As surgical instrumentation and equipment become more sophisticated and regulatory scrutiny on infection prevention practices in ambulatory surgery becomes more intense, it's increasingly important for you to regularly assess and ensure the competency of your sterile processing personnel. Here's a simple step-by-step approach you can follow.

What constitutes competency?
Start by establishing a competency-based job description for your sterile processing personnel that identifies the knowledge, skills and behaviors they need to perform well. This job description then becomes the "contract" with the employee, detailing performance expectations. Use this job description to shape the competencies you'll give staff upon hire.

For annual competency verification, write your competency statements with a goal in mind, and be selective. Don't try to have a competency for every task; instead, zero in on the high-risk/high-volume or high-risk/low-volume sterile processing procedures at your facility. Keep your competencies focused on daily tasks, as these will cause the most serious problems if not performed correctly. Also be sure to include regulatory requirements, such as what types of personal protective equipment staff must wear when performing certain duties. When developing your job description or competency statements, whether you're describing knowledge or performance areas, use action verbs such as "describes," "names," "knows," "understands," "demonstrates," "performs," "interprets" and "records."

For details on the types of knowledge and skills needed for competent performance by an ambulatory surgery sterile processing technician, download a free form at www.outpatientsurgery.net/forms.

Performing effective competencies
Observation is an excellent method of assessing the competency of your sterile processing staff. After the initial evaluation, have employees sign the competency forms stating their performance rating and whether they had any unsatisfactory areas that require additional training. If your initial evaluation of an employee's performance on day-to-day sterile processing tasks is unacceptable, provide retraining for that employee immediately and document this process. Conduct a second evaluation within 1 to 2 weeks of retraining to determine whether competency has been achieved.

Here are some pointers for conducting the 3 types of competencies:

• Training and orientation. Focus on all the core competencies necessary for your facility's services. Provide staff with educational materials that are easy to understand and evidence-based (for example, AAMI Standards, found at www.aami.org/standards). For each task you're teaching, require a return demonstration and ask the employee specific questions about the task (for example, "Which detergents are used for cleaning?"). Document all orientation performed and the return demonstration results, and keep these for your records.
• Annual competency testing. Select key tasks and knowledge areas required for competent performance that have caused problems in the past or that are not frequently performed (for example, changing paper in the sterilizer printer), and have employees demonstrate their abilities to complete these tasks. Be sure to document all annual competency testing.
• Special competencies for new devices/procedures. Whenever your facility obtains new equipment or instrumentation (including loaners), you need to make sure your staff are proficient at using, handling and cleaning the new devices according to their manufacturers' instructions. Manufacturers will often provide competency checklists to help with training and assessment. If they don't, develop a list of tasks and knowledge needed for proper use of the new device or equipment and document each employee's return demonstration of these tasks.

While in-house training and assessment are important, the best method for verifying the competencies of your sterile processing staff is certification. The Association for the Advancement of Medical Instrumentation recommends that "all personnel performing sterile processing activities be certified as a condition of employment. At a minimum, all such personnel should successfully complete a central service certification examination within 2 years of employment and should maintain that certification throughout their employment." The Certified Ambulatory Surgery Sterile Processing Technician is a 5-year, competency-based certification provided by the Certification Board for Sterile Processing & Distribution, which also offers study materials and guides that can be used for training as well as preparation for certification.