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Sterile processing professionals have cited an urgent need for better training to ensure medical devices and instruments are properly cleaned and patients are protected. They said many hospital executives fail to appreciate the time and commitment it takes to effectively train staff in sterile processing practices.
“Time to train and perform competencies must be allocated to ensure devices are processed correctly each and every time, or they may not be safe for the patient,” said Nancy Chobin, the former executive director of the Certification Board for Sterile Processing and Distribution and co-chair of the AAMI Endoscope Committee. “If even one step is missed or not performed correctly, the entire disinfection or sterilization process can be ineffective.”
Case in point: the life-threatening infections linked to a specific type of duodenoscope-a device that helps doctors examine the top of the small intestine. Based on a yearlong investigation detailed in a recent Senate committee report, at least 250 patients who underwent procedures involving duodenoscopes were infected with antibiotic-resistant bacteria between 2012 and the spring of 2015.
The issue is not restricted to duodenoscopes. Numerous sophisticated devices must be cleaned and processed between procedures in healthcare facilities, with varying results.
During the first half of 2015, inadequate reprocessing and sterilization of medical equipment, devices, and supplies was among the top “not compliant” citations issued by The Joint Commission. According to a report, 60 percent of critical access hospitals, 54 percent of hospitals, and 53 percent of office-based surgery centers were cited for noncompliance to the infection prevention and control standard IC.02.02.01 between Jan. 1 and June 20, 2015.
“It is startling to know that not reducing the risk of infections associated with reprocessing was among the leading noncompliant areas for over half of the facilities surveyed last year,” said Rose Seavey, president of Seavey Healthcare Consulting, LLC. “I hope that organizations take the information seriously and perform proactive risk assessments on their reprocessing issues to decrease infection risks to their patients.”
For most, this means ensuring that anyone who cleans, disinfects, or sterilizes devices is trained and competent. According to Chobin, the challenge is to ensure that all healthcare facilities provide or arrange for hands-on training with competency verification when new staff are hired and annually for all sterile processing professionals. “This is non-negotiable,” she said.
Linda Condon, director of central sterile processing at The Johns Hopkins Hospital in Baltimore, MD, agrees that training is not something that should be done only once.
“Training is not a quick ‘show one time and move on’ because each device has its own instructions,” Condon said. “Unfortunately, the time it takes to train staff and maintain competencies is undervalued.”