Second OpinionsHow do you transport contaminated instru...

How do you transport contaminated instruments?

I work in a very small, 2-OR hospital. We're trying to comply with AAMI and AORN standards regarding the transportation of instruments from the OR to the decontamination room after a case. Decontam and sterile processing are just down a restricted hall from the OR, about a 1-minute walk. Up till now, scrubs have been covering the back table with an impervious drape and rolling it to decontam, but a mock Joint Commission surveyor told us that's not good enough. But it seems over-complicated and very inefficient for us to load the instruments into a closed container to walk them 30 feet down the hall. I'd love to hear any suggestions on how others handle this situation. Thank you!

Started by: Casey Pitt (OR Manager/Supervisor) at January 29, 2014 (10:40 pm)

Comments and Responses

 

we have opened a second clinic in a city 30 minutes from our main clinic. This new clinic does not have an eye wash station, nor an ultrasonic cleaner nor a sterilizer. Our MDs want to transport dirty instruments to our main clinic via our MAs. for reprocessing. These instruments would not be reprocessed until the next day. The MDs are suggesting "spraying" with an enzymatic cleaner and placing the instruments in a container for transport. Also stating that an eye wash station is not necessary.
Is this possible and how?

Diane K. (Other) at September 12, 2018 (11:11 am)

Closed Case carts! We also do use drapes to cover the carts when transporting to Sterile Processing. There should also be a Biohazard sign posted whenever transporting contaminated equipment/instruments to Sterile Processing. We spray all used instruments before transporting with a foam enzymatic so that instruments stay moist.

Julian Martinez (OR Manager/Supervisor) at January 20, 2015 (3:29 pm)

All of advisory bodies such as, AAMI, AORN, CST advice on Point of Use care of instruments, and of course transportation back to SPD. Most of OR use saline during their routines, which I do understand the reason behind that. However, when surgical instruments are treated with saline we have a lot of issues, such as pitting on the instruments.
When sterile water is used to treat the instruments, as stated above, you are creating the issue of spilling while travelling on the hallways.

The best method to use is enzymatic foam, this way you start the break down of bio film, and be compliant with governing bodies, such as OSHA. Do not forget to include a Biohazard label while transport those items.

Genti Koci (Other) at January 19, 2015 (6:12 pm)

There is now a low cost plastic table cover that meets this specific need. It is red with biohazard emblems, has elastic bottom to keep in place, and covers the entire table's contents for transport through passage ways (CFI Medical Solutions). Could be an option to explore, though I dont know if it would be considered "spill proof"?

Joanna S. (Other) at December 16, 2014 (1:47 pm)

We are a 4 room OR, ambulatory surgery center. We have the same issue as far as distance to deliver the contaminated instrumentation. We utilize a large plastic container with a lid, labeled biohazard. We place a large red biohazard bag inside the container to line it and place the dirty instruments inside the bag. Once secure the scrub takes the instruments to the decontamination room where the central sterile personnel remove it, clean the plastic container and have it ready to go for the next use. We recently had a AAAHC, and CMS surveys within three weeks of each other and was given a good grade on the transport of dirty instruments.

Bobbie Franks (Other) at April 2, 2014 (9:09 am)

Read the AAMI Standards and all answers to your questions are there. Both the Sterile Processing and the OR must have a copy of this book or purchase the CD and have it installed on your server for everyone. AORN recites the AAMI Standards for their Standards. I would answer your questions by writing the step by step processes needed however it is quite lengthy. C. Kay Watson, Consultant, SterileProcess.com

C. Kay Watson (Other) at March 24, 2014 (3:17 pm)

We are a 4 O.R. ambulatory center. Our instruments are transported on double ring stands (used instruments in sterile water in large basin, unused instruments back in their genesis pans), covered with the wrap that contained the large sterile basin -- down the hall (within the O.R.) to decon. There, the water is poured off the instuments into the hopper, and enzymatic sprayed on the used instruments. The instruments are placed on a rack until central processing comes to get them. They transfer them to a 2-shelf utility cart, cover it with a cloth bed sheet and transport them down the hall, down 6 floors via the service elevator, and down another hallway to the C.S. decon. We haven't had any "dings" from surveyors in the past.

Terrolynn G. (Other) at February 6, 2014 (12:34 pm) [last edited on February 6, 2014 (12:36 pm)]

Regarding TJC surveys: I have worked in many surgery departments (I was an RN OR Traveler for three years) and was amazed to find the differences from facility to facility. What passed inspection in one OR had gotten another OR a citation; unfortunately, I have found that the cause for the differences is the individual performing the inspection. Personality differences, having had previous OR experience (or not) are just a few factors that can influence decisions made by any inspector. It's too bad that TJC can't supply their inspectors with a standardized form that would decrease and/or eliminate the discrepancies.

Terry T. (OR Manager/Supervisor) at February 5, 2014 (11:41 am) [last edited on February 5, 2014 (11:42 am)]

We are also small, 2 OR's, and the decontamination room is literally 30 steps away. We transport our used instruments in a closed red bin container, marked with a biohazard sticker. This is adhering to AORN, and AAAHC standards.

C. King (OR Manager/Supervisor) at February 4, 2014 (7:55 pm)

According to standards, all instrumentation shuold be transported in spill proof containers with a lid or case cart.
Presently we have the case cart system at our institution (12 OR rooms).
All outpatient areas have the container system with lids (Instra-bin from Ruhof company). These work great for transport,the only thing you need to apply would be the contamination symbol to the container for communication purposes.

S. Carey (Other) at February 4, 2014 (1:04 pm)

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