Author: Megan Pietura

Prep & Pack Your Way Into SPD Success

Posted on by Megan Pietura

Sterile processing workstations are under growing pressure to meet increasing surgical case volumes, accommodating newer and larger instruments like robotics and loaners, and adherence to stricter compliance standards. From custom table solutions to full department renovations, facilities are finding innovative ways to enhance productivity, ensure compliance, and maintain organization, often in limited footprints.

At Pure Processing, we’ve collaborated with facilities across the country to implement solutions that optimize workflows and support these critical goals. Below are success stories highlighting how departments have transformed their sterile processing workstations to overcome these challenges.

 

Maximizing Space in a Renovated SPD

A facility in Illinois had to tackle a common challenge in sterile processing: space constraints. While expanding their sterile processing department to include a new assembly area, they knew that simply adding space wasn’t enough. Space was a precious resource, and ensuring it was

Dr. Raynetta Stansil

utilized effectively to support workflow was just as important as adding square footage.

The facility’s Director of Sterile Processing, Dr. Raynetta Stansil, DHA, MHA, ST, CRCST, CIS, CER, CHL, SME, shared her experience equipping her team with prep and pack workstations designed to make the most of their new assembly area:

“We had a space issue, so expanded our SPD department by adding an extra assembly area. One of the challenges was making sure we were utilizing the space appropriately—ordering the right amount of items, not too much and not too little. That’s where having the correct partnerships really came in.”

Dr. Stansil emphasized the importance of thoughtful workstation design:

“I was looking for a prep and pack table that was sleek, intuitive, and easy to use; something that made the most of the space we had. What really helped was the guidance I received (from my Pure Processing rep). He was incredibly helpful in explaining all the accessories I could add to the table and where I could place them. That made a big difference for me.”

Sourcing sterile processing workstations that integrate a variety of accessories is one way departments can efficiently utilize all available space. By opening up table space and moving tools to vertical or underutilized areas, workstations like the PureSteel™ Ergonomic WorkStation help create space for packing where they wasn’t any previously available. With customizable features designed to fit specific workflows, these tables not only improve functionality in tight areas, but also support technician ergonomics and efficiency in any space—large or small.

By prioritizing space-conscious solutions, one IL SPD team maximized their space and ensured long-term success in their updated department.

 

From Dan Hughes’ Vision to Innovation: A Customer’s Impact on Efficiency

Every great innovation starts with a problem and someone inspired to solve it. At VA Lebanon, SPS staff were looking for ways to maximize their assembly table space without sacrificing ergonomics or compliance. Enter Dan Hughes—a creative thinker and sterile processing professional whose idea would soon transform prep and pack tables for countless others in the industry.

Dan saw an opportunity to address a common challenge. Heat sealers often take up valuable tabletop space and can be awkward to work around. Recognizing the potential for improvement, he designed a solution that was as practical as it was innovative—the Hughes Seal & Stow Heat Sealer Shelf. This custom, foldable shelf provided a designated space for the heat sealer while keeping the primary workspace clear. It allowed technicians to work more comfortably, efficiently, and with less clutter, improving workflow without compromising ergonomics.

“There is less running around the department [with the addition of the heat sealer shelf]. It definitely eases some frustrations. The heat sealer has made a significant impact—streamlining motion management and keeping technicians at their stations longer, ultimately improving productivity. It’s been a fantastic product.” – Dan Hughes, BBA,NREMT,CRCST,CIS,CER,CHL

 

Compliance through Quality & Design

In the heart of downtown Chicago, one facility grappled with outdated, porous sterile processing workstations that raised serious compliance and hygiene concerns. The fixed-height design of these stations not only limited technician comfort but also failed to align with ANSI/AAMI ST79 3.3.6.2 standards, which specify that workstations must be constructed from nonporous materials like stainless steel and preferably height-adjustable.1

Seeking a comprehensive solution, the facility turned to PureSteel™ Ergonomic Workstations, custom-designed to navigate the building’s compact elevators while offering stainless steel durability and height adjustability to meet both infection prevention and ergonomic compliance requirements.

Once installed, the impact was transformative. The new workstations replaced the fixed-

height, porous tables with non-porous, highly durable stainless steel surfaces that enhanced safety and cleanliness. Finally, technicians could work comfortably and maintain proper posture throughout their shifts. To further streamline operations, integrated blue bins and light hood shelves optimized storage and organization, keeping tools and materials within easy reach, reducing clutter, and boosting efficiency.

Today, the facility’s prep and pack area stands as a model of compliance, durability and functionality. Designated zones for blue wrap, improved storage solutions, and ergonomic enhancements combine to support staff well-being and productivity. The reimagined workspace delivers clean, safe, and compliant operations that technicians rely on with confidence every day.

 

Innovative Storage Solutions

Solvita is a facility dedicated to transforming donor gifts into life-changing solutions. With meticulous care and precision, they process donated bone, tissue, and skin from deceased donors into grafts and products that save and improve the lives of millions. This important work relies on specialized custom surgical instrumentation, some of which weigh up to 30 pounds, and more. Handling these custom instruments with the utmost care is essential to ensure the safe retrieval and processing of donor gifts, honoring the lives of donors and recipients.

