Short answer: Safe handling protects staff, patients and instruments. Use a neutral zone for sharps, pass instruments with the handle towards the surgeon, count before and after, keep instruments clean during the case and place them gently in trays.
Safety practices
- Neutral zone: Place sharps instead of hand-to-hand passing
- Correct passing: Handles to the surgeon, points down
- Counting: Before, during and after
- Wipe during case: Keep soil from drying
- Gentle handling: No throwing into trays
- Sharps disposal: Blades into sharps container
End-of-case routine
- Final count
- Remove blades and sharps
- Wipe and open instruments
- Keep moist for transport
- Place in closed container
- Send to sterile services
Protecting instruments
- Do not use as hammers or levers
- Keep fine instruments separate
- Do not overload trays
- Report damaged items
- Use tip protectors
In detail: why point-of-use care matters
Instruments cleaned within minutes are much easier to reprocess than those left for hours. Point-of-use care reduces stains, damage and cleaning failures.
Worked example
A theatre introduces a neutral zone tray and point-of-use wiping. Sharps injuries fall and sterile services report cleaner instruments.
Proof box
Proof: Perioperative nursing guidance recommends neutral zones for passing sharps and point-of-use treatment of instruments.
Frequently asked questions
What is a neutral zone? A defined area where sharps are placed and picked up.
Should instruments be soaked in saline? No; keep moist with water or products made for this.
Who counts instruments? Scrub and circulating nurses.
Why open instruments after use? To expose joints for cleaning.
Glossary
- Scrub nurse: nurse handling instruments in the sterile field.
- Point-of-use: at the place of use.
- Sharps: blades, needles and pointed items.
Key takeaways
- Neutral zone for sharps
- Wipe and keep moist
- Handle gently
Standards and sources
- AORN (Association of periOperative Registered Nurses)
- Related: instrument counts (see Why are surgical instruments counted before and after surgery?), cleaning guide (see The complete guide to cleaning and sterilising surgical instruments)
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