With legislation in New York being signed into law on July 31, 2013, there are now two states that require sterile processing/central service technicians to be certified and engage in continuing education to maintain and improve their core competencies. The bill that New York Gov. Andrew Cuomo signed into law, A.878-a (Bronson)/S.697-a (Grisanti), will take effect on Jan. 1, 2015. It requires central service technicians to become certified and undergo continuing education credits. These technicians are responsible for ensuring that instrumentation and equipment used in medical and surgical procedures are properly cleaned, disinfected, inspected and sterilized prior to patient use.
"New York patients in our healthcare facilities will be safer from the spread of infections," said bill co-sponsor Sen. Mark Grisanti. "Our central service technicians are the first line of defense in maintaining quality control to prevent and control the spread of infection,” And as Assemblyman Harry Bronson added, “As many families know, all aspects of medicine have become more technical and require better training for all medical providers. This legislation will ensure that central service technicians have the proper training on how to clean medical equipment to prevent and control the spread of infection, and protect our families.”
The International Association of Healthcare Central Service Materiel Management (IAHCSMM) has long been an outspoken advocate of state certification of CS technicians. Improperly sterilized instruments used in surgical procedures can introduce bacteria into a patient that sets up the risk for infection. IAHCSMM says that certification of CS technicians will help drive positive patient outcomes and reduce healthcare costs overall.
“Central service technicians are part of the team of professionals dedicated to preventing such infections. Certification demonstrates a commitment to patient safety and quality,” says Josephine Colacci, JD, director of government affairs for IAHCSMM.
In its "Certification for Central Service Technicians" document, IAHCSMM notes, " IAHCSMM’s top legislative priority is to ensure that there are certified central service technicians in every healthcare facility. IAHCSMM maintains every patient has the right to receive the highest quality of care during his or her visit to a healthcare facility. Through certification, Central Service Technicians will be properly educated to assist in the challenge to reduce healthcare associated infections. Every patient deserves to have an educated, certified Central Service Technician responsible for reprocessing his or her instruments." The document adds further, " The Central Service profession continues to evolve at a rapid pace with new surgical items being introduced regularly. The processing of robotics, endoscopes, joint replacement, and related instruments and equipment requires an advanced technical knowledge that only certification will provide. Association for the Advancement of Medical Instrumentation (AAMI) standards recommends certification for individuals responsible for sterilization activities, as well as those who manage Central Service processes. Joint Commission Patient Safety goals require specific knowledge of the processing and monitoring of instrumentation and equipment to comply with their rigid quality control policies in order to prevent patient injury. To comply with these requirements, Central Service Technicians must receive ongoing, formal training, including certification, in order to perform their daily duties safely, effectively and consistently. Certification will promote healthcare quality, reduce the risk of healthcare associated infections, and ensure successful patient care. This is an issue of basic patient safety. Central Service Technicians can help prevent infections in patients. Our patients deserve the highest level of patient safety and care. Certification of Central Service Technicians will assist in achieving this goal."
The ongoing education required to maintain certification also helps CS professionals stay abreast of ever-evolving instrumentation and equipment, and industry standards and best practices.
“Certification will keep technicians educated on standards-based instrument processing practices, so these professionals can perform their jobs safely and effectively, while keeping quality and patient safety at the forefront," says Wilhelmina Jones, CRCST, president of the New York State Association of Central Service Professionals.
Until now, New Jersey was the sole state in the nation to require certification. IAHCSMM will build upon this momentum to lay the foundation for certification legislation in other states. Legislation will be introduced in Pennsylvania and Massachusetts sometime this fall, and numerous other states will introduce legislation in 2014.
“Today is a positive step forward for patients,” Colacci says. “We hope this will be the tipping point for many other states to follow.”
Let's take a look at what the New York legislation requires. A central service technician cannot be employed unless the individual meets one of the following:
- has successfully passed a nationally accredited central service exam for central service technicians; and holds and maintains one of the following credentials administered by a nationally accredited central service technician credentialing organization: the certified registered central service technician credential, the certified sterile processing and distribution technician credential or a substantially equivalent credential; or
- provides evidence that the person was employed or contracted for the services as a central service technician in a healthcare facility for a cumulative period of one year, occurring within the four years immediately prior to the effective date of the legislation. Any contractor or employer of persons functioning as a central service technician on the effective date shall confirm in writing to each employee or contractor his or her employment in a capacity functioning as a central service technician in a healthcare facility as of the effective date of this section; or
- is a student or intern performing the functions of a central service technician if the student or intern is under the direct supervision of an appropriately licensed or certified healthcare professional and is functioning within the scope of the student's or intern's training.
A central service technician who does not meet these requirements will have 18 months from the date of hire to obtain the certified registered central service technician credential or the certified sterile processing and distribution technician credential.
A person who qualifies to function as a central service technician in a healthcare facility must annually complete 10 hours of continuing education credits to remain qualified to function as a central service technician.
A healthcare facility may employ or otherwise contract with a person who does not meet the requirements to function as a central service technician in a healthcare facility if:
- after a diligent and thorough effort has been made, the healthcare facility is unable to employ or contract with a sufficient number of qualified central service technicians who meet the requirements
- the healthcare facility makes a written record of its efforts and retains the record at the facility; and
- the person meets the requirements within two years of the start of employment or contracting for the performance of central service technician duties.
As we have seen, in 2005 New Jersey became the first state to mandate certification for central sterile staff. The New Jersey Department of Health mandates the following in sections 8:43G-8.2 and 8:43G-8.3:
- There shall be a full-time director or supervisor of central service.
- The director or supervisor of central services shall have two years of supervisory experience and shall be certified through a national sterile processing program recognized by the New Jersey Department of Health and Senior Services.
- All personnel involved in sterile processing shall be certified through a national sterile processing program recognized by the New Jersey Department of Health and Senior Services within three years of employment and by Aug. 2, 2009.
- Personnel involved in the use of ethylene oxide shall have the appropriate licensure from the New Jersey Department of Environmental Protection.
Regarding central service staff education and training, in N.J.A.C. 8:43G-5.9 the New Jersey Department of Environmental Protection requires the following:
- All new central service employees shall receive on-the-job training on practices and equipment unique to the hospital.
- Competency for processing tasks shall be documented annually by the employee’s supervisor or by the director of central services