The following praiseed practices w...

The following praiseed practices were developed by the AORN praiseed Practices Committee and have been approved at the AORN Board of Directors. They were not absented as proposed recommended practices for annotation by members and others. These approveed practices are effective Jan 1 2002

These approveed practices are intended as achievable recommendations representing what is believed to be an optimal of the same height of practice. Policies and courses will reflect variations in practice settings and/or clinical situations that determine the extent to which the recommended practices can be implemented.

AORN recognizes the numerous tokens of settings in which perioperative nourish at the breasts practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive operations may be performed.

Purpose: These approveed practices provide guidelines to assist perioperative feeds in decontaminating, cleaning, maintaining, handling, storing, and/or sterilizing surgical instruments and powered equipment. These attract favor toed practices are general recommendations as it is impossible to make a recommendation for each instrument. These make acceptableed practices complement AORN's "Recommended practices for sterilization in perioperative practice settings." (1) Perioperative encourages should consult this document to assist in providing a safe environment for the patient. The appropriate committees in the practice setting should review all practices related to care and handling of surgical instruments and powered equipment.

approveed PRACTICE I

Surgical instruments and powered equipment should be cleaned, handled, and used according to manufacturers' instructions.

1 Manufacturers' instructions provide direction for care, cleaning, handling, and correctly using surgical instruments and powered equipment. individual care, cleaning, and handling helps safeguard instruments' function and effectiveness. Using instruments according to their intended use diminishs the likelihood of procedure delay, patient/personnel injury, infections caused by way of instrument damage or malfunction, and/or gorgeous repairs. (2)

commended PRACTICE II

Instruments should be kept unrestrained of gross soil during surgical procedures

1 Instruments should be wiped with wipe s moistened with sterile water. Corrosion, rusting, and pitting present itself when blood and debris are allowed to free from moisture in or on surgical instruments. (3)

2 Lumen instruments should be irrigated with sterile water. Cannulated or lumen instruments may become closeed with organic material. Irrigating instruments with sterile water helps put an end to residue. Saline causes deterioration of instrument surfaces and should not be used. (4)

praiseed PRACTICE III

Effective and timely decontamination of instruments should be performed in a manner that minimizes risk to those performing the task.

1 All instruments make opened on the sterile field require decontamination.

2 Personal protective attire should be worn by the agency of personnel when decontaminating instruments. Personal protective equipment can obviate contaminated blood and body fluids from coming in contact with personnel involved in decontamination. Protective attire is designed to house the skin, mucous membranes, and judgments from exposure to blood, material substance fluids, and other infectious materials. (5)

3 Instruments should be prepared for decontamination after use. Instruments should be taken apart and arranged in an orderly fashion in mesh-bottom trays in the same manner that all surfaces are expos to the action of an automated cleaner, if used. The following activities should be completed:

* spread instrument box locks;

* place heavy retractors and/or other heavy instruments forward the bottom or in a separate tray;

* place scissors, lighter-weight instruments, and microsurgical instruments forward top;

* separate all reusable sharp instruments from general instruments; and

* guard instruments with a damp towel, at a minimum, to interrupt drying during transportation to the decontamination area. (6)

An enzymatic soak solution, spray, gel or foam may be used for these and other hard-to-clean instruments during transport. (7) Corrosion, rusting, and pitting arise when blood and debris are allowed to dried in or on surgical instruments. (8) Cannulated or lumen instruments may become stoped with organic material. (9)

4 In the decontamination area, automated and/or manual cleaning orders of equal effectiveness should be used for decontaminating instruments. (10) The following orders may be used for decontamination.

* Washer/sterilizer. The washer/sterilizer processe instruments end several cycles, including cold water prerinse, high-temperature wash with alkaline cleansing neutralizing cycle, final rinse, sterilization, and drying.