HSPA Point-of-Use Care and Transport 1 — Questions and Answers
Question 1: What is the primary goal of point-of-use care for surgical instruments?
- To sterilize instruments at the bedside
- To prevent soil from drying on instruments by keeping them moist and removing gross contamination immediately after use (Correct answer)
- To count instruments before sending them to SPD
- To lubricate instruments after surgery
Correct answer: To prevent soil from drying on instruments by keeping them moist and removing gross contamination immediately after use
Point-of-use care prevents blood, tissue, and body fluids from drying on instrument surfaces. Dried bioburden is significantly harder to remove during decontamination and can shield microorganisms from disinfection and sterilization. Immediate attention at the point of use is the foundation for successful reprocessing downstream.
Question 2: What should be applied to instruments at the point of use to keep them moist?
- Sterile saline only
- An enzymatic foam, gel, or spray specifically designed for point-of-use pre-treatment, or a moist towel if pre-treatment products are unavailable (Correct answer)
- Bleach solution
- Alcohol wipes
Correct answer: An enzymatic foam, gel, or spray specifically designed for point-of-use pre-treatment, or a moist towel if pre-treatment products are unavailable
Enzymatic pre-treatment products (foams, gels, sprays) are designed to keep instruments moist and begin breaking down organic soil immediately. They prevent bioburden from drying while the instruments await transport to the decontamination area. If enzymatic products are unavailable, a moist towel can keep instruments from drying as a temporary measure.
Question 3: Why should instruments never be allowed to soak in saline at the point of use?
- Saline is too expensive for soaking
- Saline is corrosive to stainless steel instruments, causing pitting and surface damage that harbors microorganisms and weakens the instrument (Correct answer)
- Saline causes instruments to become too slippery to handle
- There is no reason to avoid saline soaking
Correct answer: Saline is corrosive to stainless steel instruments, causing pitting and surface damage that harbors microorganisms and weakens the instrument
Sodium chloride (saline) is highly corrosive to stainless steel surgical instruments. The chloride ions cause pitting corrosion that creates microscopic surface defects where microorganisms can hide from cleaning and sterilization. Even brief exposure to saline can initiate corrosion. Only manufacturer-recommended pre-treatment solutions should be used.
Question 4: What is the correct container type for transporting contaminated instruments from the OR to SPD?
- Any available bin or basin
- A rigid, leak-proof, puncture-resistant container with a secure lid that is labeled as biohazardous (Correct answer)
- A clear plastic bag
- Instruments should be carried on an open tray
Correct answer: A rigid, leak-proof, puncture-resistant container with a secure lid that is labeled as biohazardous
OSHA and facility policies require contaminated instruments to be transported in rigid, leak-proof, puncture-resistant containers with secure lids. These containers prevent exposure of transport personnel, hallway traffic, and elevator occupants to bloodborne pathogens. Biohazard labeling alerts anyone who might encounter the container to its contents.
Question 5: What PPE is required when handling contaminated instruments at the point of use?
- No PPE is required at the point of use
- At minimum, gloves appropriate for the task; additional PPE such as fluid-resistant gown, face protection, and heavier gloves may be needed depending on the splash and sharps risk (Correct answer)
- Standard exam gloves only
- Only a mask is required
Correct answer: At minimum, gloves appropriate for the task; additional PPE such as fluid-resistant gown, face protection, and heavier gloves may be needed depending on the splash and sharps risk
PPE selection at the point of use depends on the risk assessment. Gloves are always required for handling contaminated instruments. If there is risk of splashing (when spraying enzymatic foam or handling instruments in fluid), a face shield and fluid-resistant gown are needed. Heavy-duty or cut-resistant gloves reduce sharps injury risk during sorting and containment.
Question 6: What is the maximum recommended time between instrument use and the beginning of decontamination?
- No specific time limit exists
- Instruments should reach the decontamination area as soon as possible, ideally within the timeframe specified by the facility's policy, to prevent soil from becoming fixed (Correct answer)
- 48 hours is acceptable if instruments are kept moist
- Decontamination can wait until the next day
Correct answer: Instruments should reach the decontamination area as soon as possible, ideally within the timeframe specified by the facility's policy, to prevent soil from becoming fixed
While no universal maximum time exists, prompt transport to decontamination is critical. The longer instruments sit, even with pre-treatment, the more difficult cleaning becomes. Facility policies typically specify maximum transport times. Best practice is to transport instruments to decontamination as soon as possible after the procedure ends.
HSPA Point-of-Use Care and Transport 1
What is the primary goal of point-of-use care for surgical instruments?