HSPA Point-of-Use Care and Transport 2 — Questions and Answers
Question 1: How should sharp instruments be managed at the point of use for safe transport?
- Place them loosely on top of other instruments
- Secure sharps in designated compartments, use tip protectors, or place in sharps-specific transport containers to prevent injuries during handling and transport (Correct answer)
- Sharps do not require special handling
- Only scalpel blades need sharps precautions
Correct answer: Secure sharps in designated compartments, use tip protectors, or place in sharps-specific transport containers to prevent injuries during handling and transport
Sharp instruments pose significant injury risk during handling and transport. Needlestick and sharps injuries are a leading cause of bloodborne pathogen exposure in healthcare. Sharps should be contained in designated areas of the transport container, with tip protectors where appropriate, and never placed where they could contact hands during loading or unloading.
Question 2: What information should accompany contaminated instruments during transport to SPD?
- No information is needed
- At minimum: the procedure type, number of trays and instruments (including any additions or known missing items), and any known patient exposure risks such as prion disease or specific infectious agents (Correct answer)
- Only the surgeon's name
- Just the room number
Correct answer: At minimum: the procedure type, number of trays and instruments (including any additions or known missing items), and any known patient exposure risks such as prion disease or specific infectious agents
SPD staff need to know what they are receiving to plan decontamination appropriately. The procedure type and instrument count help with sorting and verification. Known infectious agent exposures (especially prion disease) may require modified reprocessing. Missing instrument information triggers investigation for potential retained surgical items.
Question 3: Why is it important to disassemble multi-part instruments at the point of use?
- To make them fit in smaller transport containers
- To prevent soil from drying in joints and connections where it becomes extremely difficult to remove, and to allow pre-treatment solution to contact all surfaces (Correct answer)
- Disassembly at point of use is not recommended
- Only to count all parts separately
Correct answer: To prevent soil from drying in joints and connections where it becomes extremely difficult to remove, and to allow pre-treatment solution to contact all surfaces
Multi-part instruments have joints, connections, and mating surfaces where soil becomes trapped and dries quickly. Disassembling at the point of use exposes these surfaces to pre-treatment solution, preventing soil fixation. Additionally, it ensures all components travel together to decontamination and facilitates thorough cleaning of every surface.
Question 4: What is the role of the circulating nurse or surgical technologist in point-of-use instrument care?
- They have no responsibility for instrument care
- They are responsible for initiating point-of-use pre-treatment, ensuring instruments are kept moist, performing initial counts, and preparing instruments for safe transport to SPD (Correct answer)
- Only the SPD technician handles instrument care
- Their role is limited to counting instruments
Correct answer: They are responsible for initiating point-of-use pre-treatment, ensuring instruments are kept moist, performing initial counts, and preparing instruments for safe transport to SPD
The circulating nurse or surgical technologist is the first person responsible for instrument care after the procedure. They initiate pre-treatment (spraying, moistening), ensure instruments remain moist during closing counts, maintain accountability for all instruments, and prepare them for safe transport. Their actions directly impact the success of downstream reprocessing.
Question 5: What should be done with instruments that are grossly contaminated with bone cement or tissue?
- Soak them in hot water to dissolve the cement
- Remove gross contamination at the point of use using appropriate techniques, apply enzymatic pre-treatment, and transport promptly; note the contamination type for SPD so they can plan additional cleaning steps (Correct answer)
- Wait for the cement to harden for easier removal
- These instruments cannot be reprocessed
Correct answer: Remove gross contamination at the point of use using appropriate techniques, apply enzymatic pre-treatment, and transport promptly; note the contamination type for SPD so they can plan additional cleaning steps
Bone cement (polymethylmethacrylate), tissue, and other adherent materials become exponentially harder to remove once they dry and cure. Removing as much gross contamination as possible at the point of use (while following safety protocols) significantly improves cleaning outcomes. SPD should be informed so they can employ appropriate solvents or extended cleaning methods.
Question 6: How should powered surgical instruments be prepared at the point of use before transport?
- Transport them fully assembled and plugged in
- Remove batteries if applicable, disassemble per manufacturer IFU, wipe external surfaces, protect cords and hoses, and apply pre-treatment to accessible surfaces (Correct answer)
- No preparation is needed for powered instruments
- Only remove the power cord
Correct answer: Remove batteries if applicable, disassemble per manufacturer IFU, wipe external surfaces, protect cords and hoses, and apply pre-treatment to accessible surfaces
Powered instruments require specific point-of-use care. Batteries should be removed if the manufacturer specifies (to prevent damage during cleaning). Components should be disassembled per IFU for cleaning access. External surfaces should be wiped to remove gross soil. Cords and hoses should be protected from damage. Pre-treatment prevents soil drying on all accessible surfaces.
HSPA Point-of-Use Care and Transport 2
How should sharp instruments be managed at the point of use for safe transport?