Execute end of case procedures

27. After a completion of a CABG, the circulating nurse states "Dressings are on and we have another case to follow. Go ahead and clean up your table." Which of the following statement is the best reaction? A. "I'll breakdown; I have a knife handle loaded." B. "Agreed, the patient dressings are on." C. "I will once the patient is out." D. "Agreed, it will allow for a quick turnover."

"I will once the patient is out." Rationale The back table and Mayo must remain sterile in case the patient needed to be placed back on cardiopulmonary bypass after the procedure is complete but before the patient leaves the room. Cleaning up your back table and Mayo before the patient leaves the room is never allowed under any circumstance in open heart procedures.

6. Which of the following does not need to be cleaned in the operating room after every case? A. Surgical lights B. Standing stools C. Equipment D. Air filter vent

Air filter vent Rationale The air filter vent needs to be changed 3-4 times a year. It is not necessary to change air filter after every case. Surgical lights are being handled intraoperatively and may house unseen particles and should be cleaned after every case even if it appears to be clean. Equipment should always be cleaned after each surgical case and patient as equipment also can house bodily fluids and particles from the case. Standing stools collect fluid from the case which includes blood and should be cleaned properly after every case.

37. Place the following steps for transferring the patient from the operating table to the stretcher in the correct order. (Click and drag the options in the left column to their correct position in the right column.) Transfer the patient under the anesthesia care providers' direction. Transfer medical equipment and devices. Make sure all tubing and drains are freed up. Align the stretcher with the O.R. bed and lock the wheels. Cover the patient and raise the side rails.

Align the stretcher with the O.R. bed and lock the wheels., Make sure all tubing and drains are freed up., Transfer medical equipment and devices., Transfer the patient under the anesthesia care providers' direction., Cover the patient and raise the side rails. Rationale To safely transfer a conscious patient to the stretcher, first you must make sure the transfer cart is properly positioned and locked next to the OR bed. Then before the patient moves over, free up any IV or catheter tubing. Then the patient can be moved over using a patient transfer device. Anesthesia always coordinates the movement of patients. Once the patient is on the transfer cart, immediately raise the side rails to prevent an accidental fall out of the cart.

29. Place the steps below in the correct order for processing instruments in decontamination received from the OR. (Click and drag the options in the left column to their correct position in the right column.) Scrub off bio burden. Open all box locks and ratchets. Check for sharps. Rinse the instruments. Put the instruments in the washer.

Check for sharps., Open all box locks and ratchets., Scrub off bio burden., Rinse the instruments., Put the instruments in the washer. Rationale When handling instruments that have just arrived in decontamination, always make sure there were no sharps left on any instruments or in the tray to prevent injury when you begin cleaning the instruments. All box locked and racheted instruments must always be cleaned open so the cleaning solution can get into the rachet. Now you can scrub off any residual bioburden from the instruments. Instruments are now ready to be rinsed in distilled water before the final step of placing in the instruments in the washer. The washer further cleans, the instruments but does not sterilize the items at this point.

8. The surgical technologist has just completed a flexible bronchoscopy procedure on a patient with acute bronchitis. The next case will require the same bronchoscope. Which of the following actions should the surgical technologist take with the bronchoscope? A. Clean the bronchoscope according to standard procedures. B. Discard the bronchoscope. C. Flash sterilize the bronchoscope. D. Place the bronchoscope in water.

Clean the bronchoscope according to standard procedures. Rationale Cleaning it according to standard procedures ensures that the bronchoscope is properly cared for and clean for it's next use.

33. The surgical technologist has just completed a laparoscopic cholecystectomy with cholangiogram. Which of the following tasks must the technologist complete at this time? (Select the three (3) correct answers.) A. Transport the patient to the post-anesthesia care unit. B. Communicate the amounts of contrast and local anesthetic used to the circulator. C. Break down the surgical field. D. Transport instruments to the decontamination area. E. Begin opening for the next procedure.

Communicate the amounts of contrast and local anesthetic used to the circulator., Break down the surgical field., Transport instruments to the decontamination area. Rationale Once the procedure is completed, the amount of any contrast and local used during the procedure must be communicated to the circulator for documentation. The surgical field can be broken down at this time because the drapes need taken off the patient and the patient cleaned up. The used instruments must be taken to decontamination after every case. Patient transport to PACU must be performed by the anesthesia care provider as well as the circulating nurse to give the patient status report to the PACU nurses. The next procedure cannot be opened until the patient is safely in PACU and the OR is cleaned.

