Author: Megan Pietura

Sink Organization’s Role in Streamlining Workflows

Posted on by Megan Pietura

As we discussed in our blog post, Disorganization Dilemma – Reprocessing Sinks, a lack of organization around reprocessing sinks can be detrimental to a department’s training/onboarding initiatives, productivity, or compliance against IFU & patient safety. But, if there’s a problem, there’s an opportunity to improve!

Here are a few methods to organize a sink that can help your department improve outcomes:

 

Pegboards

Pegboard back walls add a new dimension to the organization of reprocessing sinks and are often a first step towards improving processes and workflows. The customizable, modular nature of pegboards means that they can be fitted with whatever sterile processing technicians & GI nurses need, right where they need it.

For departments that haven’t used an organizational pegboard before, introducing one is like giving an artist a canvas for the first time; they suddenly have a space they can configure in a multitude of ways, laying out equipment and materials not where they can, but where they want and need to.

Workflow etch plates

Another great option to create intuitive sink organization? Workflow guidance.

Indicator plates are simple in concept but big on impact. By visually identifying each area of a reprocessing sink, sterile processing and GI managers accomplish a few things:

  • Lay the groundwork for further organization and customization
  • Enable new team members to easily learn your department’s processes
  • Demonstrate that distinct areas are designated for specific reprocessing tasks, something The Joint Commission is likely to look for in a survey

Shelving

Adding shelving to your sink’s pegboard brings storage to a whole new level, literally. While some sinks have shelving or cabinets mounted above them, they may prove difficult to access or entirely inaccessible for shorter technicians. If a team member needs to request help or find a step stool to access storage above the sink, a considerable amount of time is added to the completion of their work, not to mention safety hazards associated with slip and falls.

Shelving options that have open configurations and are easily cleanable is also important to consider. Closed cabinetry and shelving can harbor bioburden, and are often too large or deep for most staff to clean properly.

Chemistry bottle holders

Chemicals, such as disinfectants and enzymatic detergents, are required for a wide array of tasks in reprocessing departments. Bottle holders for these chemistries mounted directly to a sink’s pegboard keeps them readily accessible and easily visible, ensuring that they’re available when needed, and replaced when running low. Placing bottle holders near dosing pumps also makes it easy to drop in leads and have a ready supply of whatever chemical is required.

Timers

Many IFUs require specified amounts of time for certain tasks. While a small, standalone timer is often used to manage these tasks, it is easy for those timers to be misplaced or forgotten about. This can result in wasted time, an inability to accurately time certain tasks, or insufficient cleaning time per a device’s IFU.

Mounting a large, backlit, highly visible timer at each area of a reprocessing sink where required enables team members to accurately soak devices for the required amount of time and keep tabs on how much time is left, ensuring that IFUs are met, and time isn’t wasted. Timers with alarms may also be available. As most central sterile departments become loud during peak reprocessing times, built-in alarms keep tasks on pace, and prevent oversoaking or over-exposure to chemistries.

Other tools and equipment

There are myriad of tools and equipment that departments can implement to help their team accomplish their tasks in a streamlined, efficient manner; these examples are just a small handful. The problem is that they can often clutter the working area at the sink, leading to departments either under utilizing the tools managers purchase, or opting not to acquire useful tools because there isn’t room for them.

Tools such as flushing systems, magnifiers, and inspection scopes can be easily affixed to a pegboard, allowing departments to leverage previously underutilized space and bring game-changing tools to where technicians and nurses need them.

 

Optimizing the way your reprocessing sinks are organized is a low-cost, high-impact project that can lead to immediate results in terms of process improvement, throughput, and even ergonomics.

If you’re interested in exploring ways to better organize your reprocessing sinks, let us know!

Entering the Sterile Processing Industry: Insights from our 2022 Technician Survey

Posted on by Megan Pietura

Staffing & retention is a top concern for industries across the country. Finding great people and keeping those you already have has become more difficult than ever. Knowing this, we asked sterile processing technicians about their experience in the industry in our 2022 Technician Survey, including how they started their careers in central sterile services.

Here’s how our respondents answered:

How techs get into SPD - survey data

Referred by a friend or colleague

It’s not what you know, it’s who you know. 33.58% of our respondents indicated that they originally got into sterile processing via a referral from a friend or colleague. This points to a potentially under-utilized source of new teammates: networking.

