Improper “pre-cleaning” of instruments at the point of use poses a potential risk of infection to patients. Hospitals continue to struggle with achieving high compliance with the removal of visible bioburden from the instruments prior to transport. In 2018, an accreditation agency reported 70% of surveys resulted in citations concerning improperly cleaned or disinfected medical equipment, devices, and supplies. The objective of this initiative was to simplify the decision-making process for the front-line staff and to standardize the process of dirty instrument transport to the Sterile Processing Department (SPD).

In January of 2019, the hospital conducted a risk assessment to examine their process for dirty instrument transport in detail and identified gaps in compliance. A complete review of all procedures was performed to determine the best method for “pre-cleaning” and transport of instruments. The SPD posted step-by-step instructions in the department and carts that were used for instrument transport were tagged with instructions.

A total of 16 units conducted procedures at the bedside that required instruments to be transported to the SPD. All supplies necessary (enzymatic cleaner, transport container with biohazard label, and instructions) for the transport of dirty instruments were readily available in SPD. This process improvement reduced the variability in transport of dirty instruments, while increasing compliance with the use of an enzymatic cleaner at the point of use.

This initiative demonstrates that tagging the carts increases compliance with the use of an enzymatic cleaner at point of use and the transport of dirty instruments. The results were validated with no findings of noncompliance during infection control rounds. Tagging the carts with instructions increases patient safety, and simplifying the process increases staff satisfaction with performance of infection control procedures.