24. Which of the following should the surgical technologist do with the instruments following a cystoscopy? (Select the three (3) correct answers.) A. Close all channels of the cystoscope. B. Disassemble the instruments. C. Open all channels of the cystoscope. D. Place cameras with cords on top of the cystoscope in the tray. E. Loosely coil cords.

Disassemble the instruments., Open all channels of the cystoscope., Loosely coil cords. Rationale Since the cystoscopy has finished, it is necessary to dissemble and take apart everything that was put together to perform the surgery. All channels that were closed should be opened before they are transported to sterile processing. Loosely coil cords so that they are not damaged. Cameras and cords should not be placed on top of the tray because it will damage the telescopes.

40. Place the steps below in the proper order for manually cleaning instruments. (Click and drag the options in the left column to their correct position in the right column.) Rinse all instruments in cold water. Don PPE. Soak instruments in detergent. Clean lumens while submerged.

Don PPE., Soak instruments in detergent., Clean lumens while submerged., Rinse all instruments in cold water. Rationale Donning PPE is the first thing which should be done prior to cleaning instrumentation. Secondly, the instruments should be soaked in a detergent. Thirdly, instruments should be cleaned while they are submerged. Finally, they should be rinsed in cold water.

38. Which of the following actions should the surgical technologist take for soiled instruments prior to transportation to the decontamination area? (Select the three (3) correct answers.) A. Cameras, light cables, pneumatic drills and other delicate equipment should all be transported separate in one basin filled with saline to avoid biofilm buildup. B. During surgery, instruments exposed to blood and body tissue are periodically wiped free to prevent caking and drying. C. Water is avoided for cleaning or soaking instruments because it causes pitting, rusting, and corrosion. D. Sharp instruments are separated out to prevent injury. E. Instruments can be placed in a separate basin with the heaviest ones at the bottom and lighter ones on top.

During surgery, instruments exposed to blood and body tissue are periodically wiped free to prevent caking and drying., Sharp instruments are separated out to prevent injury., Instruments can be placed in a separate basin with the heaviest ones at the bottom and lighter ones on top. Rationale Saline should not be used on metal instruments because it can cause them to pit and rust. Instrument cleaning should begin at the point of use by using sterile water to wipe instruments down during the procedure. Instruments should be placed back with heaviest on the bottom and lightest on the top to prevent damaging the more delicate instruments. Cameras and light cords should never be submersed in saline.

3. How should the surgical technologist transport dirty instruments for decontamination? A. Immediately contained and taken for decontamination. B. Let the instruments sit out to dry to kill any pathogens before transport. C. Soak in saline and sit in the hallway for an hour to allow the salt to clean the instruments. D. Clean the instruments in the OR because there is no need to bring them to decontamination.

Immediately contained and taken for decontamination. Rationale Instruments should be wiped of all visible blood using a towel or a lap sponge that has been dampened with sterile water. Soiled instruments should never be left to dry or soaked in saline. Soiled, contaminated instruments should be sent to decontamination as soon as possible.

25. Which of the following is the responsibility of the surgical technologist when transferring a patient from the OR table to a stretcher? A. Lock the wheels prior to transfer. B. Hold the patient's head when transferring. C. Begin breaking down the back table. D. Assess the patient for skin tears after the transfer.

Lock the wheels prior to transfer. Rationale The surgical technologist as well as any surgical team member can make sure the transfer bed wheels are locked before transferring the patient onto it. It is the anesthesiologist's responsibility to hold the head during transfer. Always participate in assisting the patient before cleaning the back table. Any patient assessment such as observing skin tears should be made by the circulator.

34. Place the surgical technologist post-procedural duties in the correct event sequence. (Click and drag the options in the left column to their correct position in the right column.) Transport instruments to the decontamination area. Maintain field sterility until patient has left the OR. Separate instruments and break down the sterile field. Assist with room turnover.

Maintain field sterility until patient has left the OR., Separate instruments and break down the sterile field., Transport instruments to the decontamination area., Assist with room turnover. Rationale It is best practice to keep the back table sterile until the patient has left the room in the event of an emergency required resuming the surgical procedure. After the patient leaves the room, instruments must be separated to get ready to send to decontamination. The rest of the sterile field can also be broken down. Now all dirty equipment can go to decontamination and the room turnover process can be completed.