So, what are some easy ways to take advantage of the networks you already have?

  • Social media – Utilizing social media platforms such as Facebook and LinkedIn can help you engage your personal and professional networks, and drive awareness about open positions.
  • In-person – Talking with friends and teammates can create unique opportunities through word-of-mouth. You never know who may know someone looking for a job or career change!
  • Internal referral programs – When resources allow, consider creating an internal referral program. Reward existing employees while filling vacant positions.

With so many sterile processing technicians pointing to referrals as their entry point to the industry, investing some time and energy to invigorate social and professional circles could help resolve vacancies.

 

Moved from another department in the hospital/facility

Leveraging professional circles just became even more important. With 25.37% of respondents saying they landed in the SPD from another department in their hospital, you may already know the next technician you’ll hire!

Here are some ways to identify potential candidates internally:

 

  • Communicating with other managers – despite the fact that it may mean losing a teammate in their department, letting managers of other departments know that you’ve got positions could get them to point internal staff your way. Word-of-mouth works here as well.
  • Talk to your HR team – make  your Human Resources (or equivalent) department know that there’s room for employees to grow in your department. It’s much easier to move someone to a new position within the organization than it is to find someone new!
  • Ask your teammates for help – members of your department may already know someone in your organization that could be interested in making a change.
  • Market your department – candidates need to be actively lured in to apply for jobs. Post photos, host fun employee events, and set up your department’s own set of Core Values to make your department seem more attractive.

 

No prior knowledge of SPD

Awareness is the key for the 25.37% of respondents that said they had no knowledge of sterile processing before finding an open position and joining the team. This notable percentage signals that there are people out there that would probably like a job in SPD, but simply don’t know it’s an option.

Some ways to generate awareness and find new candidates include:

  • Partnering with local educational institutions – from a high school to a four-year university, reaching out and partnering with them to help place students looking for employment, or simply volunteering to speak to classes about sterile processing can help funnel new candidates into your department.
  • Attending job fairs – job fairs are hosted by all kinds of organizations, from schools, to local governments and counties, to non-profits and community centers. Many of these sources will also promote job vacancies for free.
  • Get in touch with local Chambers of Commerce – Chambers of Commerce can be valuable resources for local organizations. They often have their finger on the pulse of the community they operate in and can help you create awareness about sterile processing positions. They may also serve as conduit to get you in touch with other helpful organizations in the community.

 

We’ve covered some methods that can help SPD Managers drive awareness of their open positions and sterile processing in general, but what happens once you’ve got a great team place? You need to keep them. Check out our blog post Creating and Maintaining a Great Culture in Sterile Processing to learn how to create a department that technicians want to work in!

Appreciation – The Key to Retention

Posted on by Megan Pietura

Retaining great talent is pivotal to any sterile processing department’s success; the work technicians do is critical to patient safety. Given this importance, a department really feels it when a good technician makes the decision to leave. So, why do technicians decide to leave?

That was one of the questions we asked in our recent 2022 Technician Survey: Why do technicians leave departments, aside from compensation?

Here’s how our respondents answered.

Bar graph depicting reasons sterile processing technicians leave departments. Lack of appreciation 36.89%, management style 21.31%, Painful/repetitive movement 15.57%, lac of upward mobility 13.11%, nature of work 6.56%, something else 6.56%

 

Lack of appreciation

One response blew the rest out of the water: lack of appreciation.

And why wouldn’t it? A basic human desire is to be appreciated for what you do, and in the case of sterile processing technicians, that’s a lot! Despite an instinctual urge to associate appreciation with compensation and benefits, there are plenty of other ways to show your team that what they do is appreciated.

  • Verbal appreciation – Seemingly obvious, verbal affirmations can be easily overlooked, especially when this skill may not come naturally to every manager. Sometimes a simple verbal affirmation, or a “job well-done”, can show a teammate that you see and appreciate their efforts.

 

  • ‘Monthly’s’ – Creating an informal program that recognizes team members on a regular cadence is a great way to improve departmental morale and publicly recognize individuals. This can come in the form of something as simple as “Technician of the Month”, to something a bit more fun, like “Patient Safety Warrior”, of the month!

 

  • Events – Sometimes just getting the team together for a free lunch and some bonding time in the name of appreciation demonstrates that management is paying attention and wants to reward their team for all they do. Events offer a venue to get know each other and decompress with people who recognize the realities of working in central sterile.

