From Last Stitch to Clean Room

In practice

The last skin stitch is placed in a gallbladder removal. Jordan, the scrub person, has kept the instruments wiped and moist through the case. After the dressing is on and the patient has left the room, Jordan, still in protective equipment, removes the blades from the knife handles with an instrument, not with fingers, and places them in the sharps container with the used needles. Jordan opens every hinged instrument, takes apart the instruments that come apart, and keeps the pieces together in the tray. The instruments are moistened as policy directs, placed in the transport container, and the lid is closed; the container carries the biohazard label. Jordan bags the drapes and linen at the table, without shaking them, and seals the trash. The environmental services team arrives. They clean and disinfect the operating table, the equipment that was touched, and a blood spot on the floor near the table, leaving each surface wet for the time on the product label. The container goes to the decontamination area by the soiled route. There, a technician in heavy gloves, a gown and a face shield receives it, sorts the instruments, and loads the washer-disinfector, hinges open and nothing stacked. Later, in the packaging area, each instrument is inspected before the set is assembled. Back in the operating room, the circulating nurse checks that the room is clean and begins setting up for the next patient.