Way back when I was working as an operating room nurse in a tertiary healthcare facility, I was assigned as the circulating nurse during a phacoemulsification of cataract procedure. The scrub nurse assisting the surgeon that day was an external staff member from another facility.
After the procedure, I observed her bringing the used surgical instruments to the scrub sink located along the hallway just outside the operating room. Instead of properly cleaning the instruments, she simply rinsed them under running water—without using enzymatic cleaner or following our facility's standard decontamination protocols.
I immediately intervened and reminded her that the scrub sink was designated strictly for handwashing and not for instrument cleaning. I explained that our facility maintains a separate decontamination room—located approximately 20 steps away—where all used instruments are to be transported. There, they must be soaked in an enzymatic cleaner to break down bioburden, ensuring thorough cleaning and infection control before sterilization.
To ensure compliance, I personally accompanied her to the decontamination room. I walked her through the correct process, ensuring that the instruments were properly soaked for the appropriate contact time with the enzymatic cleaner before further cleaning steps. She did make a face while I was supervising her—clearly not thrilled about being corrected—but if it’s for the safety of the patient, it’s worth the effort. Upholding strict infection control standards must always be observed.
She followed the proper steps as I guided her through the decontamination process. She may have felt uncomfortable about being called out, which could be why she chose not to engage with me after the incident. Regardless, I remained observant and continued to monitor her practices after subsequent ophthalmic procedures. Over time, I noticed that she consistently followed the correct reprocessing protocols I had previously emphasized, which reassured me that the intervention had a positive impact on her practice and, ultimately, on patient safety.
Based on the CDC Guideline for Disinfection and Sterilization in Healthcare Facilities (2008), items must be cleaned using water with detergents or enzymatic cleaners at the designated Decontamination Area before processing. Enzyme solutions should be used in accordance with manufacturer’s instructions, which include proper dilution of the enzymatic detergent and contact with equipment for the amount of time specified on the label.
The next time I would encounter an external staff member, I would cordially ask if they are familiar with the locations of the essential stations—such as the Core Room, Scrub Area, Slop Sink, Decontamination Room, and the Drying and Packaging Area. I would be more than willing to show them around, as familiarity with these key areas greatly contributes to workflow efficiency and supports smooth coordination within the surgical team.
I’m naturally a warm and friendly person, but when it comes to protocol violations, especially those involving decontamination and the disposal of infectious waste, I don’t hesitate to speak up. Upholding sterility in the Surgery Suite is non-negotiable. As nurses, it is our responsibility to help break the chain of infection, safeguard our patients, and ensure a safe working environment for ourselves and our colleagues.