However, the weight and design of these instruments caused significant wear and damage to their workstations. These large, custom shaped instruments required substantial amounts of blue wrap, making adequate storage space critical to maintaining an efficient and organized workspace. The weight of the instruments may have also lead to the frequent damage on height-adjustable lifters, which were breaking often.

When Solvita sought to upgrade their workstations to better handle these challenges, they prioritized functionality, durability, and storage.

To create a solution tailored to their needs, the SPD team collaborated on designing their ideal setup using a 3D workstation builder tool. A key development was a double shelf to maximize storage capacity for blue wrap,  optimizing space for their growing workload.

Custom workstations featuring double bottom shelves were installed, along with enhancements like blue bins for efficient organization, a small light hood shelf, and UV blacklight functionality. These advanced features help staff thoroughly inspect surgical instruments for bone fragments, ensuring compliance with stringent cleaning standards and maintaining the integrity of donor gifts.

The upgraded workstations have transformed the facility’s operations with improved materials, enhanced storage, and optimized organization. Unique needs were not only powerful for staff and operations, but for honoring the integrity of delicate and rare donor gifts.

 

Sterile processing departments face diverse challenges—from limited space and outdated equipment to increasing demands for compliance and efficiency. Collaboration, innovative design, and customized solutions can overcome these obstacles and transform workspaces. Finding a vendor that operates as a partner to design, not just a Catalog of options, is the magic spark that solved each unique assembly challenge.

 

Looking to write your own prep and pack success story? Contact Pure Processing to see how we can help improve your department’s productivity and organization!

 

Sources:

  1. ANSI/AAMI ST79 3.3.6.2

From Vision to Victory: Using Roadmaps to Achieve Goals in SPD and GI

Posted on by Megan Pietura

In our previous blog, Building Habits of Improvement: SPD Style, we explored the consequences of having poor habits, or no habits, that focus on consistent and constant improvement of a department’s practices. By now, you may have ideas for changes you’d like to make—but how do you turn that vision into a reality?

Transforming your ideas into an actionable roadmap is an important step. Below you’ll find a free resource proven among business professionals to start building a roadmap that puts ideas into reality. If you’re still figuring out which habits to prioritize, don’t worry—we’ll also share practical suggestions to help you get started.

 

About the Roadmap Tool

To get started, download the Practical Roadmap to SPD Success tool. This tool is based on proven business strategies designed to help teams identify areas for improvement and put together plans to apply them. Once downloaded, follow these steps:

  • Step 1: Identify some micro-upgrades and professional initiatives you would like to implement, along with the desired date you would like them fully integrated as new habits or practices.
  • Step 2: Pick one of your goals and identify the roadblocks in the way. For each challenge, list the following:
    • What is the challenge associated with the goal?
    • Why is it a challenge?
    • What can be done to remove the challenge?
  • Step 3: Write 5 steps you will take to complete your goal, in order. Write out the actions you will take to reach each of your goals.

With the Roadmap in hand, let’s explore some examples of micro-upgrades and professional initiatives to help you get started!

 

Examples of Micro-upgrades

In our previous blog, we listed some potential areas for improvements in endoscope reprocessing and sterile processing departments. One solution to apply improvements is investments in new technologies. Let’s break down some specific equipment you can consider implementing to start improving your department.

 

Automated Flushing Systems & Dosing Pumps for Automation

Automated flushing devices save time, increase efficiency, and help facilities achieve repeatable, high-quality cleaning outcomes. A value analysis of common manual flushing systems in reprocessing departments demonstrates how inefficient processes can contribute to poor cleaning outcomes and increased risks. Surgical site infections (SSIs), for example, can extend hospital stays by up to 9.7 days and increase hospitalization costs by over $20,000 per admission.1

Implementing automated flushing systems to replace syringes and spray guns enhances consistency and reliability in flushing instrument channels. Automated systems reduce the variability inherent in manual flushing, ensuring thorough removal of bioburden and debris from intricate or long channels. This consistent performance supports compliance with standards and instrument instructions for use (IFUs), improves patient safety, and reduces the physical strain on technicians.

By adopting automated systems, facilities can help mitigate these risks, streamline workflows, and ensure more consistent and reliable instrument reprocessing.

Sink Liners for Reducing Instrument Damage

It can be shocking how much money and time goes towards instrument repair. A study Cori Ofstead demonstrated that implementing routine borescope inspections significantly reduced major repair needs, cutting costs from $1,212,702 in 2022 to $724,419 in 2024—a savings of nearly $488,000. Furthermore, the mean cost per repair dropped from $4,426 to $2,337, with a concurrent increase in the number of uses between repairs from 52 to 87.2   

Implementing sink liners in your department helps protect surgical instruments and endoscopes, maintaining their operating condition and minimizing costly repairs or replacements. By reducing the risk of damage from impacts, sink liners lower the likelihood of wear and premature replacements. This simple addition supports better inventory management and enhances a busy gastroenterology department’s fleet operations by reducing instrument downtime.

By implementing tools like sink liners to minimize damage, departments could experience comparable savings and optimize their overall operational budget. Pin mats may also be a solution for protecting borescope catheters.

