Infection Control Today - 12/2003: Perspectives

Professional Infection Control Management or Glorified Dishwashers?

By Becki Harter, CST, RCST, CRCST, FEL

I had the pleasure of speaking at the Indiana Regional IAHCSMM meeting in October and was very proud to see so many certified central service (CS) technicians there. It has been an uphill battle getting healthcare to see how valuable professional certification in this area really is. I know my colleague, Nancy Chobin, also is a champion of certification and it is so good to see so many starting to reach for professional certification in national organizations for such a critical step in infection control.

At conferences, I get the opportunity to speak to many in the profession and listen to their views and concerns. One thing rang clear to me at this regional meeting. The profession of central service is largely discredited or rarely recognized as one of the singularly most important steps in the infection control process that it is.

In many healthcare systems, the central service area is referred to as glorified dishwashers and Christmas-package wrappers. I can say I was a bit appalled at that prospect, but on the other hand, I can see why healthcare systems feel that way since non-skilled labor is generally hired for central service positions. A person can make more at a fast-food restaurant with less risk than an individual who works in a CS department. There seems to be less emphasis on this critical area than there really should be. I would like that to change.

I have been encouraged by the record number of CS personnel that have growing interest in being professionally certified. It would be wonderful, however, if healthcare systems would recognize this as a step up and pay accordingly. After all, if you are a graduate nurse, your pay is increased once licensed, and if you are a scrub technologist, your pay is increased once you receive certification. The same should be true for certified central service technicians. Currently this is not always true, if at all, in some areas. Perhaps the problem lies in that there is not a clear understanding of what is required to become a certified central service technologist.

The course of study for CS is as follows:

  • General field studies where and what the function of CS is
  • Medical terminology
  • Human anatomy
  • Microbiology
  • Infection control asepsis, regulations concerning OSHA, JCAHO, CDC for infection control and other related infection control practices for CS.
  • Decontamination and disinfection practices, to include procedures and commonly used solutions and their kill properties.
  • Equipment management
  • High-temperature sterilization and sterilization solutions
  • Low-temperature sterilization
  • Surgical instrumentation
  • Sterile packaging and storage protocols
  • Total quality management and QA
  • Safety and risk management
  • Regulations and recommended practices
  • Purchasing practice
  • Inventory management and distribution
  • Information technology
  • Human relations skills and professional development
  • Healthcare trends and the impact on CS

This represents 19 areas of study that I can assure no on-the-job training can teach. This is not to say that some who were trained on the job cannot do the job successfully. However, there are pieces to the puzzle missing that are readily available in someone who has studied, practiced and certified specifically for CS. It is very easy to detect a certified CS employee vs. one who is not. The mindset and professional seriousness to the job is very present in a certified technician. There is a clear understanding of the job and what is needed to do it safely. There is less incidence of taking shortcuts because there is an inherent understanding of the risk that is taken when this practice is allowed. The in-depth understanding and study has taught sober respect for the profession and the major role it plays in the overall safety to patients. If the CS department does not do its job correctly with great vigilance, any aseptic or sterile technique employed after that is to no avail. If contamination or questionable practice happens in CS, the entire system of infection control is compromised. Your patient is at risk.

So why is this area treated with such laissez fair? Perhaps because there is not a clear understanding of how critical this area is to the infection control process and the implementation of a successful positive patient care directive. Just as you would not want a person giving you nursing care who was not registered or a scrub nurse that was not certified, the same should hold true for CS. Why is registration or certification so important that unless you have it you will not be hired? It tells an individual that this person has undergone a course of study and has shown proficiency in the choice of study by receiving registry or certification. I am a certified surgical technologist by trade, in addition to being a certified registered central service technician and I can say, knowing what I know about both professions, I would be very nervous to depend on a non-certified anything to take care of me. The two professions are too in depth and can have great affect on a patient if either one is not given due resolve. Why rely on the on the job trained?

Most healthcare systems suffer from the lack of qualified available personnel, so they are forced to train in-house. As much as I have met RNs that can scrub with the best of them, give me a CST any day because their course of study is more in depth and specific to the role. The same is true with CS. Give me a staff of certified CS technicians any day over those who are not.

The more CS personnel who aspire for certification, the better the chance of getting the pay that is consistent with that professional vocation. Choose any one of the professional CS organizations in your area and go for it! Your services are needed and your knowledge is required. In a perfect world I see every healthcare system hiring only certified central service technicians and requiring certification for those who are already in house. I also see the financial rewards for such a professional accolade and honor. I see great strides being made in infection control practices that include CS as the driver of such efforts. I see infection rates dropping and infections prevented as the professional element is raised to this wonderful profession. We can do it, one healthcare facility at a time. Before you know it, we will have achieved our goal. What is that goal? That every CS department would be filled with professional certified CS personnel earning pay equivalent to the necessity of that role.

We have work to do. We must set our sights on a new standard and work diligently to obtain it for our patients sake. Require certification as a prerequisite for any CS position. For information on how you may be certified, feel free to contact Sterilization By Design, Inc. for the professional organizations that offer such a time-honored professional certification program or go to the web by searching CS organizations. Then get started on the professional recognition you deserve and your patients rely on.

Becki Harter CST, RCST, CRCST, FEL, is president and CEO of Indianapolis-based Sterilization By Design, Inc.

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