I recently underwent a surgical procedure and was reminded of what it’s like to be in the patient’s shoes. I realized that two things are of primary importance to patients—finding a trusted physician and the quality of the care received at the hospital.
In order to provide true quality care, hospitals must make adhering to safety standards a priority, especially considering all the areas of the hospital that contribute to the patient experience. As the department responsible for cleaning and sterilizing surgical instruments (instruments that go inside of patients), the Central Sterile Department is integral to both physician satisfaction and the patient experience—as well as patient safety.
Let’s take a look at the effect that Central Sterile has on these areas, and how to make patient experience and patient safety improvements a priority.
Physician satisfaction depends largely on whether doctors feels able to provide the quality and quantity of care needed by their patients. Support teams (like Central Sterile) shoulder great responsibility in a doctor’s ability to deliver efficient care. For example, redesigning processes and ensuring staff competencies help guarantee that trays will be delivered to the Operating Room complete and in a timely fashion. This not only fosters physician satisfaction but also clinical staff satisfaction, and ultimately, patient satisfaction.
When was the last time you walked through your Central Sterile Department? Because Central Sterile tends to be in the basement with other support services, it can easily be forgotten. Furthermore, it can be difficult to grasp when problems have become chronic—that is, until (in the worst case) they are revealed in the media. The success of a surgical operation does not just depend upon the patient-facing care delivery team. It’s also contingent on what’s happening behind the scenes.
Here are four major elements within the purview of Central Sterile that can help improve patient safety.
Temperature and humidity are two variables that can make or break patient safety and should vary to meet specific standards in general work areas, decontamination, sterilization equipment access rooms, sterile storage, and personnel support areas as outlined by The Joint Commission. Each location should have independent temperature and humidity monitors, with the data read and recorded by personnel daily to detect changes that might occur and ultimately affect sterilization results and the staff’s level of comfort. Keep work areas comfortable enough for workers but cool and dry enough to minimize bioburden.
While tap water may be used for initial rinsing, final rinses should be performed according to the standards provided in the manufacturer’s instructions for use (IFU). These can call for deionized, distilled, or reverse osmosis, depending on the instrument.
Air flow is important in preventing the spread of contaminants. Department air flow must pass from the preparation and packaging areas to the soiled and decontamination areas. In terms of physical layout, the Central Sterile Department should be designed to separate areas in which contaminated items are received and processed from the areas in which clean items are packaged, sterilized, and stored. Physically separate functional work areas with walls or partitions to control contaminants during the reprocessing phases. The distance between related work areas should be minimized, and there should be adequate space for the workflow. Restrict pedestrian traffic to authorized staff (who must wear personal protective equipment when necessary).
When it comes to sterile processing, the rule of thumb is always follow the manufacturer’s IFU and ensure that there is enough time allotted to do so properly. Cleaning and sterilization have grown more complex with the continuing technological advances of surgical instrumentation. Attention to detail is key.
Equipment & Required Materials
Recalibration, ongoing periodic cleaning and maintenance, and contractor servicing should all also be performed according to the manufacturer’s IFU. Similarly, adhere to the IFU for the specific use and function of the product. Establish appropriate records and tracking methods to be sure that everything is done by the book (and the book is the IFU).
Even though sterile processing technicians do not deal with patients directly, their role has a significant impact on outcomes and on the hospital’s overall reputation. In order to protect patient safety, recent developments in medical device manufacturing and technology require new criteria of education, core competencies, and skill sets for instrument reprocessing.
The stigma associated with sterile processing technicians is partly due to their lack of visibility. Not only does education about sterile processing help the organization as a whole function more efficiently, it empowers your staff, validates a system that is committed to quality and adheres to protocol, reinforces industry best practices, and allows the team to build solid, onboarding procedures based on that education.
A Basis for Comparison: Device Manufacturing Facilities
Device manufacturing plants are incredibly clean and highly organized—everything has its place and there is a place for everything. Staff is trained on and uses Lean Six Sigma. The overall plant layout and structure help workers with their number one priority—producing products that are error-free.
Yet when we transfer this factory thinking to healthcare, it little resembles the level of quality or attention to detail we hope to ensure. Why aren’t we treating our patients with the same care that a manufacturing plant treats its products?
Central sterile employees must undergo accreditation surveys every three years. But between accreditation surveys, a lack of sustained enthusiasm may creep in, exacerbated by little sense of urgency to keep up standards. Central sterile departments are not FDA regulated, and unlike manufacturing plants, are not subject to surprise inspections. Therefore, it is vitally important for providers to set their own standards.
* * * * *
All patients want to be cared for by professionals they trust. This means a compassionate, attentive provider and a safe environment. All healthcare professionals have a responsibility to make these items a priority. We must never lose sight of the fact that one day we will all be on the receiving end of the healthcare system. As we work to provide the best care, we must never lose sight of the patient perspective. It’s time to include Central Sterile in our fight to protect patient safety. Our patients’ lives—and one day our own lives—may depend on it.