By Harley D. Berlant, CRCST, CIS, CHL
Every central service (CS) department should have a designated educator. In fact, I believe that the need for a well-trained educator in this department is as great – if not greater -- than for any other department in the hospital.
Nearly every hospital and surgical services department has a nurse educator on staff. This individual instructs the surgical technician and RN on ways of the operating room to best serve the needs of the surgeon and patient. This person is also responsible for providing in-services for new technologies introduced into the surgical theater.
While the need for a nurse educator in the OR is undoubtedly important, many facilities fail to recognize how critical a CS educator is to the facility and, most importantly, to the patients served. CS professionals are responsible for disinfecting, sterilizing, storing, distributing, and otherwise managing surgical instrumentation and instrument processing equipment. These devices and systems are ever-evolving and are becoming increasingly complex and sophisticated. Constant due-diligence from well-educated and skilled CS staff is essential for ensuring that safe, high-quality and well-functioning devices make it in the hands of the end users.
Standards, recommended practices and manufacturers' instructions for use (IFU) also change regularly; therefore, it’s vital that anyone involved in CS-related functions be well-versed on the latest standards and practices. In the absence of a CS educator whose primary role is stay abreast of these changes, share and disseminate them with staff, and ensure that technicians understand how to apply them, it’s easy to see how shortcuts and missteps can occur – and how safe practices and adherence to best practices can fall by the wayside. This is especially true given the demands and resource constraints that plague many CS departments across the country today.
CS Educators Set the Stage for Quality
There are many reasons facilities lack a full-time CS educator. A primary reason, I have been told, is that some administrative personnel operate under the potentially dangerous assumption that CS education should fall under a full-time OR educator’s umbrella of responsibilities. Therefore, they see little incentive in hiring a dedicated CS educator.
What many executives fail to recognize is that OR educators often lack the specific and detailed knowledge needed to effectively guide and educate CS professionals. In fact, some OR educators have never even visited the CS department, let alone have a solid understanding of the many processes that take place there.
An effective CS educator is necessary for any patient-centric and safety-focused facility. This individual brings to the table a rich foundation of professional knowledge, and a keen understanding of what it takes to effectively educate adults (many of whom may come from varying backgrounds and experience levels). At the very least, CS educators should be a certified CS technician – and they should also have training in adult education. Ideally, I believe they should also have three to five years of experience in both CS and the OR. Here’s why: if they are bringing new employees to the surgical suite, they must know surgical processes and aseptic techniques – not to mention, have an understanding of hundreds of instruments and all of the equipment used to process them (regardless of whether the hospital currently has them in inventory).
Some may ask, “How can my hospital afford another full-time equivalent?” My answer is, “They can’t afford NOT to have a full-time educator on staff.” Fortunately, facilities may be able to hire one at little or no additional cost.
Building the Case
Before turning to an administrative executive to decide whether or not a CS educator can be hired, it’s wise for CS managers to honestly and realistically examine any full- or part-time position vacancies within the department.
It may be determined, upon careful calculation and assessment, that any unfilled part-time positions that have been difficult to fill (or even a full-time position that’s been available for a month or more because the right candidate failed to come along) might not be 100% necessary. Perhaps some minor task restructuring with existing staff (and some focused strategizing to increase process and departmental efficiencies) could help staff absorb the responsibilities that part-time technicians – or even an FTE -- might have held. If so, those vacancies could allow the hiring of a dedicated, well-skilled CS educator, an individual who can further promote efficacy and efficiency through knowledge advancement and adherence to current standards and recommended practices.
The pay rate for a CS educator will be higher than for a technician, and this increase must be justified to the administrator. The best way to do this is to address the need with the surgical services director. This individual often understands the needs of CS and can help CS managers justify the need for a full-time educator to the administrator. Note: If a CS manager lacks support from the surgical services director, the facility’s infection preventionist may also prove a worthy ally. If possible, CS managers should attain a job description for an existing educator within the hospital system. This can then be modified with tasks and requirements suited to the CS department.
In the demanding, high-tech and ever-evolving world of sterile processing, the need for a dedicated, full-time CS educator has never been greater. Quality and safety depend on a facility’s ability to monitor changes and advancements in the discipline; interpret how those change impact the CS department and facility, overall; and continuously educate staff to ensure that they know how to consistently and safely perform processes (and also understand why diligent adherence to standards and best practices is important to patient safety).
Despite working behind the scenes, the CS department plays a direct role in patient care delivery. If a tray is delivered with missing, contaminated or malfunctioning instruments, or with a breached or otherwise compromised sterile wrap, for example, patient safety becomes jeopardized. It’s essential that any errors are promptly addressed with CS professionals.
A full-time, in-house CS educator will help ensure that in-services and additional training occur most expeditiously. This professional will also help ensure that the department operates proactively instead of reactively, and keeps patient safety at the forefront.
Harley D. Berlant, CRCST, CIS, CHL, has more than 18 years of experience in healthcare departmental management, including central service/sterile processing, materials management and perioperative support. He most recently served as SPD manager and educator for several facilities. Berlant currently consults full-time for Florida Creative Consultants, a sterile processing education and consulting company, which he established in 1983. He has been an active member of the International Association of Healthcare Central Service Materiel Management (IAHCSMM) since 1983. He has spoken at several annual seminars and continues to teach classes to CS professionals.