From meticulous bedside pre-cleaning to high-level disinfection, endoscope reprocessing is a complex process that benefits greatly from standardization. That’s no easy task when you consider the potential disparity in skill and experience among incoming reprocessing techs. But regardless of whether your techs have multiple advanced certifications or are starting the job green, your training should aim to standardize everything about how they approach the tough task of turning around endoscopes.
• Shadow a veteran tech. One way to ensure consistency in the reprocessing process is to have new hires shadow an experienced staff member, who can demonstrate each step until they’re sure it clicks. The new techs can then complete the same steps repeatedly until the specifics are ingrained in their muscle memory.
Christine Young, a surgical technician and the cleaning room manager at Greenwood (S.C.) Endoscopy Center, remembers her training well. Ms. Young shadowed a veteran tech who had worked at the facility for 16 years, all day, every day, and watched everything she did over and over again until the trainer felt she was ready for hands-on learning herself. “Eventually, she’d say, ‘OK, go ahead and jump in there and you start now,’” says Ms. Young. “And if I was doing something wrong, she’d correct me.” Ms. Young’s trainer officially handed off the reins to her about a year ago, and now she heads up the endoscope reprocessing training at Greenwood, using the exact same teaching approach as her predecessor.
They all receive the same exact information and the same exact training.
— Erin Walker, RN
• Break down the process. Because endoscope reprocessing consists of multiple detailed phases, it helps to break down the training one phase at a time. At Greenwood, all new techs start at the bedside, where they learn all about precleaning the scopes and preparing them for transport to the cleaning room. “This first step usually takes a good week before the new person has it down pat,” says Ms. Young. Then, the process plays out for rest of the steps in the reprocessing training — from manual cleaning straight through until the scopes are stored — and the new techs “graduate” when the trainer feels they’re ready to compete each phase without supervision. “Sometimes, it can take two to three months before you feel like they can go off on their own,” says Ms. Young.
Greenwood has seen a variety of skill levels come on as reprocessing techs — individuals from surgical tech school, cardio and endoscopy techs, and those with no experience at all — but each new hire is required to go through the same process of shadowing and doing, regardless of their skill level or experience. “It’s the same orientation for everybody,” says Erin Walker, RN, an infection control nurse with Greenwood. “They all receive the same exact information and the same exact training.”
• Doublecheck with checklists. Healthcare professionals love checklists for a reason: They work. Before sending reprocessing techs off on their own, review a step-by-step list of tasks to make certain they’re up to the job. “When we have new hires training in the cleaning room,” says Ms. Young, “they must complete a checklist of steps before they can work without someone shadowing them.”
In addition to staff checklists, vendor reps also come to the facility to hold yearly training with all of Greenwood’s techs. Whenever a new person is hired, the rep will come back to do the training for that person.
• Reassess frequently. Audit your staff’s performance regularly after the initial training is complete to ensure standardization of the reprocessing process remains in place and bad habits aren’t allowed to form. “We conduct yearly audits, during which each staff member has to demonstrate the steps in the reprocessing checklists and follow the process exactly as they were trained,” says Ms. Walker. “We also conduct frequent reassessments.”
For instance, Greenwood recently made a change to the reprocessing process that requires techs to brush and flush the channels of the scopes in the precleaning phase. “It was an extra precaution we decided to take, and we held an all-staff in-service to ensure everyone was training on the new step the same way,” says Ms. Walker. But after a few months, when Ms. Walker started to notice some small deviations in the performance of some staff members, she held spot audits and made corrections when necessary.
Ms. Walker encourages all facility leaders to make the rounds and watch the reprocessing staff in action in order to keep the disinfection process consistent. But don’t be obvious about it. “You don’t want to walk around with a clipboard,” she says. “Then, they know you’re coming.” OSM