Enhanced PPE among updates to improve instrument sterilization safety

Editor's Note

Updates to evidence-based guidance in the AORN 2026 Guideline for the Care and Cleaning of Surgical Instruments were summarized in a November 7 AORN news story to outline key updates such as new PPE recommendations for perioperative staff working in the decontamination area. For example, new recommendations in the updated guidance call for PPE with the highest level of fluid protection possible, including the use of fluid-resistant surgical mask, face shield, fluid-resistant gown with thumb loops attached to the cuff, general purpose utility gloves with extended fitted cuffs, and fluid-resistant shoe covers or boots.

The news story also summarized strengthened recommendations for borescope inspections and cleaning verification practices. For example, borescope inspections were discussed for routine verification as well as when evaluating new, repaired, refurbished, or loaned instruments to identify internal damage or residue before use. This includes complex robotic instruments, arthroscopic shaver hand pieces, and suction cannulas with narrow channels that can be difficult to clean and inspect, per the news story.

Other updates described from the 2026 guideline addressed new direction on transporting contaminated instruments off-site to standardize oversight and maintain a consistent standard of care that also complies with federal regulation. Clearer point-of-use treatment, steps for delayed cleaning, water quality expectations, and discussion regarding mechanical perfusion to flush lumens in complex devices were also highlighted.