CONTINUING EDUCATION
Guideline Implementation:
Surgical Instrument Cleaning
1.3 www.aorn.org/CE
LIZ COWPERTHWAITE, BA; REBECCA L. HOLM, MSN, RN, CNOR
Continuing Education Contact Hours
indicates that continuing education (CE) contact hours are
available for this activity. Earn the CE contact hours by
reading this article, reviewing the purpose/goal and objectives,
and completing the online Examination and Learner Evalua-
tion at http://www.aorn.org/CE. A score of 70% correct on the
examination is required for credit. Participants receive feed-
back on incorrect answers. Each applicant who successfully
completes this program can immediately print a certificate of
completion.
Event: #15517
Session: #0001
Fee: Members $10.40, Nonmembers $20.80
The contact hours for this article expire May 31, 2018. Pricing
is subject to change.
Purpose/Goal
To provide the learner with knowledge specific to imple-
menting the updated AORN “Guideline for cleaning and care
of surgical instruments.”
Objectives
1. Explain the importance of processing surgical instruments
correctly.
2. Describe steps that should be performed intraoperatively to
prepare instruments for disinfection.
3. Describe the steps in the decontamination process.
4. Identify heating, ventilation, and air conditioning parame-
ters (HVAC) specific to the decontamination area.
5. Identify special precautions to observe during instrument
processing.
542 j AORN Journal
Accreditation
AORN is accredited as a provider of continuing nursing
education by the American Nurses Credentialing Center’s
Commission on Accreditation.
Approvals
This program meets criteria for CNOR and CRNFA recerti-
fication, as well as other CE requirements.
AORN is provider-approved by the California Board of Regis-
tered Nursing, Provider Number CEP 13019. Check with your
state board of nursing for acceptance of this activity for relicensure.
Conflict of Interest Disclosures
Ms Cowperthwaite and Ms Holm have no declared affiliations
that could be perceived as posing potential conflicts of interest
in the publication of this article.
The behavioral objectives for this program were created by
Rebecca Holm, MSN, RN, CNOR, clinical editor, with
consultation from Susan Bakewell, MS, RN-BC, director,
Perioperative Education. Ms Holm and Ms Bakewell have no
declared affiliations that could be perceived as posing potential
conflicts of interest in the publication of this article.
Sponsorship or Commercial Support
No sponsorship or commercial support was received for this
article.
Disclaimer
AORN recognizes these activities as CE for RNs. This
recognition does not imply that AORN or the American
Nurses Credentialing Center approves or endorses products
mentioned in the activity.
http://dx.doi.org/10.1016/j.aorn.2015.03.005
ª AORN, Inc, 2015
www.aornjournal.org
Guideline Implementation:
Surgical Instrument Cleaning
1.3 www.aorn.org/CE

LIZ COWPERTHWAITE, BA; REBECCA L. HOLM, MSN, RN, CNOR

ABSTRACT
Cleaning, decontaminating, and handling instructions for instruments vary widely based on the type of
instrument and the manufacturer. Processing instruments in accordance with the manufacturer’s in-
structions can help prevent damage and keep devices in good working order. Most importantly,
proper cleaning and disinfection may prevent transmission of pathogenic organisms from a contam-
inated device to a patient or health care worker. The updated AORN “Guideline for cleaning and care
of surgical instruments” provides guidance on cleaning, decontaminating, transporting, inspecting,
and storing instruments. This article focuses on key points of the guideline to help perioperative
personnel implement appropriate instrument care protocols in their practice settings. The key points
address timely cleaning and decontamination of instruments after use; appropriate heating, ventila-
tion, and air conditioning parameters for the decontamination area; processing of ophthalmic in-
struments and laryngoscopes; and precautions to take with instruments used in cases of suspected
prion disease. Perioperative RNs should review the complete guideline for additional information
and for guidance when writing and updating policies and procedures. AORN J 101 (May 2015) 543-549.
ª AORN, Inc, 2015. http://dx.doi.org/10.1016/j.aorn.2015.03.005
Key words: cleaning, decontamination, HVAC, ophthalmic instruments, laryngoscopes, prion diseases.

