ICT asked sterile processing experts to tackle a few thorny issues related to instrumentation and the operating room (OR). Our experts are:
Lisa Huber, CRCST, BA, ACE, FCS, sterile processing director at Anderson Hospital in Maryville, Ill. and president of the IAHCSMM
Natalie Lind, CRCST, CHL, educational director for the IAHCSMM
Sharon Greene-Golden, CRCST, FCS, CSSD manager at Mary Immaculate Hospital in Newport News, Va.
Nancy Chobin, RN, AAS, ACSP, CSPDM, corporate consultant and educator at Saint Barnabas Health Care System in New Jersey
Michele DeMeo, sterile processing manager at Memorial Hospital in York, Pa.
Bruce T. Bird, CRCST, central processing director at Primary Children’s Hospital in Salt Lake City
Q: The surgical team gets anxious about the quality of the reprocessing done on instruments and devices – what can you tell them to remind them of the care that the sterile processing department (SPD) takes to ensure the proper steps have been taken in the cleaning, decontamination and sterilization process?
Huber: It is important to keep the OR staff informed regarding training, in-servicing and other professional development measures taken by the central sterile supply department (CSSD) to ensure that staff members are not only competent, but indeed the experts in the realm of instrument processing. It is also important to share with the OR staff successes in quality measures, such as accuracy rates. When things do go wrong in any of the processes, communication is essential for remedying the problem and reassuring OR staff members that CSSD professionals will do their part to prevent such errors from occurring in the future. For example, if a sterilizer malfunctions, CSSD staff should communicate the status of the repair, promptly identify if there is a positive biological indicator and keep the OR (among others) informed of the recall status. If a cleaning or assembly error is made, CSSD staff must communicate to the OR that follow-up measures have been promptly taken to ensure that the mistake is not repeated.
Greene-Golden: The CSSD team members are always aware that they play an important part in patients’ overall surgical experience. The OR team must understand that their team members in the CSSD always obtain and follow the instrument/device manufacturers’ written instructions for cleaning, packaging and sterilization. They make sure that all items are clean and properly working. Then they process the instruments, ensuring that all the parameters of sterilization are met. CSSD teams are now also using challenge packs which allow them to release the load to the OR with confidence that the cleaning, decontamination and sterilization processes have been followed.
Chobin: All devices must be reprocessed in accordance with the device manufacturer’s written instructions. Due to the sophistication of surgical instrumentation needed today for today’s advanced surgical procedures, many devices require extended cleaning protocols and may also require extended sterilization cycles. Both of these factors will impact on the turnaround time of the instrumentation. It is important for the SPD manager to keep OR personnel advised of special processing protocols which would impact on the turnaround of surgical devices and sets.
Bird: If they receive a quality product 100 percent of the time, they have no need to question whether something has been properly processed. They see and experience the end result that reflects quality processing. Also, showing is sometimes better than telling. If the surgical team can observe, and maybe even participate in, the cleaning, inspection, packaging and sterilizations processes, they can see for themselves the level of expertise of the CSSD staff and the quality processes they follow. The CSSD should be proactive in regard to all instrumentation. When surgical services purchases new instrumentation, CSSD should expect surgical services to provide the written guidelines from the manufacturer before the item is placed in the system for use. This will help the surgical team understand how serious CSSD is about processing items correctly. A top-performing CSSD will become resource to its customers on all processing issues.