 

Another key to retention? Leadership and management styles. Check out our blog post on reprocessing leadership to learn more: Reprocessing Department Leadership: How Can You Mobilize Your Teams for Success?

The Joint Commission – The Fundamentals of Preparing Your Department

Posted on by Megan Pietura

Most medical facilities in the U.S. will face an accreditation survey at one point by the Joint Commission (TJC); about 88% hospitals are certified by the TJC. This accreditation process provides structure and guidelines for healthcare systems, and provides measured ways to improve patient care, and reduce healthcare associated infections (HAI’s), particularly surgical site infections (SSI’s). But in 2006, the shift to making surveys unannounced surveys began, encouraging healthcare facilities to be continuously prepared, and focus on a consistent process of improving and bettering outcomes.

This surprise visit can create a sense of chaos or unease in the minds of some sterile processing and GI managers. Even a single observation can lead to a request for improvement (RFI). But by understanding some core fundamentals, any healthcare facility can be prepared for their next visit.

Understand your accreditation body

Not all medical facilities will face accreditation by TJC. For ambulatory centers, they may face accreditation through the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), or Accreditation Association for Ambulatory Health Care (AAAHC), and all states have healthcare licensing programs. Verify your accreditation body, so the appropriate regulations and considerations are kept in mind.

 

Re-read the essentials

The TJC will want assurance that facilities are following relevant regulations, standards and guidelines pertaining to instrument reprocessing. ANSI/AAMI ST79 and ANSI/AAMI ST91 provide guidance on workflow and department organization and are worth a re-read often, by all staff members. The Centers for Disease Control (CDC), Association of Operating Room Nurses (AORN), Society of Gastroenterology Nurses and Associates (SGNA) are also very relevant to name a few. This may also be an appropriate time to ensure departments have the most updated copies of these relevant guidelines.

Instrument instructions for use (IFU) are also important, and should be updated.

The Sterile Processing in Healthcare Facilities: Preparing for Accreditation Surveys guideline is another helpful tool, especially for newer management or staff members.

 

Routinely dust off competencies

Sterile processing is the subject matter of all things related to instrument reprocessing. Surveys want assurance that staff are fully competent (and confident) in their core cleaning responsibilities. They may also assess certifications, and involvement with professional associations. Ensuring job responsibilities accurately reflect work, and yearly assessments of responsibilities are performed are important.

Ensure that current policies and procedures at the facility are reviewed and reflect current regulatory guidance. Staff must be able to demonstrate knowledge and adherence to the hospitals policies.

 

Mock surveys

Mock surveys, and implementing tracer methodology, can help create a living exercise of the real thing. Getting away from a desk, table or sink and conducting a tracer and secondary tracer exercise can bring out real gaps in compliance, training, or areas for improvement. It can also be crucial to include infection control, the OR, or others to lessen the ‘tunnel vision’ effect.

 

Takeaways

Accreditation is not to be feared. The accreditation and survey process helps provide frameworks for healthcare facilities to ensure an ongoing commitment and dedication to patient care. But a proper understanding of the process and requirements involved can greatly reduce stress and anxiety when a surprise survey is announced.

 

Now that you’ve got the fundamentals down, check out: How to Ace a Visit from the Joint Commission

Six Takeaways from the ANSI/AAMI ST91:2021 Update

Posted on by Megan Pietura

Starting your department on the road to ST91 compliance

 

Some of the most common minimally invasive procedures in the U.S. are endoscopy procedures, making endoscope reprocessing crucial to patient safety (ProMedica.org). Although common, these procedures do not come without risk; endoscopes are extremely intricate and advanced medical instruments, making them hard to clean by nature. “Contaminated endoscopes are the medical devices frequently associated with outbreaks of health care-associated infections” (NCBI.gov).

Patient safety, research, and process advancement continue to be a top priority for gastroenterology and sterile processing departments across the country. On March 3, 2022, AAMI released the updated ANSI/AAMI ST91:2021 Flexible and semi-rigid endoscope processing in health care facilities (AAMI.org). These guidelines were presented to help GI and central sterile departments create processes and procedures that reflect the latest research and advancement in endoscope reprocessing.

