By I. Francis Kyle III, CRCST, CIS, CHL
May 2015 marked my 18th month of working as a sterile processing technician. A lot has happened during the past year and a half, so this is a good time to reflect on what I have learned about this important but behind-the-scenes profession in the healthcare industry.
Since November 2013 my employer has been Jewish Hospital in Louisville, Ky. Founded in 1905 and now owned by the non-profit KentuckyOne Health (a subsidiary of the Colorado-based Catholic Health Initiatives), the 462-bed hospital specializes in cardiology, neurology, orthopedics and pulmonary, and is federally designated to perform all five solid organ transplants (heart, kidney, liver, lung and pancreas). As a third-shift tech, I’ve been privileged to play a small role in the many recent and exciting changes that have taken place at Jewish Hospital’s sterile processing department. The changes were summarized in our SPD manager’s (Weston Balch, CRCST, CIS, CHL) Infection Control Today article, “Certifiably Educated: One Department’s Drive to Serve with Smarts” (May 2015, Vol. 19, No. 5, p. 12).
The brief reflection—in the form of an acrostic—is based on hands-on training and education by means of weekly staff meetings and emails; hospital-led Safety Coach sessions; monthly reading of Infection Control Today; earning the three certifications (“triple crown”) offered by the International Association of Healthcare Central Service Material Management (Certified Registered Central Service Technician, Certified Instrument Specialist and Certified Healthcare Leader) and the bi-monthly reading of IAHCSMM’s Communique; reading of the 240-page ANSI/AAMI Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities; taking the Instrument University course “Surgical Instrument Care and Handling” by Spectrum Surgical (STERIS); and attending the 50th annual IAHCSMM conference and exhibition in Fort Lauderdale, Fla., May 2-6, 2015, courtesy of a scholarship from Belimed.
Steam sterilization. It’s helpful to understand the science behind and history of sterilization. For instance, it was the physician, pioneering microbiologist and Nobel Prize-winning Robert Koch (1843-1910) and his German associates who first devised the first non-pressure flowing steam sterilizer in 1881. And it was in the 1890s that Aesculap created the first rigid sterilization container. Originally made of stainless steel, the containers switched to a lightweight anodized aluminum in the 1960s.
Teamwork. It’s absolutely crucial if the SPD and the operating room (OR) staff are to safely and successfully serve the patient.
Error Prevention. I’ve made my share of errors and have hopefully increased in humility and fewer errors by learning from my mistakes. Good training and mental focus are huge. With repetition being a key to learning, it’s important to learn how to do repetitious tasks correctly early on in one’s training.
Reverence. This is one of the four values of KentuckyOne Health that I see on display every day at work. My employer defines reverence as “Respecting those we serve and those who serve.”
Infection Control. Because hospital-associated infections (HAIs) are always a threat, they must be controlled by SPD techs like me who seek to break the chain of infection: Causative agent, reservoir of the agent, portal of exit of the agent from the reservoir, mode of transmission, portal of entry Into the host and susceptible host. If any one of these six stages is broken, then the chain is broken.
Leadership. From the SPD and OR managers, supervisors and lead techs, to Jewish Hospital’s chief medical officer Jeffrey Goldberg, to KentuckyOne Health president and CEO Ruth Brinkley, I’ve been impressed with the many positive changes being made at the 110-year-old Jewish Hospital. This includes the following organizational culture concepts that KentuckyOne Health introduced in 2014, and that were guided by the first-rate Senn-Delaney Leadership Consulting Group: Mood Elevator, Appreciation, Be Here Now, Accountability, Curious and Assume Positive Intent.
Ethics. Isn’t relegated to just a university course. This branch of philosophy has a very real application for the SPD worker even though the patient is “sight unseen.”
Patients. They’re always the No. 1 priority and concern.
Rewarding. Next only to church ministry employment, this is the most meaningful job I’ve ever had. I have volunteered in hospitals before—the Hospital of Central Connecticut (New Britain, Conn.) and the Hospital for Sick Children (Toronto, Ontario, Canada)—and a sibling is an OB/GYN physician, but this is my first time being employed in the healthcare industry. Though pressure filled, hospital employment is worth my time and best effort. A fascinating job that is different each day.
Operating Room. The SPD liaison to the OR is key to having an amiable and productive partnership.
Continuing Education. One never masters sterile processing and surgical instrumentation. There’s always more to learn due to frequent advances in medicine and instrumentation. IAHCSMM knows this so they understandably require their certificants to earn annual continuing education credits. In fact, this annual CE credit requirement will become the law in Connecticut on Jan. 1, 2016, thanks to Public Act 15-11 signed by Gov. Dannel P. Malloy. Connecticut joins New Jersey and New York in requiring by law that central service technicians be certified.
Excellence. This is one of the four values of KentuckyOne Health that my SPD co-workers and I strive for each day. “Living up to the highest standards” is how my employer defines excellence.
Susceptible host. This is the sixth and last link of the microbiology-based chain of Infection that SPD techs must seek to break by proper instrument decontamination, cleaning, packaging, sterilization and storage.
Safety Coach. I’m thankful for the training provided by Kristi Cox, the SafetyFirst training specialist at Jewish Hospital. From SBAR (Situation, Background, Assessment, Recommendation/Request) to ARCC (Ask, Request, Concern, Chain of Command) to STAR (Stop, Think, Act, Review) to repeat-backs and read-backs, the kind of high reliability organizational principles and training Jewish Hospital and all KentuckyOne Health employees are receiving has been adopted and proven successful in the healthcare, airline and nuclear power industries. “SafetyFirst is not something we do. It’s the way we do our work.”
International. IAHCSMM has chapters and more than 22,000 members in Canada, China, India, Ireland, Pakistan, Philippines, Saudi Arabia, South Africa, Taiwan and United Arab Emirates. And every year IAHCSMM hosts a national U.S.-based conference and participates in the annual World Sterilization Congress of the World Forum for Hospital Sterile Supply.
Needleholders. These are among many types or “families” of surgical instruments that SPD techs are expected to know. Some other types include forceps, retractors, scissors and suction devices. Important to each instrument is the manufacturer’s instructions for use (IFU), of which is to include instructions for proper sterilization timing (e.g., 25-minute steam sterilization instead of five minutes) and the correct way to decontaminate, clean and process the instrument.
Government Regulations. It is comforting to this former appendix-removal patient and current sterile processing tech that federal U.S. agencies such as the CDC, DOT, EPA, FDA and OSHA exist partly to protect the hospital patient and worker. And that the U.S. has the non-profit Joint Commission to keep hospitals accountable by means of inspection and accreditation.
I. Francis Kyle III, CRCST, CIS, CHL, is a sterile processing technician at Jewish Hospital & St. Mary’s HealthCare in Louisville, Ky.