5. What are the correct measures to prevent bioburden from forming on instruments? (Select the three (3) correct answers.) A. Placing a wet towel over the instruments. B. Soaking instruments in a basin of saline. C. Placing the instruments in Cidex. D. Flushing lumens with sterile water, wiping down instruments intraoperatively, and spraying instruments down before leaving the OR suite.

Placing a wet towel over the instruments., Placing the instruments in Cidex., Flushing lumens with sterile water, wiping down instruments intraoperatively, and spraying instruments down before leaving the OR suite. Rationale Instruments should never be soaked in saline. Saline destroys the integrity of the instruments, causing them to be unsafe for surgery. Safe practices for preventing bioburden include, placing a wet towel over instruments, placing the instruments in Cidex, and flushing lumens with sterile water, wiping down instruments intraoperatively, and spraying instruments down before leaving the OR suite.

16. Which of the following metal suction devices has a removable guard with multiple holes and needs taken apart prior to sterilization? A. Yankauer B. Baron C. Poole D. Frazier

Poole Rationale The Poole suction tip has a removable guard. The Yankauer, Baron, and Frazier do not have removable parts.

23. Place the options below in the correct order for removing and discarding drapes postoperatively. (Click and drag the options in the left column to their correct position in the right column.) Remove any equipment, instruments, cords and tubing. Pull drapes slowly away from the head proceeding downward. Place drapes in proper disposal bag. Apply appropriate wound dressing.

Remove any equipment, instruments, cords and tubing., Apply appropriate wound dressing., Pull drapes slowly away from the head proceeding downward., Place drapes in proper disposal bag. Rationale Before the drapes can be removed, any instruments or equipment on the top of the drape must be removed to avoid being thrown away. The dressing should be applied and covered before drape removal. The drape should be removed starting at the head and rolling the drape up toward the feet, containing any biohazard to the inside of the drape. The drapes should then be placed the proper trash receptacle.

10. The surgical procedure is complete and dressings are on the patient. Place the steps below in the correct order for removing the drapes. (Click and drag the options in the left column to their correct position in the right column.) Place the drapes in a biohazard bag. Remove instruments and equipment. Wrap the drapes toward inside containing blood or fluid. Pull the drapes away from the patient starting from head to feet.

Remove instruments and equipment., Pull the drapes away from the patient starting from head to feet., Wrap the drapes toward inside containing blood or fluid., Place the drapes in a biohazard bag. Rationale Before the drapes can be removed, any instruments or equipment on the top of the drape must be removed to avoid being thrown away. The drape should be removed starting at the head and rolling the drape up toward the feet, containing any biohazard to the inside of the drape. The drapes are considered biohazard since they are contaminated with blood or body fluids.

19. Which of the following is occurring during the postoperative phase of surgery? (Select the three (3) correct answers.) A. Traffic into and out of the OR is restricted. B. Unused supplies are returned to appropriate area. C. The sterile field is preserved until the patient has left the room. D. Sterile furniture is moved into position. E. Specimens are taken to the proper area for transport.

Unused supplies are returned to appropriate area., The sterile field is preserved until the patient has left the room., Specimens are taken to the proper area for transport. Rationale The postoperative phase begins as soon as maintenance anesthesia has ended and the patient is safely transported to PACU. Since the surgical procedure has concluded, the unused supplies may now be returned and specimens obtained during the procedure can now be placed in their appropriate area. Until the patient has exited the room, the sterile field should be maintained. Sterile furniture should be in place prior to beginning a procedure. Traffic in and out of the room is restricted in the intraoperative phase to prevent contamination during the case.

39. After a final count is performed following an abdominal aortic aneurysm, which of the following should the surgical technologist do immediately after dressing the wound? A. Dispose of sharps in an approved container. B. Place a wet towel over all instruments with box locks open, place in a leak-proof container and transport to decontamination. C. Gather unused supplies to be returned in the supply room. D. Wait to break down the set up until the patient has been transported to the PACU.

Wait to break down the set up until the patient has been transported to the PACU. Rationale It is crucial to remain sterile and keep the sterile field intact in the event it becomes necessary to re-open the patient. Do not send any supplies to decontamination or dispose of sharps until the patient is safely transported to PACU.