Anti-Fatigue Mats for Ergonomic Fatigue and Injury Prevention

Implementing anti-fatigue mats in your department helps reduce discomfort caused by prolonged standing, promoting the well-being of staff. Mats provide a cushioned surface that alleviates foot, leg, and hip fatigue, ensuring employees can work more comfortably and efficiently.

Beware of mats which don’t provide anti-fatigue benefits. Many floor mats may only offer non-trip or slip benefits and may provide no ergonomic benefit at all.

 

Magnifier Task Lights for Surgical Instrument Inspection

Implementing task lights with magnifiers in your department ensures optimal lighting for fine-detail inspections, reducing the risk of eye strain and improving staff performance. These lights provide focused illumination, helping technicians spot imperfections and defects that might be missed with the naked eye, reducing errors. ANSI/AAMI ST79: 3.3.5.6 and ANSI/AAMI ST91: 4.3.8 provide the necessary lighting and luminosity standards, emphasizing that proper lighting is essential for identifying bioburden, damage, and imperfections, which directly impact outcome quality.

Examples of Professional Initiatives

Improving your department doesn’t always mean making product investments; it may require self-development! Below are a couple considerations to improve professional well-being and development.

Communication

  • Huddles: Start each shift with a quick 10-minute huddle to share updates on equipment maintenance, staffing changes, or reminders about upcoming audits. Use this time to allow team members to ask questions or share concerns. Choose a cadence that works for your department & volumes.
  • Memo Boards: Create a central communication hub with a whiteboard or digital screen in the break room. Divide it into sections such as “Announcements,” “Shout-outs,” and “Important Dates” to highlight key facts.
  • Newsletters: Distribute a monthly electronic newsletter summarizing updates on policies, upcoming training, and personal recognition for outstanding work.

Training/Skills Development

  • In-Services: Partner with vendor reps to conduct regular on-site training sessions for new technologies, robotic instruments, or best practices in instrument reprocessing.
  • Live Workshops: Host quarterly hands-on sessions where technicians can practice advanced techniques, such as proper use of ATP testing for quality assurance or simulated high-level disinfection processes.
  • Continuing Education: Provide your team with online resources for free CE credits, such as the Pure Processing Education Page, or implement monthly training focused on a different ANSI/AAMI standards to keep the team compliant and informed.

Department Morale

 

  • Holiday Celebrations: Host a potluck during the winter holidays, with time-adjusted events for each shift, to ensure everyone can participate. Decorate the department with festive colors to reflect the season.
  • Staff Recognition: Introduce a “Technician/Nurse of the Month” program where peers nominate teammates who go above and beyond and provide the winner with a small gift.
  • Milestone Achievements: Celebrate service anniversaries with a departmental certificate, a group photo, a personalized thank-you note.

Rounding

  • Action Follow-Up: If a technician raised concerns about decontamination bottlenecks last week, follow up during rounding by showing a tangible fix, like a new cart wash schedule.
  • Pulse Check: Spend time observing the prep-and-pack team during peak hours. Ask them directly about their current challenges or tools they think could make their workflow smoother.
  • Hands-On Assistance: While rounding in decontamination, assist in troubleshooting a piece of malfunctioning equipment or help technicians manage a backup on a tray cart to ensure they don’t feel unsupported.

 

By combining thoughtful investments in tools and equipment with a proactive focus on team engagement, education, and morale, departments can build the habits which deliver long-term, high-quality results. Transformation doesn’t happen overnight; it’s about consistent effort and celebrating incremental victories along the way.

Start small, stay focused, and use the Practical Roadmap to SPD Success tool to guide your journey. Every step brings your department closer to operational excellence and ensures your team is ready to meet the challenges of tomorrow.

Building Habits of Improvement: SPD Style

Posted on by Megan Pietura

“Quality is not an act, it is a habit.” – Aristotle

Quality is a standard measure of achievement and can be determined by a scientifically determined metric that makes something high standard. Habits are a repeatable practice we put into place to improve the quality of our routines, performance, and ultimately, improve quality.

Work fatigue and eventual burnout can arise from unaddressed gaps in our work environment. Sometimes those gaps are a small nuisance that has been festering, like unresolved repairs, or workarounds from a lack of resources. Work fatigue might also be the result of poor habits and a lack of consistent practices and upgrades. Incremental changes and upgrades can have a compounding result (Mereu & Jordan, 2024) that can improve, or hurt, our departments over time related to work fatigue and burnout. Bad habits compound over time, too.

Below we will explore two different types of work areas that can influence how our team interacts with each other and their work. There are many potential gaps which contribute to negative quality outcomes. By identifying these risks, departments can better form habits & improvements to remove them.

 

Micro-Issues: Wolves in Sheep’s Clothing  

Keeping up with fluctuating volume and demand is part of the daily grind in sterile processing and endoscope reprocessing departments. Gaps in processes can result in strain, inconsistent quality and staff challenges.

