The ABCs of Reprocessing: Educating Sterile Processing Staff

By Kathy Dix

There are several ways to address the overall improvement of the SPD’s job performance, education and training. Education should address cleaning, disinfection, and reprocessing, personal protective equipment (PPE) and safety issues, and chemical handling, says Becki Jenkins, CST, CRCST, RCST, FEL. “Unfo-tunately, unless the hospital recognizes the central sterile (CS) department as an operational professional entity, there is very little internal education on cleaning/disinfection/reprocessing processes,” she adds.

“Unless the CS supervisor makes the effort to supply and require education and/or the infection control (IC) or risk management (RM) departments have a good understanding of how important CS is to the overall IC or RM plan, this area of education in the healthcare system is sorely lacking,” Jenkins comments.

The solution to this problem? “Mandatory certification for CS professionals in every state!” Jenkins asserts. “How do we do this? Contact your local health department or commissioner, who will direct you to your local general assembly representative for healthcare certifications and licensure. This department will help you formulate a proposal for amendment or bill in your local general assembly. There will be time needed to wait for approval. Once approval is made, the requirement then is made to the state healthcare system, allowing them to hire only certified professional CS staff in the CS/SPD departments.”

Jenkins observes that often, an approach to hospital administrators is quickly shunned. “You will be told, in many instances, that no hospital will lobby for something that will mean they have to pay more money to their workers ... sad but true that most hospitals will opt for substandard help or significantly under-educated help in such a critical area, rather than paying a bit more for the best possible care for their patients,” she says. “It is seen as a financial burden rather than a best practice/patient safety issue.”

However, the second factor — personal protective equipment (PPE) — is often addressed more frequently. “Routine in-services are done at least twice a year for PPE and safety issues through our IC and RM departments as a compliance with JCAHO requirements for such education initiatives,” she discloses.

Chemical handling safety training is ongoing and is specific to the chemical handled, Jenkins adds. “For example, Cidex OPA is in-serviced in the department by department educators as a yearly mandatory competency check-off with an internal department in-service at least twice a year. Following manufacturer’s indications and recommendations for use is strongly required and encouraged to include documentation practices.”

“Our job in central service/SPD is similar in some ways to that of a soldier,” declares Don Gordon, CRCST, FCS, network director for central service at North Bronx Healthcare Network, and president of the International Association of Healthcare Central Service Materiel Management (IAHCSMM). “We are at war with microorganisms. Natalie Lind, educational director at IAHCSMM, identifies this war as ‘the battle of the bug’,” he adds. “Our attack starts in the most important area — the cleaning/decontamination area. This is crucial to achieve victory and is the most important step in winning the war. The enemy is finally defeated in the sterilization area. The peace must be preserved and our role in maintaining the integrity of the sterile items is all part of winning the conflict.”

The arsenal of weapons to fight this battle of the bug includes both chemicals and equipment, but one must be knowledgeable of their proper use. “Education of SPD/CS personnel is key. It is important that it is an ongoing event.

The cleaning/decontamination area encompasses many different concerns, including the actual cleaning/reprocessing/disinfection process, safety issues, chemical handling, etc. It is important that we know our enemy ... knowing how these microorganisms live, grow, are transmitted and, most importantly, how they die,” he explains.

Gordon’s team turns to the infection control team for an annual in-service, which is always available for consultation. “It is important that CS supervisors not only supervise, but educate and use everyday opportunities that come up as a way of teaching. The use of PPE is important because it helps protect those working in this area from splashes and other means of contamination. It is important to stress that the ‘enemy’ who is invisible to the naked eye can be dangerous, and we must take all precautions to protect ourselves.”

Training quality differs depending on who offers it; it can be accomplished in many different ways in different facilities. The end result is proof of the quality, Gordon points out. “We have found that staff meetings on a regular basis provide an excellent stage for training and problem-solving. Sometimes a CS/SPD department finds itself overburdened with work and shortage of staff, and this becomes a reason/excuse for postponing or canceling large group in-service training. If this happens, consider individual or small group sessions, which are also more productive in achieving your training goals.”

Encouraging attendance at professional association education meetings and seminars is also crucial, he adds. “Not only are the topics often timely, it provides an avenue to discuss issues and problems with other colleagues in your field. When we receive a brochure on an upcoming meeting/seminar, do we share it with our department? Do we post it on the bulletin board? Do we say to our staff, ‘Are you interested in attending this educational opportunity with me?’ Similarly, when we see an interesting article in a professional publication, do we post it or make copies for distribution to our staff? When we receive a copy of a professional publication, do we leave it in the staff lounge with a note? For example: ‘See page 29; there is an important article on decontamination!’ There are so many different ways to train and educate; one must just use his imagination.”

Overall job performance improvement is possible, but there is no simple solution. “Common sense and trying to imagine what appeals to you as a person is a start,” comments Gordon. “I know I like to think that my job is important. Try to relate training to the importance of a person’s job. Analogies as I described before — the battle of the bug — although perhaps somewhat corny, can be important in remembering important goals and issues. Individual/one-on-one/working together training is usually very productive and provides the trainee a feeling that he or she is receiving personal attention, provided it is performed as a team approach — ‘we are working together’ — and not in a condescending way. Everyone likes a pat on the back and wants to know they are appreciated.

We have a separate column in our hospital’s newsletter announcing all of the good things our CS department is doing, as well as publicizing individual accomplishments such as passing the Central Service Technician Training (CSTT) course or becoming certified. All this assists in promoting the educational process.”

Additional funding for training is certainly one means of promoting quality. The state of New Jersey, in passing its mandatory CS certification law, received state assistance in setting up statewide educational programs, he states. This can assist CS personnel in their preparation for passing the certification exam. “However, it is important to remember the old adage — ‘you can lead a horse to water, but you can’t make him drink,’” Gordon adds. “You can provide opportunities for education, but one must take advantage of those opportunities.

“The national and local/regional professional associations provide excellent seminars with well-renowned speakers on timely topics pertaining to today’s CS/SPD challenges. However, the numbers of attendees at these conferences are only a fraction of the CS/SPD workforce. Is money/time the issue? People like to use this sometimes as an excuse, but is it? Thousands of people go to college and spend thousands of dollars and years for degrees that lead to better jobs or promotions. We can certainly afford the time and money to attend educational seminars, the same as others go to college. In fact, there are companies in our field and our national professional associations that provide scholarships for attending conferences and taking CS technical training courses. And if you have trouble getting out of your house and have a computer, IAHCSMM/Purdue University provides an online CS Technician Training course that includes a chat room with fellow course attendees and an instructor for e-mail communication for asking questions on the subject matter. The educational opportunities are out there. One must only reach out and take advantage of these opportunities. Education is the key to raising the bar in our field,” Gordon concludes.