4. When should the scrub person begin cleaning and dismantling sterile instruments at the end of a procedure? A. When the patient is out of the room. B. After the secondary wound dressing has been applied. C. After the soiled drapes have been taken off the patient. D. When the surgical team verbalizes agreement to surgical time out.

When the patient is out of the room. Rationale The scrub person should begin cleaning and dismantling sterile instruments when the patient is out of the OR. Dismantling sterile instruments before the patient is out of the room puts the OR team at risk for contamination if the patient's dressing needs to be removed or changed it should be done in a sterile manner. In case of an emergency and the patient needs to be reopened new instruments will need to be retrieved and opened if sterile instruments are not kept sterile until the patient is out of the OR.

41. Once surgical instruments are broken down and placed back in the case cart, which of the following locations should they be taken to? A. a sub-sterile room B. an instrument storage area C. a decontamination area D. a sterile processing area

a decontamination area Rationale After the case, the decontamination area is where instruments are placed into a washer-decontaminator or washer- sterilizer before instruments can be safely handled with bare hands in the sterile processing area. An instrument storage area contains already sterilized items ready to be used. A sub-sterile room is another room for a room with scrub sinks and/or blanket warmers outside the operating room.

21. Which member of the surgical team guides and directs the move when transferring a patient from the OR table to the stretcher? A. surgeon B. circulating nurse C. surgical technologist D. anesthesiologist

anesthesiologist Rationale No other surgical team member is permitted to initiate a patient transfer other than the anesthesiologist because he is in charge of the patient's airway. On his signal, the anesthesiologist will lift the head and slide it over while the rest of the surgical team assists with moving the rest of the patient to the transfer bed.

11. When moving the anesthetized patient from the table to the stretcher, which of the following individuals decides when the patient is ready for moving? A. circulator B. surgeon C. anesthesiologist D. surgical technologist

anesthesiologist Rationale The anesthesiologist is responsible for coordinating the movement of the patient because they are in charge of the patient's head and airway. The remaining team members must be positioned on either side of the patient and one person at the foot of the bed.

42. Which of the following is the proper method to transfer soiled instruments from the OR to the Sterile Processing Department? A. clamps open, soaking in a basin of water B. instruments with multiple parts sent assembled C. instruments locked and off the stringer D. clamps locked, soaking in a basin of saline

clamps open, soaking in a basin of water Rationale Instruments should be transferred to sterile processing with the instrument clamps opened and soaking in water to begin the decontamination process. Anything that was assembled at the beginning of the case must be unassembled for decontamination. Saline must never be used to clean instruments because it can cause the metal to pit and rust. By opening clamped instruments, it helps prevent instruments from being sterilized clamped, which would cause the ratchet to not be sterilized.

35. Which of the following are used to clean instruments at the end of the procedure? (Select the three (3) correct answers.) A. enzymatic solution B. saline C. alcohol D. detergent solution E. sterile water

enzymatic solution, detergent solution, sterile water Rationale Saline must never be used to clean instruments because it can cause the metal instruments to pit and rust. Alcohol is not used on instruments: it is an antiseptic prep solution used on skin. Sterile water, enzymatic cleaner and detergent are all acceptable options to begin the instrument cleaning process without damaging the instruments.

20. When removing PPE, it is important to remove A. gown before gloves. B. gloves before gown. C. eye protection after mask. D. mask after eye protection.

gown before gloves. Rationale If the gloves were removed before the gown, you would contaminate your hands by touching the used gown while trying to remove the gown. The gown should be removed first, then the gloves, then the eye protection and mask removed last.

31. Which of the following PPE is a surgical technologist working in decontamination required to wear? (Select the three (3) correct answers.) A. hair cover B. sterile gown C. non-sterile gloves D. face shield E. sterile gloves

hair cover, non-sterile gloves, face shield Rationale A non-sterile gown and gloves, hair covering and face shield are necessary to protect the surgical tech during the decontamination process. Sterile gowns and gloves are only for use during the surgical procedure. A waterproof apron would be required in decontamination because the person will be immersing instruments in a large sink of water to initially rinse the instruments. A face shield will protect the person from any accidental splashing of water, cleaning solution, or bioburden onto the face. Shoe covers are also required to keep the feet clean from any splashing of fluids from the sink to the floor.