  • Automation: This can be automation of processes or reporting. Manual processes can be time-consuming, inconsistent and strenuous on our teams and the entire department. Think of the time dedicated to processes like syringe flushing, or the labor required to manually tally totals at the end of the month for throughput reporting. Manual labor has its time and place. The human aspect of our job is the most crucial, but eliminating manual tasks, where possible, can ease the pressure on staff, and improve engagement and outcomes. Consider the compounding effect on both the tech and quality of our throughput by focusing on manual areas of work.
  • Damage Prevention: Instruments can be both complex and delicate making them susceptible to damage. Ofstead and Associates, in a recent study, indicated the infections were also linked to endoscope with damage and residual (2024). This can lead some technicians to hesitate at the thought of reprocessing specific instruments or specialties for fear of their fragileness and potential harm when not handled and processed appropriately.
  • Ergonomic Fatigue and Injury Prevention: Ergonomics is a continuous source of discussion and consideration. ANSI/AAMI ST79 3.3.6.1.3.& ANSI/AAMI ST91 4.2.1 both address ergonomics as an injury prevention safety measure. Furthermore, 48.02% of 2024 SPD State of the Industry participants indicated that they had experienced an injury on the job ranging from chemical exposure to bodily injury including sprains, strains and fractures. With long hours and laborious tasks, ignorance of ergonomic considerations can not only injure key staff but make retention of new ones difficult. Scrutiny and distrust from administration can be a side effect of a department frequently putting its workers on worker’s compensation leaves. One neglected area compounds into multiple negative effects costing money and time.
  • Inspection Accessories:  ANSI/AAMI ST79: 3.3.5.6 & Annex D &  ANSI/AAMI ST91: 4.3.8 & Annex E provides guidance on the type of lighting, luminosity as well as visual inspection tools for internal inspection of lumened instruments.  Insufficient lighting and a lack of visual inspection tools can lead to missed damage, unidentified bioburden and false security. Much like the risk caused from damage, there is equal concern for undetected imperfections on our processes.

 

Professional Gaps

Professional development plays an equally influential role in the quality of our outcomes and creating positive habits, or influencing negative ones.

  • Communication: Sterile processing departments often have multiple shifts. It’s easy for announcements, process updates and key changes to become muddled over the course of the day and weeks. Inconsistent communication can lead to disorganized work, confused priorities and non-uniform processes. It’s also a ripe area for distrust to be sown amongst our teams.
  • Training/Skills Development: ANSI/AAMI Standards ST79 & ST 91 both address training and education as a requirement for onboarding and includes recommendation for incremental evaluations. (ANSI/AAMI ST91 6.3 &  ANSI/AAMI ST73 4.3) Furthermore, 52.36% of participants in the 2024 GI Landscape Report  and 45.37% of 2024 SPD State of the Industry survey participants indicated that they lack adequate training and skills development opportunities. Without consistent education and training, our teams can lose touch with best practices, new technology and time to practice improved skills sets.

  • Department Morale: It’s often been said that we spend more time with our work teams than we do with our own families. They see and/or hear of our ups and downs and help us work through high stress situations with us. Our team’s morale can be impacted by both internal or external influences and can greatly impact how they interact with each other and their work. When stress levels are high, motivation and engagement can diminish, leaving our work and quality lacking.
  • Rounding: It’s easy as leaders to unintentionally lose touch with the daily grind in the department. The missed huddle, or the forgotten follow-up that was promised can all contribute to communication and preconceived assumptions of leadership by the team. Improper follow-up and environmental awareness can result in tension, unresolved challenges and extended workarounds that impact the team’s ability to perform their task well.

 

Workarounds and bad habits are rampant, if you know where to look. Those bad habits compound into more significant issues, if they are left to fester. the focus on habitual improvements starts with the awareness these issues exist and assessing your department’s daily habits. Identifying current practices against desired outcomes and understanding the professional growth of your team can start the process to rectifying bad habits and getting back to a focus on quality outcomes. Never underestimate the power of that one change; it can truly alter the trajectory of your department!

 

References

  • https://hbr.org/2024/02/the-restorative-power-of-small-habits
  • ANSI/AAMI ST79
  • ANSI/AAMI ST91
  • 2024 SPD State of the Industry Report
  • 2024 GI Landscape Report
  • Cori L. Ofstead, Abigail G. Smart, Larry A. Lamb, and Frank E. Daniels, December 2024
  • Impact of Borescope Inspections on Endoscope Repair Frequency and Costs

Celebrating SP Week Year Round

Posted on by Megan Pietura

Each year, sterile processing departments everywhere look forward to a single week, their week; SP Week.

SP Week offers the opportunity for healthcare facilities and their employees to celebrate sterile processing working in the heart of the hospital to ensure patient safety during each and every surgery.It’s difficult work that many don’t have an appreciation for, which is why dedicating a week each year is so important.

But is it really enough?

We didn’t think so! We sat down with Adrienne Hill, Sterile Processing Manager at Penn State Health – St. Joseph, the winner of Pure Processing’s 2024 SP Week photosubmission raffle, to discuss the importance of SP Week, activities, and how to carry a little bit of that SP Week energy into the rest of the year.

 

The Importance of SP Week

SP Week serves to drive awareness of sterile processing departments and the critical work that gets done within them. “It gets our department out there for people to see”, Hill explained.

This awareness isn’t limited to sterile processing-adjacent departments. Everyone, from doctors to surgical techs to nurses, and even members of senior leadership, celebrate the sterile processing

team during SP Week. This is important not only because SPD teams deserve to be acknowledged, but also because other areas of the hospital need to understand why sterile processing is such a critical part of operations.