http://dx.doi.org/10.1016/j.aorn.2015.03.005
ª AORN, Inc, 2015
www.aornjournal.org AORN Journal j 543
CowperthwaitedHolm
I nstruments used in surgery should be properly cleaned
and decontaminated and in good working order. Items
that are soiled or working incorrectly could compromise
patient care.1-5 Perioperative personnel should process in-
struments according to the manufacturer’s written instructions
for use (IFU). Proper cleaning and disinfection may prevent
transmission of pathogenic organisms from a contaminated
device to a patient or health care worker.1,3,4,6-10
The AORN “Guideline for cleaning and care of surgical in-
struments”11 (formerly titled “Recommended practices for
cleaning and care of surgical instruments”) was updated in
September 2014. AORN guideline documents provide
guidance based on an evaluation of the strength and quality
of the available evidence for a specific subject. The
guidelines apply to inpatient and ambulatory settings and are
adaptable to all areas where operative and other invasive
procedures may be performed.
Topics addressed in the updated instrument cleaning guideline
include care of new, repaired, refurbished, and loaned in-
struments and devices; requirements for the sterile processing
areas; cleaning products and equipment; instrument inspec-
tion; and special precautions to observe during instrument
processing.11 This article elaborates on key takeaways from the
guideline document; however, perioperative RNs should
review the complete guideline for additional information and
for guidance when writing and updating policies and
procedures.
Key takeaways from the AORN “Guideline for cleaning and
care of surgical instruments” include the following:

Instruments should be cleaned and decontaminated as soon
as possible after use.

The heating, ventilation, and air conditioning (HVAC)
system in the decontamination area should be maintained
within the HVAC design parameters at the rate that was
applicable at the time of design or most recent renovation of
the HVAC system.

Special precautions should be taken when processing intra-
ocular ophthalmic instruments.

Laryngoscope blades and their handles should be cleaned,
decontaminated, dried, and stored in a manner that reduces
patient and personnel risk of exposure to potentially patho-
genic microorganisms.

Special precautions should be taken to minimize the risk of
transmission of prion diseases from contaminated in-
struments (Figure 1).
544 j AORN Journal
May 2015, Volume 101, No. 5
SCENARIO
Nurse M is the scrub person for a cataract procedure. During
the procedure, Nurse M removes gross soil from the in-
struments by wiping the instruments with a sterile, lint-free
sponge that has been moistened with sterile water. She also
periodically irrigates the lumens of instruments with sterile
water to remove gross soil, immediately after use if possible.
When the procedure is completed, Nurse M segregates the sharp
instruments from the others and puts them into a puncture-
resistant container. She removes the disposable sharp items
and puts them in a puncture-resistant, leakproof container with
a biohazard label. Nurse M opens the hinged instruments (eg,
tenotomy scissors) and disassembles the irrigation/aspiration
handpiece according to the manufacturer’s written IFU. She
separates delicate instruments and heavy instruments into
different containers so that the delicate instruments will not be
damaged during transport to the decontamination area. To keep
the instruments moist, she places a towel moistened with sterile
water over the instruments. She sends all of the instruments that
have been opened on the sterile field to be processed in the
sterile processing area, whether or not they have been used.
Technician G arrives at work, changes into scrub attire, and
reports to the sterile processing area. As his first task of the day,
he checks and documents the HVAC parameters in this area,
which are maintained at

