HSPA Point-of-Use Care and Transport Flashcards

What is the correct handling procedure for instruments used on patients with known Creutzfeldt-Jakob disease (CJD)?

Answer: Immediately quarantine the instruments in a designated container, label them clearly as CJD-exposed, notify SPD and infection prevention, and do not allow routine reprocessing until specific guidance is received

CJD prions are extraordinarily resistant to conventional sterilization. Instruments exposed to known or suspected prion-contaminated tissue require immediate quarantine and special handling per facility policy, which may include specific decontamination protocols, prolonged autoclaving at elevated temperatures, or disposal. Routine reprocessing is inadequate for prion decontamination.

What transport route considerations apply when moving contaminated instruments through a facility?

Answer: Use designated transport routes that minimize exposure to patients, visitors, and clean supply areas, following facility traffic patterns that separate clean and soiled flows

Even though instruments are in closed containers, transport routes should minimize contact with patient care areas, clean supply routes, and high-traffic public areas. Many facilities designate specific elevators and corridors for soiled transport. This reduces the risk of container breach in populated areas and maintains the separation of clean and soiled workflows.

Why should instrument trays be kept flat during transport rather than tilted or stacked improperly?

Answer: Tilting can cause instruments to shift, leading to damage to delicate tips, activation of sharp edges, spillage of pre-treatment solution, and potential container breach

Keeping trays flat and properly positioned during transport prevents instruments from shifting and colliding (which damages delicate tips and edges), avoids spillage of pre-treatment solution (which creates bioburden exposure and allows instruments to dry), and maintains the integrity of the container closure. Proper cart design and loading technique support flat transport.

What role does the instrument count play in the point-of-use to transport transition?

Answer: The closing instrument count must be reconciled before instruments leave the OR, as a missing instrument count may indicate a retained surgical item requiring immediate patient intervention

The surgical instrument count must be complete and reconciled before any instruments leave the operating room. A count discrepancy may indicate a retained surgical item, which is a never event requiring immediate investigation and potentially imaging the patient. Once instruments leave the OR, tracking a missing instrument becomes far more difficult.

How should endoscopic instruments and cameras be handled at the point of use?

Answer: Handle with extra care to protect optical components, wipe lenses with approved materials, keep lumens moist, and transport in padded or dedicated containers that prevent damage to delicate components

Endoscopic instruments contain delicate optical components (lenses, light guides, cameras) that require careful handling. Lenses should be wiped with manufacturer-approved materials to prevent scratching. Lumens must be kept moist. Dedicated transport containers protect fragile components from impact damage. Rough handling can cause costly damage and delays.

What is the significance of maintaining the cold chain for temperature-sensitive instruments during transport?

Answer: Some instruments, batteries, and components are temperature-sensitive and can be damaged by excessive heat or cold during transport or holding, requiring awareness of environmental conditions

While most surgical instruments are temperature-stable, some components such as certain batteries, polymeric parts, and optical elements can be damaged by extreme temperatures encountered during transport (e.g., through outdoor connectors between buildings, near loading docks). Temperature-sensitive items should be identified and protected during transport.