 

SP Week Activities

It’s one thing to celebrate and verbally express appreciation, but it’s also important to show teams their appreciation through actions. This can come in a variety of forms, such potlucks, organized lunches, vendor visits and more.

But it’s not all food! SP Week serves as an excellent time to set aside for things like education, team bonding, and more than a little bit of fun. Hill explained a unique activity they opened up to anyone in the hospital to try out:

“We put together a mock heavily soiled case cart that was a mess. We actually shaved up red paper to simulate blood and we sprayed the pre-cleanse all over the inside of the cart. Then we had a piece of paper next to it that asked participants to name the six things that are wrong with this case cart and what is the right way. If they got it right, then they would win a prize.”

This activity, open to other departments, highlighted just how much sterile processing teams need to know and how critical their attention to detail is. It was safe to say that participants from outside of SPD had a tough time.

A few other activities SPD teams could consider doing in their departments include:

  • Wrap contests
  • Word searches
  • “About me” cards to help teams get to know each other better
  • Live or on-demand education sessions from an educator or vendor
  • Dedicated times for technicians to complete CE-accredited content
  • Scavenger hunts
  • For more ideas, check in with vendors (like Pure Processing) for pre-made activities your team can take advantage of!

Managers can also take additional steps to show their team how much they appreciate them, as Hill outlined:

“I wrote thank you cards to everybody, the team gets goodies from vendors, we put together little gift bags. I bought everybody little notebooks that they can write in, and inside of them it said: ‘Always know what you do matters.’”

 

SP Week All Year

It’s clear that SPD teams appreciate having a week dedicated to their work and profession each year, but supervisors, managers, directors and other leaders can take steps to make teams feel appreciated all year long. Here are some of the ideas discussed:

  • Make the department festive for holidays
  • Schedule monthly potlucks
  • Encourage socialization during downtime to help teams get to know each other better
  • Use daily huddles to acknowledge your team’s good performance
  • Encourage feedback from your team so they know they’re heard
  • Find fun ways to recognize individuals for going above and beyond
  • Surprise SP Week activities: every now and then, surprise your team with the kind of activity that normally only happens during SP Week, like wrap contests or scavenger hunts.

These steps don’t always need to be time consuming, either. Hill explained that it’s often the little things that let people know they’re seen:

“You know, even just keeping the break room stocked with things like paper plates, or coffee, or snacks; just the small things that they shouldn’t have to do or worry about, especially for the off-shifts that don’t have a cafeteria they can go to. Maybe writing those thank you notes a little more often. Call out birthdays and let people know that you care about them.”

Hill also added, “Try to find ways to spend time together outside of the department and get to know each other better. I know people have lives outside of the department and some aren’t interested in spending personal time with coworkers, but for those that are, try to help make it happen.”

 

Conclusion

We all look forward to SP Week every year. On the vendor side, we love celebrating the sterile processing teams keeping everyone safe and finding new ways to demonstrate our appreciation. For those in departments, doing the work, there’s a ton of reasons to celebrate SP Week.

As Hill explained, however, that sense of appreciation and excitement doesn’t need to be limited to a single week each year. Sure, it can’t be lunches and activities every day, but the things that make SP Week special, those moments of appreciation, bonding, and fun, can happen anytime of the year. You just need to start!

Interested in exploring other ways to show your team appreciation? Check out Appreciation: The Key to Retention

Endoscope Reprocessing: 3 Reasons Your Endoscope Manual Cleaning Practices Are Failing

Posted on by Megan Pietura

The complexity and advancements in flexible endoscopes designs have expanded our preventative and diagnostic care in healthcare today, but it hasn’t been without challenges and strain, especially on our sterile processing and endoscope reprocessing teams.

Ofstead & Associates consolidated and released summarized data this past quarter that showed yet another increase in MAUDE database reporting on flexible endoscope adverse events in 2024 Q31. Findings also suggest that flexible endoscopes are ranked as the highest risk factor for healthcare associated infections compared to other semi-critical medical devices3 (Benowitz, 2020).

As the professionals who are responsible for reprocessing flexible endoscopes, it is crucial to understand the “why”: what are the challenges and reasons failures happen in our reprocessing cycle? Understanding these challenges and identifying opportunities to address them positively supports our teams and improves preventative and diagnostic care in our healthcare facilities.

 

Reason #1: Obscured or Overlooked Damage

Flexible endoscopes, just like any other medical device, are subject to generalized wear and tear. Long working channels are a challenge to not only clean but also inspect for quality cleaning measures. Bends, scratches and other imperfections within the channel wall can lend to biofilm formation; undetected bioburden can often be passed over with just a traditional bristled brush.

Consequently, we learn that brush bristles or elastomer discs alone cannot effectively clean and adapt to each channel condition. One material over the other is also a contributor to effectiveness. A validation study has shown that a combination of bristles and squeegee methods provides a more comprehensive and repeatable clean in flexible endoscope channels.

Additionally, what can appear as a small “imperfection” can prove to be costly, from loose parts and cracks to damaged seals, each one has the potential to harbor bacterial, viral or fungal growth resulting in cross contamination and pathogenic transmission.

