transport to the processing area, use of chemicals and equipment to clean and decontaminate the item, and inspection for cleanliness and function. Failure to correctly clean and decontaminate surgical instruments can impede subsequent sterilization processes and place patients at risk for developing surgical site infections. The AORN "Guideline for care and cleaning of surgical instruments" provides general guidance for care of reusable medical devices. When processing instruments, perioperative team members should use the guideline in conjunction with the instrument manufacturer's validated instructions for use. This article discusses the guideline recommendations related to prepurchase evaluation, point-of-use treatment, transport, cleaning and decontamination, and education; it also includes a scenario to illustrate these topics.