Amid nationwide staff shortages, leaders in gastroenterology and sterile processing department’s are more overwhelmed than ever. Implementing the latest ST91 updates into your department may seem like a daunting task that could include significant time, effort, or renovation costs, but getting started is easier than it looks.

Here are just 6 impactful improvements to help your department begin the journey towards ST91 compliance.

 

1. Implement height-adjustable equipment

Staff ergonomics continues to be an important factor in creating compliant departments that also reduce unnecessary costs and pain, like in workers compensation claims or days away from work. Consider making investments towards more ergonomic equipment when possible.

“Sinks, counters, and work surfaces should be:

  • height-adjustable or positioned at heights that accommodate the average height of employees and the tasks to be performed at each location; and
  • sufficient to accommodate the endoscope length”

Section 4.2.1 – General Considerations; ANSI/AAMIST91:2021

 

“Sinks should be height-adjustable so that personnel do not have to bend over to clean endoscopes. An ideal decontamination sink is height-adjustable, approximately 36 inches (91 centimeters [cm]) from the floor.”

Section 4.3.2 – Sinks and accessories; ANSI/AAMIST91:2021

2. Change the way you think about sink design

Sink design is more than height-adjustment. A properly designed sink that meets both compliance standards and department restrictions can also reduce device damage or repair costs. Basin sizes are one design element that can impact scope reprocessing, such as in total immersion in detergents or tight coiling.

“Sinks should be deep enough to allow complete immersion of the endoscope to minimize aerosolization. The size of the sink should be adequate (i.e., a minimum of 16 inches x 30 inches) to ensure that the endoscope can be positioned without tight coiling and 8 to 10 inches (20 to 25 cm) deep, enabling a person of average size to work comfortably without undue strain on the back.”

Section 4.3.2 – Sinks and Accessories; ANSI/AAMIST91:2021

It may be prudent to invest in a custom sink design, or partner with a vendor who can provide consultations of challenging decontamination areas.

 

3. Implement a borescope to inspect high-risk endoscopes

If your department reprocesses high-risk endoscopes, now might be the time to evaluate a borescope program. While borescope programs can be complicated or expensive to implement, it may identify other areas of improvement for a department, like a lapse in manual cleaning or damages that occur during transport.

“High-risk endoscopes (e.g., duodenoscopes, linear ultrasound (EUS) endoscopes, bronchoscopes, endobronchial ultrasound (EBUS) endoscopes, ureteroscopes, cystoscopes, and as determined by the facility) shall be evaluated with cleaning verification tests after each use.”

Section 7.8.4 Cleaning Verification; ANSI/AAMIST91:2021

 

“Visual inspection alone is not able to determine if the reduction in clinical soil is sufficient for an effective cleaning result but is critical to determine any defects or potential damage to the endoscope.”

 

“Visual inspection can include the use of borescopes to inspect the inner channels/lumens present in many flexible endoscopes.”

Section 13.5.1 General Considerations; ANSI/AAMIST91:2021

 

Looking to implement a borescope program? Download our free checklist to ensure you’re considering all relevant areas impacted by integrating this technology into your department.

 

4. Implement lighted magnification for inspection

As important as internal inspection, having the proper illumination throughout a department can aid in assessing all endoscope varieties. Elevator channels and distal tips need particular attention for gross soil or other bodily substances.

“Lighted magnification should be used to inspect endoscopes and accessories for external cleanliness and damage.”

“According to the FDA/CDC, it is recommended that areas of the endoscope at the distal end be inspected using at least 5x magnification, 10x magnification for duodenoscopes.”

Section 7.8.2 Visual Inspection; ANSI/AAMIST91:2021

 

5. Enhance manual cleaning procedures

Manual cleaning is the foundation to effective high-level disinfection and sterilization outcomes. Any residual bodily fluids or debris can impact steps further along in endoscope reprocessing.

Automated flushing devices are one option to ensure endoscope channels are being flushed according to their manufacturer’s IFU while removing the variability of either manual methods, or between different practices among staff.

“Flush all channels according to the endoscope manufacturer’s written IFU.”

Section 7.6 Manual Cleaning Steps; ANSI/AAMIST91:2021

 

6. Better anti-fatigue mats

Keeping a clean work environment in endoscope reprocessing areas is critical. Ensure that high-touch items, such as anti-fatigue mats, are chosen that can be easily cleaned and maintained. Anti-fatigue mats also add further ergonomic benefits.

