SPD 101, Back to the Basics

The reprocessing of medical devices and surgical instruments has evolved rapidly over the years. From the original days of sterilization taking place in the operating theaters and OR staff autoclaving items in between cases, to the cleaning of instruments in the surgical scrubs’ sinks. Luckily, the advancements in reprocessing education, standards, best practices, and guidelines have allowed our industry to become its very own special craft. Nowadays there are opportunities coming up all over the world for healthcare professionals to learn this unique skillset and create a lifelong career. While the industry is advancing, it is critical that all sterile processing (SP) professionals remember the basics of reprocessing, taking it back to what is most important in this fast-paced environment – ensuring clean and sterile instruments for patient surgical procedures. Let us look at some of the essential things to remember when working in the field.

The Purpose

Remember the why it is we do what we do in the SP department is primarily an effortless way to increase your motivation, strive for excellence and stay compliant. The world of SP is a unique one, where we are heavily responsible for patient outcomes, yet we never meet them and rarely see them. Simply reminding yourself and your team of the patients on the end of the instruments you are handling can help to reset a department in times of turmoil. It is also important to interact with each other as the humans we are, with compassion and vigilance on best practices so we are providing the ultimate patient experience during their surgical procedures and care.

As the Healthcare Sterile Processing Association recommends in their 8th edition manual, the purpose of instrument reprocessing can be summed up into an easy acronym, F-A-N. Ensuring instruments and devices that flow through SP are Functional, Accurate and Neat. Basically, ensuring everything works as it is intended to, which requires SP to thoroughly test items, Functional. Ensure instruments belong in their dedicated sets and have a set place to go. Count sheets can help with this, and inventory lists can drive success in this area, Accurate. And lastly, ensuring the department and the sets being processed are organized and kept clean, Neat.

The Instruments

Surgical instruments and devices used in procedures are very costly and can often be very intricate. Without these exceptional tools patient procedures would be more challenging and surgeons would be faced with a higher risk of poor patient outcomes. Because the healthcare sector depends so heavily on the proper use and care of these instruments it’s critically important for SP professionals to remind themselves, each time they handle them, of their importance.

When putting instruments back into back-up inventory and creating a safe storage environment.
When unloading and loading reprocessing equipment ensuring each item is placed correctly.
When receiving new items at the facility and determining what sets they are to be placed in.
When ordering additional items and replacing the damaged ones.
When creating a repair program to extend the life cycle of the high investment the department has made.

The Team

Teamwork makes the dream work. Unsurprisingly, that is an entirely true statement when it comes to healthcare and patient care. The surgical team comprises of a variety of healthcare professionals that must work in a highly coordinated manner with each other to provide the best patient experience and outcome. It is essential, in the world of reprocessing, to have a collaborative team that works well together. Without cohesion the unit may experience turmoil and, with that, the possibility that chaos will ensue. Each member of the patient care team plays a specific role, and it’s very important to know and understand the expectations of you and your peers. The SP will function like a well-oiled machine when proper practices are in place, protocols are followed, and everyone delivers. Sometimes this is easier said than done. To achieve that well-oiled machine:

Support your peers in times of need, helping one another to achieve daily goals and work duties.
Share experiences and knowledge with each other to improve morale and increase skillsets.
Build fun activities into your weekly interaction to keep the mood lighter in a stressful environment.
Incorporate all roles and staff members into your education program, providing continuous education to your team.

Cleaning 101

Cleaning is the first step in the reprocessing cycle and one of the most important. Because of the complexities found in surgical instruments, scopes, power equipment and positioning devices used for procedures, the cleaning guidelines and instructions can be incredibly detailed. Many times, SP techs can slide into unfavorable habits while working in decontamination or simply start going through the motions forgetting to pay close attention to detail. Additionally, that team may not be provided with the proper tools to do what is so very necessary in this space. Remember, dirt, debris, biofilm cannot be sterilized but must be physically removed from the surface. We should not only focus on the instruments but also the environment we are working in, taking extreme care of our decontamination equipment, surfaces, and tools.

Keep your work surfaces clean and maintained so each instrument processed has a is treated with care during cleaning, and each team member is given a safe working environment.
Treat each item as if its contaminated and don’t cut corners when reprocessing.
Follow all cleaning instructions, policies, and procedures during the cleaning process.
Don’t rush the process, communicate effectively, and explain why you are doing what you are doing and why you require the time you need to do it properly.
Stay vigilant of your surroundings and remember to wear personal protective equipment each time you are cleaning or have any potential for exposure to contaminated instruments.
Properly maintain all reprocessing equipment and treat it as if you purchased it with your own money. These items are expensive and must function properly to achieve the best outcomes.

Sterilization 101

Sterilization can be a tricky task and requires a lot of attention to detail including monitoring and documentation. It’s a critical step in everything we do in SP but can sometimes be taken for granted or even rushed. Every SP professional should create processes that support quality and auditing when it comes to this particularly crucial step in the reprocessing cycle. Because sterilization is the last step before storage and is the most critical step in killing microorganisms before items are used again on patients, we need to slow down and carefully think through each step in the process. Every sterilizer is different and requires different steps, no matter what the modality. The use of sterilization equipment can also be dangerous for staff members, with exposure to high temperatures, potential for chemical burns, high temperature burns, loading and unloading heavy sets, ergonomic challenges. We need to ensure our teams are safe, we are following best practices and keeping the equipment maintained for safe and effective use.