two outdoor air changes per hour,

six total air changes per hour,

negative air pressure, and

temperature between 72 F and 78 F (22 C and 26 C).
Technician G puts on personal protective equipment so that
his skin will be protected from splashes and splatters from
contaminated instruments and his hands will be protected
from a potential sharps injury. The personal protective
equipment includes a fluid-resistant gown with sleeves, general
purpose utility gloves with a cuff that extends beyond the cuff
of the gown, a mask with a full face shield, and shoe covers.
Nurse M brings a closed instrument and supply transport cart
from the cataract procedure to the sterile processing area.
Technician G receives the cart and takes it to a designated
cleaning area away from the area for cleaning general surgical
instruments. He uses cleaning products that are compatible
with the instruments in accordance with the manufacturers’
IFU. After cleaning, he rinses the instruments thoroughly with
copious amounts of water and performs a final rinse with
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 May 2015, Volume 101, No. 5
print & web 4C=FPO
Figure 1. Key takeaways from the AORN “Guideline for cleaning and care of surgical instruments.”
sterile deionized water. He cleans the lumen of the irrigation/
aspiration handpiece with a brush of the appropriate diameter
and length to clean the entire lumen and exit at the distal end.
The bristles are soft enough to prevent damage to the interior
of the lumen. He rinses the lumen with sterile deionized water
and expels the water into a drain. He then dries the lumen
with medical-grade compressed air.
In accordance with the manufacturers’ IFU, Technician G
disinfects the instruments by wiping the outside of the in-
struments with 70% alcohol. He inspects the instruments
under magnification to make sure there is no residual
ophthalmic viscoelastic material present. He records the
cleaning method, cleaning solution, and lot number of the
cleaning solution for the ophthalmic instruments. Technician
G then sends the instrument set to the packaging and sterili-
zation area, where Technician K will wrap and sterilize the set
according to the manufacturers’ IFU.
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Guideline Implementation: Instrument Cleaning
Technician G then receives a laryngoscope handle and blade
from the emergency department. After cleaning and decon-
taminating the handle and blade according to the manufac-
turer’s written IFU, he sends them to the packaging and
sterilization area. Although laryngoscope handles are classified
as noncritical items that only require low-level disinfection,12
at this facility, both the handle and blade are considered
semicritical items, which require high-level disinfection or
sterilization.12 Technician K wraps the blade in an individual
package for storage and sterilizes both the handle and blade
according to the manufacturer’s written IFU.
Technician G is now processing neurosurgical instruments.
During a preoperative screening, the patient who underwent the
procedure was determined to be at high risk for having a prion
disease (ie, variant Creutzfeldt-Jakob disease). The preoperative
nurse communicated this information to the entire perioperative
team, including the sterile processing personnel, so that they
AORN Journal j 545
CowperthwaitedHolm
could follow the recommended precautions. Many of the in-
struments used in the procedure were designated for single use
only, so the scrub person discarded them in a contaminated
trash receptacle in the OR. The scrub person sent only reusable
instruments that are easy to clean and can tolerate extended-
cycle steam sterilization for sterile processing after the procedure.
Technician G decontaminates the instruments that may have
been exposed to variant Creutzfeldt-Jakob disease in a me-
chanical washer, which helps ensure cleaning consistency that
may not be achieved with manual cleaning. He uses cleaning
chemicals that have shown evidence of prionicidal activity and
are compatible with the instruments. After decontamination,
Technician G sends the instruments to the packaging and
sterilization area. He then cleans and disinfects the noncritical
environmental surfaces in the decontamination area that came in
contact with the contaminated instruments used on the patient’s
high-risk tissue. He uses a 1:5 dilution of hypochlorite solution,
ensuring that the solution remains in contact with the envi-
ronmental surfaces for 15 minutes.13,14 Meanwhile, Technician
K steam sterilizes the instruments in a prevacuum sterilizer at
273 F (134 C) for 18 minutes, which is one of the methods
recommended for use when steam sterilizing instruments that
have been exposed to high-risk tissue.13,15
KEY TAKEAWAYS DISCUSSION
The key takeaways from the AORN “Guideline for cleaning
and care of surgical instruments” address timely cleaning and
decontamination of instruments after use, appropriate HVAC
parameters for the decontamination area, processing of
ophthalmic instruments and laryngoscopes, and precautions to
take with instruments used in suspected cases of prion disease.
These takeaways do not cover the entire guideline. Rather,
they help the reader focus on important or new information
that should be implemented into perioperative practice.
Immediate Cleaning and Decontamination
“Cleaning instruments as soon as possible after use can help to
prevent formation of biofilm.”11(p619) In the scenario, Nurse
M begins the process of preparing instruments for
decontamination by removing the gross soil at the point of
use.16-18 She understands that dried blood and other organic
material could be corrosive to the instrument
surfaces.16,17,19,20 Allowing blood or other bioburden to dry
on instruments could make it more difficult to remove and
could compromise the effectiveness of the subsequent
disinfection or sterilization.8,16,18,19 Likewise, Nurse M
periodically irrigates the instruments with lumens to remove
gross soil and reduce the risk of biofilm formation. A biofilm
546 j AORN Journal
May 2015, Volume 101, No. 5
that forms in a lumen can be difficult to see and remove.21
She keeps the instruments moist by placing a towel
moistened with sterile water over the instruments. She does
not use saline, which could cause pitting of the
instruments.16,17 She sends all the instruments that have
been opened on the sterile field to the sterile processing area
for cleaning and decontamination because contamination of
unused instruments can occur without being noticed.17
HVAC Parameters
The HVAC system controls the room air quality, humidity,
temperature, and air pressure. The system is designed to
reduce environmental contaminants as well as to provide a
comfortable environment for those working in the sterile
processing area. In the scenario, the HVAC parameters are set
according to recommendations from the American Society of
Heating, Refrigerating and Air-Conditioning Engineers22 and
the Facility Guidelines Institute.23
The HVAC parameters in the decontamination area should be
those that are applicable at the time of the design of the HVAC
system or the most recent renovation of the system.24 If
personnel detect a variance in the HVAC parameters, they
should report the variance according to the facility’s policy
and procedure. Designated personnel should correct the
variance and then perform a risk assessment to determine
whether any measures need to be taken to restore the
decontamination area to full functionality.24
Ophthalmic Instruments
Inadequate cleaning and rinsing of intraocular ophthalmic
instruments have been implicated in outbreaks of toxic ante-
rior segment syndrome (TASS), an acute inflammation of the
anterior segment of the eye, which is most commonly associ-
ated with cataract surgery.25 Among other factors, incidents of
TASS have been associated with various facets of instrument
processing,5,26-35 including