 

Reason #2: Biofilm

Biofilm can formulate within minutes under the right conditions. Biofilm poses a risk not only patient safety, but also the ability to effectively clean and disinfect our medical devices. Biofilms are directly linked to hospital acquired infections (HAI) and surgical site infections (SSI) with originating sources that include medical devices4 (Milliard et al, 2023).

It has also been long understood that despite close adherence to endoscope manufacturer instructions for use (MIFU), there are still risks of biofilm and pathogen transmission relating to outbreak4 (Benowitz, 2020). This lends to the fact that despite improved efforts to reduce complications, there is still gaps in the process to consider.

Reason #3: Education, Competency & Situational Awareness

Education has many arms in medical device reprocessing, some of which include:

  • Standards-based reprocessing practices
  • Flexible endoscopy knowledge
    • Scope anatomy
    • Scope functions & use
    • Manufacturer IFU
  • Reprocessing equipment & supply knowledge
  • Outbreak awareness, study results and reporting

Awareness, competency and evaluation not only justify the need for robust reprocessing, but also the empowerment of our professionals to understand the weight and impact of their role. Providing resources to extend their knowledge and awareness may improve performance, but truesustainable advancements come in a two-part form that also includes resources and tools necessary to achieve quality outcomes.

 

Reprocessing failures are being identified as more than a failure to comply with all steps in a process. Failures in the manual cleaning process can lend to the survival of pathogens even after the disinfection of flexible endoscopes5 (Kenters, 2015). There are many contributing factors including damage, drug-resistant biofilm, and inadequate instructions for use.

As we become aware of the larger picture and the full scope (pun intended) of what it takes to safely and effectively reprocess endoscopes, it is our responsibility to perform the due diligence to improve and correct practices for the safety of our teams and our patients.

 

Interested in digging further into endoscope manual cleaning? Check out:  Endoscope Manual Cleaning: The Challenges that Impact Our Effectiveness

 

References:

  1. https://www.linkedin.com/company/ofstead-&-associates-inc.?trk=public_post_embed_feed-actor-image
  2. Ofstead CL, Buro BL, Hopkins KM, Eiland JE, Wetzler HP, Lichtenstein DR. Duodenoscope-associated infection prevention: A call for evidence-based decision making. Endosc Int Open. 2020 Dec;8(12):E1769-E1781. doi: 10.1055/a-1264-7173. Epub 2020 Nov 17. PMID: 33269310; PMCID: PMC7671768.
  3. Benowitz I, Moulton-Meissner HA, Epstein L, Arduino MJ. The Centers for Disease Control and Prevention Guidance on Flexible Gastrointestinal Endoscopes: Lessons Learned from Outbreaks, Infection Control. Gastrointest Endosc Clin N Am. 2020 Oct;30(4):723-733. doi: 10.1016/j.giec.2020.06.009. Epub 2020 Aug 1. PMID: 32891228; PMCID: PMC7962740.
  4. Maillard JY, Centeleghe I. How biofilm changes our understanding of cleaning and disinfection. Antimicrob Resist Infect Control. 2023 Sep 7;12(1):95. doi: 10.1186/s13756-023-01290-4. PMID: 37679831; PMCID: PMC10483709.
  5. Kenters N, Huijskens EG, Meier C, Voss A. Infectious diseases linked to cross-contamination of flexible endoscopes. Endosc Int Open. 2015 Aug;3(4):E259-65. doi: 10.1055/s-0034-1392099. PMID: 26355428; PMCID: PMC4554517.
  6. https://www.linkedin.com/company/ofstead-&-associates-inc.?trk=public_post_embed_feed-actor-image

4 Process Trends in GI and SPD & What You Need to Know

Posted on by Megan Pietura

The one thing we can always count on working in reprocessing departments? Something is changing and evolving. Standards are amended, new studies are published, technical information reports (TIRs) transition to standards among many other changes and recommendations that keep our world in a state of constant development.

There are several improvement recommendations that create a more robust process in sterile processing and endoscope reprocessing from decontamination to prep & pack. Efficiency and safety are at the crux of medical device reprocessing updates and expansions. However, these changes are not always easily implemented and take consideration when it comes to space, location and cost prioritization.

Reprocessing steps are becoming more nuanced and regulated as we become more aware of gaps and the growing complexity of reusable medical devices. There are several updates in the industry now that require formal implementations and workflow evaluations.

Extended soak times

Extended soak times occur when flexible endoscopes cannot be reprocessed within the recommended 60-minute time period post procedure. However, this can also go for some surgical instruments whose manufacturer IFU’s have a soak time longer than the chemistries contact range.

“When there is a delay and/or failure to perform point of use treatment, the endoscope should be processed using delayed processing protocols described in the device manufacturer’s IFU.”

ANSI/AAMI ST91:2021 7.2.2

These extended soak times are necessary for appropriate and safe reprocessing but can lead to backlogged work and slower throughput times. These soak times may require a designated area to complete the steps so as not to disrupt other priorities.