“Anti-fatigue mats should be:

  • used in areas where prolonged standing is required;
  • and constructed of materials capable of withstanding frequent cleaning”

Section 4.2.1 General Considerations; ANSI/AAMIST91:2021

 

Looking to implement any of these ideas or others for your endoscope reprocessing area? Pure Processing representatives are ready to learn about your space and provide guidance on potential reprocessing solutions. Contact us here to learn more.

 

 

Works Cited

ANSI/AAMI ST91:2021.

“Endoscopy.” ProMedica, https://www.promedica.org/services-and-conditions/endoscopy

Kovaleva, Julia, et al. “Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy.” Clinical Microbiology Reviews, American Society for Microbiology, Apr. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/

“ST91: Endoscope Processing in Healthcare Facilities.” Default, https://www.aami.org/ST91.

The State of Sterile Processing: “The Industry is Coming Home to Roost”

Posted on by Megan Pietura

In early March of 2022, Pure Processing convened members of our Voice of the Customer committee to discuss staffing and retention. We learned a lot from the conversation with them, and if you haven’t seen our blog: Sterile Processing Staffing & Retention in 2022: A Conversation with VOC, be sure to check it out.

One concept that stuck out and led to deeper conversation was the idea that the sterile processing industry “is coming home to roost.” As we listened to the VOC members discuss and elaborate on this, it became clear that something’s going on under the surface in the sterile processing world.

 

Nowhere to grow

A core tenant of building a career is having the opportunity to grow, expand, and thrive as a professional in your field. In an exceptionally competitive labor market where organizations are trying to appeal to younger generations that have a focus on career progression, sterile processing seems to have fallen behind.

There has been pushback from upper management over the years as SPD Managers and Directors have attempted to implement a hierarchy for technicians to climb within their departments. Even in situations where there are opportunities to grow, from Tech I to Tech II, for example, there isn’t always an associated compensation change or increase in responsibility.

The problems derived from the lack of growth opportunities are twofold:

  1. Not seeing an opportunity to grow, current technicians are leaving organizations or the central sterile industry entirely.
  2. Potential newcomers are assessing the growth landscape in sterile processing departments and determining that they would rather not begin a career without clear pathways for upward mobility.

In order for sterile processing departments to continue doing their critical work of ensuring patient safety, they need to be able to offer current and potential technicians the ability to grow in SPD.

 

Lack of incentives for experience, certifications, and continued education

Another aspect touched on by our VOC committee was a notable lack of incentives associated with years of experience, education, and certifications. Many organizations are screening applicants without certain certifications, but not adjusting compensation for those that do hold them. As states throughout the country mandate certain certifications, organizations may be finding it easier to justify as a “ticket to ride.”

Current and prospective technicians, however, do not view it this way. Experience, continued education, and time/money spent obtaining certifications are investments that technicians have made in themselves. The lack of incentives or compensation for certifications, education, and experience may be regarded as a lack of appreciation to current SPD professionals, and could be causing prospective technicians to perceive them as a barrier to entry.

Compensating technicians for the knowledge they’re bringing to the table or maintaining in a department demonstrates appreciation, as well as ensures the department has the best talent possible to provide safety to patients.

 

Stagnant Wage Growth

Ask almost any technician or reprocessing professional what their biggest concerns or issues  regarding the industry are and  you’re bound to find at least one commonality: wages.

Pushback on wage growth over the last two decades has led to reprocessing positions being out-competed by many other industries. Among the consequences of this stagnancy is a reluctance in the labor market to take jobs in sterile processing, contributing to a notable personnel shortage in departments throughout the country.

Stagnant wages have also led to career technicians (often referred to as ‘lifers’) to consider exploring other opportunities for the first time. A true passion for the work they do is often the only lifeline keeping these experienced professionals from exiting the industry more readily.

 

“The industry is coming home to roost.”

One of our Voice of the Customer members put it best when discussing the overarching concerns the industry is facing: “The industry is coming home to roost.”

Without clear professional ladders to demonstrate career paths, incentives and appreciation for individual growth, certifications, and education, and competitive wages, sterile processing has become less appealing to potential employees, and departments are feeling it. The industry could be facing staffing challenges for years to come. As one VOC participant commented: the industry may need some “re-engineering.”