detergent residues remaining on instruments,

insufficient rinsing of instruments,

dried debris and residues of ophthalmic viscoelastic material
remaining on instruments, and

insufficiently dried lumens.
In the scenario, Technician G cleans the intraocular in-
struments in an area separate from the general surgery in-
struments to help prevent cross-contamination from heavily
soiled nonophthalmic instruments.16 He uses cleaning
products recommended by the instrument manufacturers16,36
and rinses the instruments thoroughly to help remove
residual cleaning product.36 When rinsing the lumens,
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May 2015, Volume 101, No. 5
Resources for Implementation

Guidelines Implementation: Cleaning and Care of
Instruments and Powered Equipment web page.
AORN, Inc. https://www.aorn.org/Topics_of_Interest/
Sterilization_and_Disinfection/Cleaning_and_Care_of_
Instruments_and_Powered_Equipment/.

AORN Syntegrity Framework. AORN, Inc. http://
www.aorn.org/syntegrity.

ORNurseLinkTM. http://www.ornurselink.org/home.

Perioperative Competency Verification Tools and Job
Descriptions [CD-ROM]. Denver, CO: AORN, Inc;
2014. http://www.aorn.org/CompetencyTools.

Policy and Procedure Templates [CD-ROM]. 4th ed.
Denver, CO: AORN, Inc; 2015. http://www.aorn.org/
Books_and_Publications/AORN_Publications/Policy_and_
Procedure_Templates.aspx.