Visual Inspection: Borescopes & Cleaning Verification Test

Channels and lumens commonly appear in SPD and endoscopy departments and increased visibility measures are required to full inspect and verify the instruments cleanliness before high-level disinfection (HLD) or sterilization.

Cori Ofstead & Associates conducted a compelling research study that brought awareness and real-life application to the importance of visual inspection of channeled instruments. (Ofstead, et al, 2024) Following recommendations and IFUs doesn’t always guarantee a patient-ready product. Additionally, more detailed inspection such as borescope and cleaning verification highlights the quality of practices and outcomes, thereby shedding light on potential process gaps.

Adding this measure of inspection to your workflow also brings up questions about location and feasibility. With this added step, keeping in mind the need to reduce cross- and even re-contamination plays a role in where and how this detailed inspection takes place.

Borescopes are also incredibly delicate tools. Implementing them into workflows should consider spaces for storage, effective table space for coiling and staging instruments without smashing the borescope, and places for mounting IT and monitors.

Cleaning verification provides a pass/fail indicator to our cleaning processes and can include test such as ATP, protein, carbohydrates and endotoxin among others. (ANSI/AAMI ST79 Annex D & ANSI/AAMI ST91 Annex F) Each test provides scientific bench markers to determine cleaning efficacy and is making it’s way into standardizing processing initiatives.

Cleaning verification (borescope and marker testing) enhances department’s awareness and provides foundational benchmarks for appropriate and safe cleaning practices.

Tray Configuration

Tray configurations include a handful of checkboxes to maintain compliance. These include IFU compatibility between instruments and sterile barriers, IFU compatibility across instruments required in the set, and tray weight (ANSI/AAMI ST79 8.2 & 13.) The recommended maximum tray weight of 25lbs includes the combined weight of the instruments and sterile barrier. Some rigid container manufacturers also have validated weight limits included in their IFUs.

Tray weights not only ensure standardized weights to reduce employee strain and injury but when tracked can also help verify to sterilization load weight compliance.

“Instrument sets, including the sterile barrier system, should weight no more than 11 kg (25lb) (ANSI/AAMI ST77)”

ANSI/AAMI ST79:2017 8.2(j

Consideration should also be given to the load requirements specified by the manufacturer (e.g., number of devices, load weight)

ANSI/AAMI ST79:2017 13.9.1

Electronic Record Keeping

Digital record keeping continues to expand as technology and software capabilities increase. ANSI/AAMI ST79 13.3 both provide recommendations on what information needs to be maintained and traceable through each phase of reprocessing. Record keeping, especially at automated reprocessing machines, may require space for monitors, scanners and incubators to consolidate the process.

Electrical power is also a serious consideration. Departments may be inadequately equipped to handle additional electrical requirements. Power cords or delicate IT accessories also need protection from regular damage.

The process critical parameters (time and temperature) provided on the recording chart, printer, or tape should be reviewed, signed, and dated by the operator to indicate an acceptable cycle. For each sterilization cycle, the following information should be recorded:

      1. a) the load number;
      2. b) the specific contents of the lot or load, including quantity, department, and a specific description of the items

(e.g., towel packs, type/name of instrument sets);

      1. c) the exposure time and temperature, if not provided on the sterilizer recording chart;
      2. d) operator identification;
      3. e) the results of biological testing, if applicable;
      4. f) the results of Bowie-Dick testing, if applicable;
      5. g) the response of the CI placed in the PCD, if applicable; and
      6. h) any reports of inconclusive or nonresponsive CIs found later in the processed devices (see also 13.5.2.2)

ANSI/AAMIST79:2017 13.3.3

Prioritizing process implementation and placement not only equips the department to maintain compliance but also formalizes their processes and organization to ensure steps are not overlooked. Steps like optimized inspection and tray weight management among others contribute to overall patient safety and quality product throughput.

References:

Ofstead, et al, (2024) Beyond Endoscopes: Pilot Study of survival instrument Lumen Inspection https://array.aami.org/doi/10.2345/0899-8205-58.1.25

ANSI/AAMI ST91:2021

ANSI/AAMI ST79: 2017

Solutions for Growing Challenges in Instrument Reprocessing: How Departments can Address New, Additive Processes

Posted on by Megan Pietura

Sterile processing and endoscopy might feel like it’s in constant evolution. In just a couple short years, departments have been faced with finding solutions for the pandemic, ANSI/AAMI ST91 updates and the new ANSI/AAMI ST108 standard, a job market turned on its head, increasing surgical volumes, and so much more.

Some of the most disruptive changes occur when workflows get jolted: certain steps get added, others removed, manual labor needs increase, or challenges creep their way in through vendor trays, add-ons, and more.  Technology is also a contributing factor to disruption. In 5 years’ time, what changes could be expected in surgical instrument design? What new equipment could your department be asked to integrate?

Below are 4 trends taking over instrument reprocessing, and considerations to make if they’re happening in your department.

 

#1: Quality Assurance Testing

Protein and ATP (adenosine triphosphate) testing are strongly recommended by standards such as ANSI/AAMI ST79 and ANSI/AAMI ST91

for increased quality assurance. They can be excellent gauges to ensure processes are hitting certain standards. Departments should however be careful to consider how these additive processes integrate into existing workflows.