Many managers and directors are already taking on new initiatives to improve their departments. From persisting in their efforts to increase their teams’ wages, to collaborating with other departments in the hospital to improve communication and address longstanding problems, to creating new positions that don’t require certifications and serve as an entry point for newcomers, those in SPD management are approaching the problem head-on.

Are you looking for ways to improve your department? Culture is a great place to start! Check out our blog post on Creating and Maintaining a Great Culture in Sterile Processing!

 

Establishing & Maintaining a Great Culture in Sterile Processing

Posted on by Megan Pietura

As many have learned over the last few years and amid the Great Resignation, attracting and holding onto phenomenal talent has become more important, and difficult, than ever.

Some variables, such as compensation and benefits, can be out of a manager’s control, but there is a high-impact variable that SPD Managers can control without approval from their HR departments: Culture.

So, what steps can be taken to start building a great culture in your sterile processing department?

 

Demonstrate a willingness to help

Team members in sterile processing are in a perpetual state of multitasking with the accuracy and focus necessary to keep patients safe. Couple that level of activity and laser-focus with being short staffed, and you’re likely to end up with a frustrated team struggling to get everything done.

Jumping in to help your team when things get hectic demonstrates that you’ve got their back and that you’re willing to roll up your sleeves and do the same things they’re asked to do.

 

 

Recognize high performance

Sterile processing is a demanding job that requires not only a great deal of knowledge, but the ability to utilize that knowledge on the fly in a fast-paced environment. Often, the only feedback a technician might get is the disapproval from the OR when items are missing or lost, leading to a belief their work isn’t appreciated, or fully understood.

Taking the time to privately, or publicly, recognize technicians when they do a great job lets them know their effort is seen. It also helps to understand how each technician prefers to receive that feedback, such as in one-to-one or group meetings.

 

Make workstations work for techs

The work completed in sterile processing is taxing, to say the least. Whether it’s being hunched over a sink, stretching to reach materials, or having to make another trip across the department to grab something, little inconveniences can lead to irritations about coming to work, and can lower morale.

Seeking the input of your team and incorporating them into the decision-making process can help illuminate problems you weren’t aware of, as well as help get buy-in on new changes being made. Technicians can help identify ways to improve processes and configurations in your department to not only make their jobs easier, but also boost the productivity of your department.

 

Spend time together as a team

A lot of organizations and departments refer to themselves as a family, or a team, but rarely is it as true as it is for sterile processing departments. SPD shows up each day with an understanding that the work will be difficult and underappreciated. It’s important that everyone is on the same page, have each other’s backs, and will do everything they can to ensure patient safety. It’s a stressful job that requires passion and teamwork.

It’s important for sterile processing departments to spend time outside of the high-pressure environment they operate in together. This allows them to get to know each other better, discuss the stresses and achievements that only their coworkers will truly understand, and ultimately improve communication and team performance.

 

Focus on leadership styles that emphasize growth and understanding

Leadership can take a great team and make it terrible, or it can turn an average team into all-stars. Developing and fostering effective leadership styles for your department can make all the difference; your leadership style is the beating heart of the culture you want to create for your department.

Leadership styles that help technicians grow through coaching and learning from mistakes, allow flexibility where possible, and demonstrate an understanding of individual problems and considerations, show your department that you’re not just there to manage them, but to support them as people.

 

More Than Staffing & Retention

A great culture can transform a department, and the benefits go well beyond staffing and retention. It makes a workplace more enjoyable to be a part of and generates enthusiasm among staff, while also facilitating growth and development.

Make your department a place that a newcomer would be impressed by – a place people want to be a part of. Investing time in your workplace culture is an investment in your people.

 

We thank our Voice of the Customer panel for their time and insights. If you missed our previous blog post discussing takeaways from our March Voice of the Customer meeting about staffing & retention, check it out!

Time: How Instrument Reprocessing Professionals are Fighting the Clock

Posted on by Megan Pietura

Instrument reprocessing professionals are spending more time than ever reprocessing instrumentation. As devices have become more complex, an increase in manual and mechanical cleaning time has inevitably followed suit. Tasked with ensuring IFU compliance and meeting the dynamic demands of the operating room and heightening procedures (OR), technicians and nurses are in a perpetual battle with the clock.