The Roadmap to ASC Compliance [CD-ROM]. Denver,
CO: AORN, Inc; 2012. https://www.aornbookstore.org//
Product/product.asp?sku¼MAN543&dept_id¼1.
Syntegrity is a registered trademark and ORNurseLink is a
trademark of AORN, Inc, Denver, CO.
Web site access verified March 17, 2015.
Technician G expels the fluid from the lumen into the drain to
prevent recontamination of the rinse water with debris from
inside the lumen. He uses sterile deionized water to rinse the
instruments because untreated water may contain
endotoxins16,37 or may cause stains, deposits, or corrosion of
the instrument surface.38,39 He dries the lumens with
compressed air29,36 to eliminate moisture that could foster
microbial growth.
Laryngoscope Blades and Handles
As a potential source of contamination, laryngoscope blades
should be cleaned and high-level disinfected or sterilized after
each use according to the manufacturer’s written IFU. A
laryngoscope blade is considered a semicritical device because it
comes in contact with mucus membranes; therefore, at a
minimum, it should undergo high-level disinfection.12,40 A
laryngoscope handle is classified as a noncritical device and
thus requires only cleaning and low-level disinfection12 unless
the manufacturer’s IFU specify high-level disinfection or
sterilization. In a comprehensive integrative review of
laryngoscope blades and handles as sources of cross-
infection,41 however, the authors recommended that because
they are used concurrently, both the laryngoscope blade and
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Guideline Implementation: Instrument Cleaning
What Else Is in the Guideline?
Read the AORN “Guideline for cleaning and care of
surgical instruments”1 to learn what the evidence says
about the following:

What items should be evaluated to determine whether
a facility has the capability to comply with manufac-
turers’ instructions for instrument processing?
(Recommendation I.b.)

What should be included in policies and procedures for
managing loaned instruments? (Recommendation
II.e.)

What accessories and supplies should be stocked in the
decontamination area? (Recommendation V.e.)

When should water quality assessments be conducted?
(Recommendation VII.b.)

What types of detergents should be used for instru-
ment cleaning? (Recommendation VIII.a.1.)

Why should only instruments made of similar metals
be combined in the ultrasonic cleaner? (Recommen-
dation IX.e.4)
1. Guideline for cleaning and care of surgical instruments. In:
Guidelines for Perioperative Practice. Denver, CO: AORN, Inc;
2015:615-650.
handle should be classified as semicritical. The rough surface
of the laryngoscope handle can accumulate bioburden,41,42
which could be transferred to the laryngoscope blade when
the blade is folded closed.41-44
Technician K packages the blade to prevent recontamina-
tion.12 Storing the blade in the individual package minimizes
the chance that the blade will become contaminated, which
could happen if a contaminated blade was placed into a
package containing multiple uncontaminated blades.45
Prion Disease Precautions
A prion is a small infectious protein that can cause neurological
diseases known as transmissible spongiform encephalopathies,
such as Creutzfeldt-Jakob disease.13 Instruments that have
contacted high-risk tissue in patients at risk for a prion
disease require adequate decontamination to reduce the risk
for patients who subsequently are treated using these
instruments. Neurosurgical instruments are of particular
concern because typically there are large concentrations of
prions in the brain and spinal cord.46 Prions are known to
be resistant to conventional physical and chemical
sterilization techniques.13 Because the preoperative nurse
AORN Journal j 547
CowperthwaitedHolm
notified sterile processing personnel in advance of the patient’s
prion status, Technicians G and K were prepared to
implement special precautions and protocols, which are
required to inactivate prions. Technician G processes the
instruments according to the 2010 Society for Healthcare
Epidemiology of America “Guideline for disinfection and
sterilization of prion-contaminated medical instruments”13
and the facility’s policies.
CONCLUSION
As the patients’ advocates, perioperative nurses help ensure
that actions are performed to promote patient safety. This
includes making sure instruments are in good working order
and have been correctly processed according to the manufac-
turers’ written IFU to reduce the chance of transmitting
pathogenic microorganisms to patients or personnel. Periop-
erative RNs and sterile processing team members who have
responsibilities related to care and cleaning of surgical in-
struments should receive education and complete competency
verification on instrument care and cleaning activities. In
addition, perioperative RNs should participate in multidisci-
plinary teams that include infection preventionists, surgeons,
sterile processing personnel, and other stakeholders to

develop mechanisms for evaluating and selecting cleaning
and decontamination equipment and associated cleaning
products,

implement systematic processes for monitoring HVAC pa-
rameters in the sterile processing areas and addressing vari-
ances in those parameters, and

establish evidence-based policies and procedures to minimize
the risk of prion disease transmission.
The AORN “Guideline for cleaning and care of surgical in-
struments” is an evidence-based resource that perioperative


