The ABCs of Reprocessing: Educating Sterile Processing Staff

June 1, 2005

The ABCs of Reprocessing: Educating Sterile Processing Staff

ByKathy Dix

EDUCATION is one of the most critical components related to the workin the sterile processing department (SPD), especially in terms of cleaning,reprocessing and disinfection. However, the need for speedy reprocessing and ashortage of personnel can push education onto the back burner.

There are several ways to addressthe overall improvement of the SPDs job performance, education and training.Education should address cleaning, disinfection, and reprocessing, personalprotective equipment (PPE) and safety issues, and chemical handling, says BeckiJenkins, CST, CRCST, RCST, FEL. Unfo-tunately, unless the hospital recognizesthe central sterile (CS) department as an operational professional entity, thereis very little internal education on cleaning/disinfection/reprocessingprocesses, she adds.

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

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

Jenkins observes that often, an approach to hospitaladministrators is quickly shunned. You will be told, in many instances, that no hospital willlobby 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 orsignificantly under-educated help in such a critical area, rather than paying abit more for the best possible care for their patients, she says. It isseen 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 atleast twice a year for PPE and safety issues through our IC and RM departmentsas a compliance with JCAHO requirements for such education initiatives, shediscloses.

Chemical handling safety training is ongoing and is specificto the chemical handled, Jenkins adds. For example, Cidex OPA is in-servicedin the department by department educators as a yearly mandatory competencycheck-off with an internal department in-service at least twice a year.Following manufacturers indications and recommendations for use is stronglyrequired and encouraged to include documentation practices.

Our job in central service/SPD is similar in some ways tothat of a soldier, declares Don Gordon, CRCST, FCS, network director forcentral service at North Bronx Healthcare Network, and president of theInternational Association of Healthcare Central Service Materiel Management(IAHCSMM). We are at war with microorganisms. Natalie Lind, educationaldirector at IAHCSMM, identifies this war as the battle of the bug, headds. Our attack starts in the most important area thecleaning/decontamination area. This is crucial to achieve victory and is themost important step in winning the war. The enemy is finally defeated in thesterilization area. The peace must be preserved and our role in maintaining theintegrity of the sterile items is all part of winning the conflict.

The arsenal of weapons to fight this battle of the bugincludes both chemicals and equipment, but one must be knowledgeable of theirproper use. Education of SPD/CS personnel is key. It is important that it isan ongoing event.

The cleaning/decontamination area encompasses many differentconcerns, 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, mostimportantly, how they die, he explains.

Gordons team turns to the infection control team for anannual in-service, which is always available for consultation. It isimportant that CS supervisors not only supervise, but educate and use everydayopportunities that come up as a way of teaching. The use of PPE is importantbecause it helps protect those working in this area from splashes and othermeans of contamination. It is important to stress that the enemy who isinvisible to the naked eye can be dangerous, and we must take all precautions toprotect ourselves.

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

Encouraging attendance at professional association educationmeetings and seminars is also crucial, he adds. Not only are the topics oftentimely, it provides an avenue to discuss issues and problems with othercolleagues in your field. When we receive a brochure on an upcomingmeeting/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 inattending this educational opportunity with me? Similarly, when we see aninteresting article in a professional publication, do we post it or make copiesfor distribution to our staff? When we receive a copy of a professionalpublication, do we leave it in the staff lounge with a note? For example: Seepage 29; there is an important article on decontamination! There are so manydifferent ways to train and educate; one must just use his imagination.

Overall job performance improvement is possible, but there isno simple solution. Common sense and trying to imagine what appeals to you as aperson is a start, comments Gordon. I know I like to think that my job isimportant. Try to relate training to the importance of a persons job.Analogies as I described before the battle of the bug although perhapssomewhat corny, can be important in remembering important goals and issues.Individual/one-on-one/working together training is usually very productive andprovides 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 wantsto know they are appreciated.

We have a separate column in our hospitals newsletterannouncing all of the good things our CS department is doing, as well aspublicizing individual accomplishments such as passing the Central ServiceTechnician Training (CSTT) course or becoming certified. All this assists inpromoting the educational process.

Additional funding for training is certainly one means ofpromoting quality. The state of New Jersey, in passing its mandatory CScertification law, received state assistance in setting up statewide educationalprograms, he states. This can assist CS personnel in their preparation forpassing the certification exam. However, it is important to remember the oldadage you can lead a horse to water, but you cant 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 associationsprovide excellent seminars with well-renowned speakers on timely topicspertaining to todays CS/SPD challenges. However, the numbers of attendees at these conferences areonly a fraction of the CS/SPD workforce. Is money/time the issue? People like touse this sometimes as an excuse, but is it? Thousands of people go to collegeand spend thousands of dollars and years for degrees that lead to better jobs orpromotions. We can certainly afford the time and money to attend educationalseminars, the same as others go to college. In fact, there are companies in ourfield and our national professional associations that provide scholarships forattending conferences and taking CS technical training courses. And if you havetrouble getting out of your house and have a computer, IAHCSMM/Purdue Universityprovides an online CS Technician Training course that includes a chat room withfellow course attendees and an instructor for e-mail communication for askingquestions on the subject matter. The educational opportunities are out there.One must only reach out and take advantage of these opportunities. Education isthe key to raising the bar in our field, Gordon concludes.