Within perioperative services, many departments must coordinate the services they provide to ensure patients receive safe and efficient care. The operating room (OR) nurse is responsible for ensuring the operating room is a safe environment for the patient and the surgical equipment is in good working order. The sterile processing department (SPD) plays a vital role in infection control as they are responsible for applying the proper principles of cleaning, testing, assembly, packaging and sterilization for all reprocessed instruments. Given all of the advances in technology and the complexity of instrumentation, this requires a collaborative effort as well as trust between the OR and SPD staff which is made up of a large number of diverse individuals with a range of backgrounds and education. This continuing education activity will discuss strategies for effective communication between the OR and SPD, the relationship between biofilm and improper instrument care as well as the consequences of improper instrument care and handling. The instrument “use cycle” will also be reviewed as it relates to the handling of surgical instruments and trays. Finally, opportunities for improved relationships between the OR and SPD will be discussed to promote safe and efficient patient care.