RNs and sterile processing team members can use to help
influence safe perioperative practice.
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42. Williams D, Dingley J, Jones C, Berry N. Contamination of laryn-
goscope handles. J Hosp Infect. 2010;74(2):123-128.
43. Call TR, Auerbach FJ, Riddell SW, et al. Nosocomial contamination
of laryngoscope handles: challenging current guidelines. Anesth
Analg. 2009;109(2):479-483.
44. Howell V, Thoppil A, Young H, Sharma S, Blunt M, Young P.
Chlorhexidine to maintain cleanliness of laryngoscope handles: an
audit and laboratory study. Eur J Anaesthesiol. 2013;30(5):
216-221.
45. Standards FAQs details: laryngoscopesdblades and handlesd
how to clean, disinfect and store these devices. The Joint Com-
mission. http://www.jointcommission.org/mobile/standards_inform
ation/jcfaqdetails.aspx?StandardsFAQId¼508&StandardsFAQChapter
Id¼69. Accessed February 4, 2015.
46. McDonnell G. Prion disease transmission: can we apply standard
precautions to prevent or reduce risks? J Perioper Pract. 2008;
18(7):98-304.
Liz Cowperthwaite, BA
is the senior managing editor at AORN, Inc, Denver, CO.
Ms Cowperthwaite has no declared affiliation that could
be perceived as posing a potential conflict of interest in
the publication of this article.
Rebecca L. Holm, MSN, RN, CNOR
is the clinical editor for AORN Journal, AORN, Inc, Denver,
CO, and an RN in perioperative services at Skyridge
Surgery Center, Lone Tree, CO. Ms Holm has no declared
affiliation that could be perceived as posing a potential
conflict of interest in the publication of this article.
AORN Journal j 549
EXAMINATION

Continuing Education: Guideline

Implementation: Surgical
Instrument Cleaning 1.3 www.aorn.org/CE

PURPOSE/GOAL
To provide the learner with knowledge specific to implementing the updated AORN “Guideline for
cleaning and care of surgical instruments.”

OBJECTIVES
1. Explain the importance of processing surgical instruments correctly.
2. Describe steps that should be performed intraoperatively to prepare instruments for disinfection.
3. Describe the steps in the decontamination process.
4. Identify heating, ventilation, and air conditioning (HVAC) parameters specific to the decontamination area.
5. Identify special precautions to observe during instrument processing.

The Examination and Learner Evaluation are printed here for your convenience. To receive
continuing education credit, you must complete the online Examination and Learner Evaluation at
http://www.aorn.org/CE.

QUESTIONS 3. soaks the instruments in normal saline to remove

1. Instruments used in surgery bioburden when they are not in use.
1. should be properly cleaned and decontaminated. a. 1 and 2 b. 1 and 3
2. should be in good working order. c. 2 and 3 d. 1, 2, and 3
3. could compromise patient care if they are soiled or
working incorrectly. 3. Nurse M separates used and unused instruments and only
4. should be processed according to the manufacturer’s sends the used instruments to be processed to the sterile
written instructions for use. processing area.
5. could transmit pathogenic organisms to a patient or a. true b. false
health care worker if not processed correctly.
a. 4 and 5 b. 1, 2, and 3
c. 1, 2, 3, and 4 d. 1, 2, 3, 4, and 5 4. The HVAC parameters in the decontamination area are
maintained at
2. During the cataract procedure, Nurse M 1. positive air pressure.
1. removes gross soil from the instruments by wiping the 2. six total air changes per hour.
instruments with a sterile, lint-free sponge moistened 3. temperature between 72 F and 78  F (22 C and
with sterile water. 26  C).
2. periodically irrigates the lumens of instruments with 4. two outdoor air changes per hour.
sterile water to remove gross soil, immediately after a. 1 and 3 b. 2 and 4
use if possible. c. 2, 3, and 4 d. 1, 2, 3, and 4

