The best surgeons, anesthesia providers and nurses in the world can't provide safe, high-quality patient care if sterile processing doesn't do its job. But shockingly, despite the crucial nature of their assignment, and despite the negative publicity generated by outbreaks and mistakes in recent years, we're still falling short when it comes to reprocessing reusable medical instruments.
In the first 6 months of 2015, The Joint Commission cited more than half of all hospitals and surgery centers for noncompliance to the infection prevention and control standard (IC.02.02.01), according to the Association for the Advancement of Medical Instrumentation (AAMI). Why is it happening, and how can you make sure subpar sterile processing doesn't endanger lives and reputations at your facility?
First, let's acknowledge what might be a slightly uncomfortable truth. Sterile processing techs are often very underpaid and under-appreciated, considering the significance of the job they do. They're victims of supply and demand. Only 4 states (N.Y., N.J., Conn., and as of just recently, Tenn.) require sterile processors to be certified, and no special education or degree is required anywhere. So, theoretically, almost anyone can be hired to do the job.
Combine that reality with the limited resources often available to hospitals and surgery centers and it's easy to see how lapses happen. But if we didn't realize it before, we certainly should now in light of all the recent issues and publicity that proper training and continuous documented competency are absolute musts. Even if your state doesn't require your reprocessors to be certified, maybe your facility should.
Have an expert
How can you make sure your sterile processors are competent? Every facility should have a subject matter expert (SME) a manager, supervisor or educator who's responsible for staying up to date with current published standards and guidelines. The staying-up-to-date part is crucial. Your SME can't rely on what she learned 20, 10, or even 5 years ago. Change is constant, and compliance with evidence-based practice is a must.
Make sure you give your SME the resources she needs, including time and a budget. Along with access to the most current technical publications, she should attend national and local conferences, seminars and workshops. Meetings are invaluable for staying current, making contacts and networking with peers. Your SME has to be responsible for ensuring that polices are up to date, and that reprocessing staff members know and understand all procedures. Not everyone has what it takes to be an SME. The job requires someone who's able to think critically, be open-minded and be informed by evidence. The ability to communicate effectively is also a must.
Your sterile processing staff should be required to demonstrate competency every year, at least, which can be done in any of 3 ways: return demonstration, simulation or test-taking.
Certified or not, they want to do the right things. If they're being non-compliant or taking shortcuts, the issue is likely to be a lack of knowledge and resources. It's the job of the SME to make sure they're competent and that they understand how important it is that they follow instructions for use (IFUs) to the letter. You'll make it much easier for everyone to follow IFUs, which can be extremely long, tedious and challenging, if you keep them in an electronic binder. I recommend onesourcedocs.com, which takes all relevant IFUs and condenses them into what sterile processing needs to know for reprocessing. There's an annual subscription fee, but it's well worth it in the long run.
As an industry, we're more focused than ever on what it takes to reprocess reusable medical devices. It's about time we turned up the focus on reprocessing and competency. Obviously, nobody wants to end up being excoriated on 60 Minutes, and it's not just about passing accreditation surveys, either. This is about providing safe patient care. If you believe in following best practices, you have to make it a priority. You need a dedicated staff, and you need to do what it takes to make sure they are, and remain, completely competent. OSM