Guidelines in Practice: Manual High-Level Disinfection

There are several steps involved when performing high-level disinfection (HLD) of semicritical devices. The recently updated AORN "Guideline for manual high-level disinfection" provides perioperative nurses with evidence-based best practices for performing safe and effective HLD of reusable semicritical items. The guideline also addresses preventing injury to patients and health care workers associated with the handling of high-level disinfectants. This article provides an overview of the guideline and discusses recommendations for selection of a processing method, sterile processing areas, preparation of items for HLD, preparation of high-level disinfectants, manual HLD, drying and storage of items after HLD, and processing records. It also includes a scenario that illustrates specific concerns related to performing quality tests on high-level disinfectant solutions. Perioperative nurses should review the guideline in its entirety and apply the recommendations when performing manual HLD.