550 j AORN Journal www.aornjournal.org

May 2015, Volume 101, No. 5
5. After cleaning, the sterile processing technician rinses the
instruments thoroughly with copious amounts of water
and performs a final rinse with
a. sterile deionized water. b. clean tap water.
c. sterile normal saline. d. distilled water.
6. The sterile processing technician inspects the instruments
under magnification to make sure there is no residual
ophthalmic _____________ present.
a. viscoelastic material b. thixotropic sludge
c. semicrystalline polymers d. cytoplastic material
7. When processing instruments that were used in a
neurosurgery procedure with a patient at risk for having
variant Creutzfeldt-Jakob disease, the instrument pro-
cessing technician uses cleaning chemicals that have
shown evidence of ______________ activity.
a. bacteriocidal b. bacteriostatic
c. prionicidal d. sporicidal
8. Allowing blood or other bioburden to dry on instruments
could make it more difficult to remove and could
www.aornjournal.org
Guideline Implementation: Instrument Cleaning
compromise the effectiveness of the subsequent disinfec-
tion or sterilization.
a. true b. false
9. Among other factors, incidents of toxic anterior segment
syndrome have been associated with
1. detergent residues remaining on instruments.
2. insufficient rinsing of instruments.
3. dried debris and residues of ophthalmic viscoelastic
material remaining on instruments.
4. insufficiently dried lumens.
a. 1 and 3 b. 2 and 4
c. 1, 2, and 4 d. 1, 2, 3, and 4
10. Authors of an integrative review recommended that
because a laryngoscope handle and blade are used
concurrently, both should be classified as semicritical,
which, at a minimum, requires
a. low-level disinfection. b. high-level disinfection.
c. sterilization.
AORN Journal j 551
LEARNER EVALUATION

Continuing Education Program:

Guideline Implementation:
Surgical Instrument Cleaning
1.3 www.aorn.org/CE

T his evaluation is used to determine the extent to

which this continuing education program met your
learning needs. The evaluation is printed here for
your convenience. To receive continuing education credit, you
must complete the online Examination and Learner Evaluation
8.

9.
Will you be able to use the information from this article
in your work setting?
1. Yes 2. No
Will you change your practice as a result of reading this
article? (If yes, answer question #9A. If no, answer
at http://www.aorn.org/CE. Rate the items as described below.
question #9B.)
OBJECTIVES 9A. How will you change your practice? (Select all that
To what extent were the following objectives of this apply)
continuing education program achieved? 1. I will provide education to my team regarding why
1. Explain the importance of processing surgical instruments change is needed.
correctly. 2. I will work with management to change/implement
Low 1. 2. 3. 4. 5. High a policy and procedure.
3. I will plan an informational meeting with physicians
2. Describe steps that should be performed intraoperatively to seek their input and acceptance of the need for
to prepare instruments for disinfection. change.
Low 1. 2. 3. 4. 5. High 4. I will implement change and evaluate the effect of
3. Describe the steps in the decontamination process. the change at regular intervals until the change is
Low 1. 2. 3. 4. 5. High incorporated as best practice.
5. Other: __________________________________
4. Identify heating, ventilation, and air conditioning
9B. If you will not change your practice as a result of
(HVAC) parameters specific to the decontamination area.
reading this article, why? (Select all that apply)
Low 1. 2. 3. 4. 5. High
1. The content of the article is not relevant to my
5. Identify special precautions to observe during instrument practice.
processing. 2. I do not have enough time to teach others about the
Low 1. 2. 3. 4. 5. High purpose of the needed change.
3. I do not have management support to make a
CONTENT change.
6. To what extent did this article increase your knowledge of 4. Other: __________________________________
the subject matter?
10. Our accrediting body requires that we verify
Low 1. 2. 3. 4. 5. High
the time you needed to complete the 1.3 con-
7. To what extent were your individual objectives met? tinuing education contact hour (78-minute)
Low 1. 2. 3. 4. 5. High program: _________________________________

552 j AORN Journal www.aornjournal.org