30. Which of the following items in the OR suite should be cleaned after a laparoscopic cholecystectomy is performed? (Select the three (3) correct answers.) A. walls B. horizontal furniture C. light fixtures D. shelves E. wheels or casters

horizontal furniture, light fixtures, wheels or casters The walls only need cleaned after a case if there is visible bioburden on them. Light fixtures should be wiped down in case bioburden was splashed up onto them during the procedure. Horizontal furniture such as the back table and OR bed and their wheels should always be wiped down after each case. Shelves only needs to be wiped down during the end-of the day cleaning and prior to the first case of the day.

22. Which of the following instrument loads should have a biological indicator during the sterilization process? A. neuro dissecting instrument tray B. implantable instrumentation tray C. vascular instrument tray D. retractor instrument tray

implantable instrumentation tray Rationale A biological indicator using Geobacillus stearothermophilus is needed on each load containing an implantable device and that load should be quarantined until the results of the biological indicator are available. Routine instrument trays, such as the neuro dissecting, vascular, and retractor trays, are monitored every load with an internal chemical indicator strip.

28. Which of the following sharps go on magnetic board or sharps holder when breaking down the back table after a procedure? A. harmonic scalpel tip B. clip applier C. knife blade D. trocars

knife blade Rationale The knife blades are best contained safely on the magnetic strip in the sharps box. The Harmonic scalpel tip is not shaped like a traditional knife blade. It looks more like a clamp and does not have sharp tips on it. The clip applier and trocars are too large to be placed in the sharps box on the back table.

32. When performing a room turnover the OR walls and ceiling should be cleaned and disinfected A. after every invasive procedure. B. only if contaminated by evident bioburden. C. from bottom to top. D. only during scheduled terminal cleaning every twenty four hours.

only if contaminated by evident bioburden. Rationale Ceilings and floors are included in the terminal or "end-of-day" cleaning from top to bottom, but that is not the only time they are cleaned. Walls and ceilings must also be cleaned if there is visible bioburden.

9. When cleaning and preparing instruments to be sterilized after surgery, the surgical technologist should A. soak instruments in normal saline to remove bioburden. B. open box locks and ratchets. C. flush suction lumens with normal saline. D. immerse light cords in a standard enzymatic solution.

open box locks and ratchets. Rationale Instruments should be opened and not closed so that the enzyme solution spray or foam can begin the process of breaking down any blood or debris. Saline is not used on instruments because it pits them and can damage instruments. Light cords should not be immersed in any liquid.

7. When preparing laparoscopic instruments for decontamination and sterilization, the surgical technologist should A. leave the cords intact. B. flush the lumens with saline. C. orient the instruments with the working tips closed. D. orient the instruments with the working tips down.

orient the instruments with the working tips down. Rationale This helps ensure that the instruments are adequately stored and prevents breakage. When breaking down any case, it is essential to remember NEVER to flush or point of use clean instruments with saline. ALWAYS use water. While orienting instruments for decontamination containers, it is imperative they are open. This is helping the decontamination process easier and quicker. This will ensure the decontaminant reaches all areas of the soiled instruments. When performing laparoscopic surgery, any camera cords or light cords used for the surgery must be dissembled to ensure complete and proper cleaning and sterilization process.

14. When the patient is being transferred from the OR table after surgery, the movement should be A. swift but cautious in order to get to the Recovery Room as quickly as possible. B. performed with the comfort of the patient as the primary concern. C. gentle and rapid so that the patient does not wake up. D. gentle and slow in order to prevent circulation depression.

performed with the comfort of the patient as the primary concern. Rationale Never compromise patient safety by trying to do things too quickly. The patient's comfort should be a concern after the procedure because they may be awake and in pain.

18. When breaking down the sterile field for turnover the surgical technologist should first A. place instruments in the case cart. B. place sharps in the sharps container. C. place linen in the hamper. D. remove the case cart.

place sharps in the sharps container. Rationale Always remove the potential for a sharps injury first by placing the sharps in the specified container. Then it would be safe to begin to break down the back table, place instruments in the case cart and linen in the hamper. The case cart would be removed from the room last.