For example, consider the cleaning instructions for Zimmer orthopedic manual surgical devices (for hips, knees, trauma and extremities)1. The instructions list three separate options for cleaning and disinfection, ranging from rigorous manual to completely automated. While rigorous manual cleaning can take up to 45-50 minutes as prescribed by the IFU, sterile processing technicians only save about 10 minutes using a completely automated method using an automated washer and disinfector cycle.

Average times only increase when considering visual inspection, assembly, sterilization, and cooling time. Adhering to device cooling best practices can add up to two hours to a tray’s reprocessing time.

 

Zimmer Orthopedic Reusable Device Reprocessing Instructions*
Function Time Comments
Decontamination & manual cleaning 45 minutes, minimally Assuming a Combination method of both manual cleaning and automated washing using a washer/disinfector cycle
Assembly & visual inspection TBD Dependent on the condition of the devices, staffing, workflow, experience of staff, and other variables
Moist heat/steam Sterilization 30-45 minutes, minimally Dependent on the sterilizer cycle, model, and load size
Cooling time after sterilization 2 hours, preferred AORN Guidelines for Perioperative Practice: Sterilization2 recommend minimally 30 minutes, but preferrable 2 hours
TOTAL 3.5 – 4 hours, minimally  

 

*Reference the full Zimmer IFU for details here. This chart is referential only to provide a general sense of minimally prescribed reprocessing time.

 

Extensive reprocessing times for surgical devices are not limited to specific specialties or manufacturers. Robotic devices are another great example of lengthy IFU, especially in decontamination.

Xi EndoWrist and Single-Site Instruments*
Function Time Comments
Prime & soak 30 minutes, minimally
Flushing & spraying (while submerged) 5 min per arm, minimally
Ultrasonic 15 min Dependent on the sterilizer cycle, model, and load size
Post-ultrasonic flushing & spraying (while submerged) 5 min per arm, minimally
Thermal disinfection 5 min Optional step
Inspection, assembly TBD Dependent on the condition of the devices, staffing, workflow, experience of staff, and other variables
Sterilization 30 min, usually Dependent on the sterilizer cycle, model, and load size
Cooling time after sterilization 2 hours, preferred AORN Guidelines for Perioperative Practice: Sterilization2 recommend minimally 30 minutes, but preferrable 2 hours
TOTAL 3.5 hours, minimally  

*Reference the full and most up to date da Vinci IFU here. This chart is referential only to provide a general sense of minimally prescribed reprocessing time.

 

Staffing and retention, and impact on turnover time

As people leave sterile processing for positions in other industries, departments are trying to do more than ever with fewer people. The exodus of labor is severely straining many SPD’s ability to keep up with the demand of the OR. This issue is being compounded by the growing reprocessing times that more and more IFUs are requiring for complex devices.

While staffing concerns cannot be resolved overnight, departments should study its impact on reprocessing throughput, and begin identifying solutions now. Read more about the recent impacts to staffing retention with our latest blog, here.

 

Making better time

There are a myriad of tools, strategies, and methods departments can implement to improve reprocessing times, but cutting corners is not one of them. Adjustments to reprocessing activities utilizing a non-standardized practice that could result in lapses in compliance with IFU and regulatory guidelines should never made. Patient outcomes must always be kept top of mind when adjustment processes or workflows.

 

Strategies that support better use of time include:

  • Increase training for technicians and nurses: while this will require time and effort on the part of management, highly trained staff will not only reprocess their devices more effectively, but with greater adherence to department practices, and with more personal confidence
  • Increase device inventory, when possible: investments in instrument sets are often returned quickly, and sets can provide long-lasting returns in the form of durability
  • Improve reprocessing functions with better equipment: outdated devices and equipment may not only run slower than newer technology but added downtime can further hinder processes
  • Enhance workflows: Validate workflow issues with spaghetti maps. Spaghetti maps can provide compelling insights into how time is spent by workers hopping around departments hunting for tools and materials. Consolidating equipment and materials at workstations and sinks allows for quicker execution of tasks.
  • Communicate: Changes in a department are often met with skepticism and subsequent reluctance to conform. Conveying and demonstrating the value associated with efforts to better utilize limited time can help get buy-in and make sure the entire team is operating in the most time-efficient way.

Virtually every department will be faced with the growing dilemma of lengthening reprocessing time. Additions to the reprocessing cycle, like borescope inspections, also complicate turnaround time. But all departments have resources and tools to face these challenges. Consider how a deep dive of your department can reveal hidden time bottlenecks and highlight the areas where your limited time can be spent for the greatest ROI.