1. At the end of a procedure, there are many unused supplies left on top of the case cart. The surgical technologist should A. throw the items away. B. put the items back in their appropriate stocking location. C. keep the items in the room for the next day. D. bring the items to another room to see if they could use the supplies.

put the items back in their appropriate stocking location. Rationale Supplies should be put away at the end of the day to prepare for the following procedure and account for proper inventory control. Items that are not used should not be discarded as long as they are in their original packaging and are not soiled or damaged and sterility has not been compromised. Items from the previous day's case should not be left in the room as the next day's cases may be totally different. Bringing the items to another room to see if they can use them is not necessary because they would most likely already have all of the appropriate supplies in the room for the cases that are being done.

12. Before sending surgical instruments to CSP for decontamination, the surgical technologist must A. ensure all instruments are put back on the stringer and closed. B. ensure all instruments are put back on the stringer and left open. C. spray all contaminated instruments with saline. D. spray all contaminated instruments with water.

spray all contaminated instruments with water. Rationale Water is the best thing to use on metal instruments because it does not harm the instruments. Saline should never be used on instruments, because it contains salt and will pit and corrode the instruments. Instruments should not be put back on the stringer closed because they cannot be properly cleaned while closed. All instruments should always be cleaned by hand.

13. Which of the following should the surgical technologist do first with instruments that have been used during surgery? A. soak in saline B. let dry C. re-string D. spray with enzymatic cleaner

spray with enzymatic cleaner Rationale The first step of the decontamination process is to spray instruments with an enzymatic cleaner to get rid of blood and protein materials. Saline cannot be used because it pits and is corrosive to instruments. Letting blood and debris dry on instruments makes the decontamination process harder. Instruments should not be restrung because they need to be free of debris and hand washed.

2. The surgical technologist has just finished a tonsil and adenoidectomy procedure. The surgeon has asked for a quick turnover for the next case. The patient is still intubated in the room, but the procedure is finished. To facilitate a quick turnover, the surgical technologist should A. begin to break down the back table. B. break scrub and go pull the next case cart. C. break scrub and go bring the bed into the room. D. stay scrubbed in and maintain sterility of the back table.

stay scrubbed in and maintain sterility of the back table. Rationale For this scenario, the surgical tech should maintain the sterile field to be prepared for any post-op complications that may occur until the patient has left the room. If a surgical technologist breaks down the back table, breaks scrub, and brings the bed into the room, this is counterproductive to helping the patient if any complications should arise while the patient is in the room.

15. Which of the following solutions is best for presoaking instruments in the OR at the end of a procedure? A. sterile water B. isopropyl alcohol C. enzymatic detergent D. hydrogen peroxide

sterile water Rationale Instruments should be transferred to sterile processing with the instrument clamps opened and soaking in water to begin the decontamination process. Anything that was assembled at the beginning of the case must be unassembled for decontamination. Saline must never be used to clean instruments because it can cause the metal to pit and rust. By opening clamped instruments, it helps prevent instruments from being sterilized clamped, which would cause the ratchet to not be sterilized. Enzymatic detergent is more frequently used once the instrument has been removed from the OR and brought to the decontamination room.

36. When breaking down the back table, which of the following solutions is used to clean your instruments? (Select the two (2) correct answers.) A. saline B. sterile water C. alcohol D. enzymatic solution E. Hibiclens

sterile water, enzymatic solution Rationale Hibiclens is an antiseptic skin solution. Saline should not be used on metal instruments because it can cause them to pit and rust. Alcohol shouldn't be used because it is an antiseptic skin prep solution. Sterile water and enzymatic cleaners are the only two acceptable cleaning solutions to use while cleaning them at your back table.

17. It is acceptable to flash sterilize an instrument for immediate use when A. there is insufficient time to sterilize by the preferred methods. B. the hospital needs to maintain less inventory. C. the flow of surgery cases through the OR needs to better managed. D. the surgeon is in a hurry and the team needs to decrease turnover times.

there is insufficient time to sterilize by the preferred methods. Rationale Items for immediate use should only be done when there is no other source or route to use. It is not to be done just because the hospital does not have enough inventory to do all the cases. Additionally, it should not be done just to hurry cases or when the flow of the surgeries has not been considered.

26. Which of the following is the first priority during an environmental cleaning of the surgical suite? A. wearing correct PPE B. cleaning all surfaces in OR C. removing contaminated waste D. unlocking the OR table

wearing correct PPE Rationale Before coming in contact with any contaminated items, don PPE to minimize your exposure to microbes. Once you've donned your PPE, then you can start cleaning the surgical suite and unlock the OR table to clean it if necessary.