 

Do you have (or need) some ideas to improve your department’s turnaround time? Contact a Pure Processing representative to determine how you can shave time off tasks and start winning the battle against the clock.

 

Works Cited

  1. Reusable device reprocessing instructions. Reusable Device Reprocessing Instructions | Zimmer Biomet. (n.d.). Retrieved April 22, 2022, from https://www.zimmerbiomet.com/en/support/reusable-device-reprocessing-instructions.html
  2. Association of Operating Room Nurses. (2018). Guidelines for Perioperative Practice: Sterilization.

Sterile Processing Staffing & Retention in 2022: Insights from Central Sterile Managers

Posted on by Megan Pietura

At Pure Processing, our Passion for Processing runs deeps (it’s one of our Core Values, after all). It was also one of the catalysts for the creation of our Voice of the Customer (VOC) committee in May of 2020; who better to help shape the improvements and future of sterile processing than its own managers and leaders?

We were fortunate enough to convene many of our VOC members in March of this year to discuss a topic that organizations throughout the country are grappling with in 2022: Staffing & retention.

Each VOC member shared their experiences with their staffing challenges, but also some of the ways that they addressed them. From city center hospitals to rural medical centers, here are some of the ways that our committee addressed the staffing and retention challenges they faced:

 

Take note of errors, but don’t publicly shame.

Sterile processing departments need to be able to catch and record errors in order to improve, but calling out technicians publicly and shaming them in front of their peers can lead to burnout and high turnover.

 

Provide a professional ladder for members of SPD to climb.

Everyone wants to be able to grow in their profession, and sterile processing technicians are no different. Having a clear and attainable ladder for team members to climb allows them to continue growing right where they are.

 

Put a buffer between the rest of the hospital and SPD technicians.

Sterile processing departments can be chaotic and tense all on their own; technicians don’t need staff from other areas of the hospital coming into their place of the work to give them a piece of their mind. Ensuring that input and feedback from other departments flows through management channels allows everyone to be heard without causing undue stress.

 

People working in SPD don’t want to find a new job in fast food, even it pays more.

SPD professionals are passionate about what they do and understand the impact they have on patient safety. Despite the wage growth in industries like fast food and retail, members of our VOC panel indicated that people working in SPD don’t necessarily want to jump ship strictly based on pay, because they take pride in their work. That being said…

 

Make sure compensation is competitive for your region.

Compensation is an ongoing point of contention in many industries, and sterile processing is no exception. Making sure that the compensation offered by your department is comparable to other SPD positions in your immediate geographic region helps to guarantee an apples-to-apples comparison when competing for and retaining talent.

 

Create a work environment that people don’t want to leave.

SPD Managers can improve retention rates by striving to create a work environment that technicians want to continue working in. Demonstrating a willingness to jump in and help, making workstations more functional, and recognizing high performance were some of the examples given to create a desirable department to work in.

 

Include your team.

Members of your team can provide insight on how to improve the department. Getting them involved in projects from the start can help avoid pitfalls in terms of practicality and implementation. Asking for their input and incorporating them in the decision-making process is a great way to give team members a voice and get them invested in the department.

 

Keep morale high.

From showing appreciation, setting aside time to spend together as a team, to focusing on leadership styles that emphasize growth and understanding, many of our VOC members commented on the importance of maintaining high morale and the approaches they take to doing so.

 

Let HR know what to look for.

Some sterile processing departments aren’t as involved as they would like to be in the recruiting and hiring process. Letting HR departments know what kind of previous experience is valuable is a critical step to identifying great talent for your department.

 

Partner up with local schools.

While not all of our VOC participants had central sterile programs at their local colleges or institutions, all of those that did had a relationship with them and were actively engaging them. Even attending high school job fairs or speaking engagements made an impact. Letting students know about the nature of SPD and generating awareness can help bring in more applicants and create interest in the field.

 

A common theme: Culture

We really enjoyed our conversation with our VOC participants (and we really appreciate you taking the time – thank you!).

The conversation spanned a wide range of different ideas and thoughts on how to best retain and attract talent, but one theme seemed to weave throughout: creating a great culture.

Interested in what we learned about creating a great culture in sterile processing? Keep an eye out for our upcoming blog post: Establishing and Maintaining a Great Culture in Sterile Processing.