If your department uses any form of quality assurance testing, whether ATP, protein, borescope inspection among others, these might be consideration points to reduce harmful ‘noise’ they could introduce:

  • Space: Dedicating space & storage for testing kits, readers, borescopes and more protects the integrity of the devices themselves and provides room to stage instrumentation.
  • Power: Borescopes especially require additional outlets. Separating borescope inspection in an area like decontamination and integrating into a station which supplies electrical outlets can make integration that much smoother. As well, this dedicated area can reduce damage for delicate borescope catheters.
  • Computers and/or tracking systems: Results from QA testing might need to be uploaded into a computer or tracking system. If record-keeping is done manually, then that area also requires space for test results. Separate stations can mitigate clutter at QA areas.

#2: Increased Soaking

In the early 2010’s, the addition of longer robotic instrumentation with increased soaking times forced sterile processing to funnel resources into decontamination. Delayed endoscope reprocessing, too, put pressure on endoscopy departments to accommodate long soak times .

If your department requires extended periods of soaking, separating these instrument sets or scopes from standard throughput sink basins removes bottleneck risks. Instrumentation can soak without clogging up workflows.

Extended soaking also requires accessories such as timers, temperature gauges, dosing pumps, and others. Consider setting up dedicated areas just for soaking functions, which can convert to cleaning basins as volumes increase.

Departments which are taking on increasing surgical volume for certain specialties may need to go so far as integrating entire separate sink systems to accommodate special instruments sizes, steps and volume.

flushing robotics 003

#3: Instrument Trays

Whether wrapped or in rigid containers, both sterile barrier systems introduce challenges to workflows.

For departments consolidating wrapping, or changing their proportion of wrapped versus rigid use, considerations around wrap storage should take place. If wrapping is done in multiple areas of assembly, is wrap centralized toa single, shared location, or easily accessible for staff? Minutes can accumulate into hours wasted across multiple technicians when they makeshift extra space or wait their turn for the designated station. Is wrap being inspected before use? Lighted wrap tables can integrate both storage for blue wrap, wrap supplies, and

introduce large, dedicated areas where wrapping is required. Built-in lighting also ensures wrap and instrumentation is functional before loading into sterilizers.

If loaner trays are already a staple in your department, then tray weight might be a concern. Before having overweight vendor trays to sneak into your department, a scale station could be integrated at check-in stations. Providing immediate feedback to vendors on overweight trays can reduce compliance and ergonomic complaints. Scale stations which are mobile can also be moved to other areas where they’re required.

#4: Record-Keeping

With digital record-keeping needs becoming the standard practice, so too does the need for power. Dedicated stations which integrate outlets, mounting infrastructure for monitors and under-table storage for computers can go a long way into making stations less cluttered. Protecting powered items is also a point of consideration. Are the IT accessories cluttered on top of each other, with power cords strewn about? Or are items organized and away from water and damage risks?

 

Sterile processing and endoscopy departments must be prepared for a world of non-stop change. Quality assurance, record-keeping, a change in tray configurations and increased assurances in manual cleaning all have the potential to disrupt workflows. But these changes don’t always require major investments or purchases. Scalable, flexible solutions which can be built and organized for your department’s unique needs are available, and make change must easier to take head-on.

 

Preparing to add quality assurance testing, and need dedicated areas to do so? Or are overweight vendor trays making their way into your department? Contact us today to learn about easy-add solutions for all department spaces!

2024 Sterile Processing State of the Industry Report – Actionable Insights

Posted on by Megan Pietura

The annual State of the Industry Report delivers unique, interesting insights for SPD professionals across the country. The survey often affirms known challenges, while simultaneously shedding light on new and emerging ones. What can leaders and managers do with all this information?

Here are some actionable insights from the 2024 Sterile Processing State of the Industry Report.

 

Finding great people

People are entering the sterile processing industry in a variety of ways. Interestingly, the largest group of respondents indicated they had no knowledge of sterile processing before taking their first role.

  • Found open position without prior knowledge of SPD: 37.43%
  • Referred by a friend or colleague: 18.63%
  • Moved from another department in the hospital/facility: 31.11%
  • Pursued education at a university/college with the intent of starting a career in SPD: 12.83%

Actionable insight: 62.57% of participants entered the sterile processing industry from within the healthcare field, via referral, or because of personal aspirations. Leveraging your professional and personal networks is a great way to find your next teammate.

 

Building a great team around what SPD techs enjoy about their work

We asked participants to identify the aspects of working in sterile processing that they enjoy the most. Participants submitted free responses, with some incorporating more than one aspect of the job they enjoy.

  • Impact on Patient Safety: 45%
  • Continuous Learning & Variety of Work: 30%
  • Sense of Accomplishment & Importance of Work: 19.78%
  • Problem Solving & Challenging Work: 11.74%
  • Teamwork & Collaboration: 10.43%
  • Playing a Behind-the-Scenes Role: 10%

Actionable insight: Technicians that love working in sterile processing have and share many similar traits. When hiring for open spots on your team, it may be a good idea to look for candidates with the following qualities:

  • Caring
  • Curious
  • Open to learning
  • Team-oriented
  • Stands behind their work
  • Interested in the well-being of others

 

Turning common problems into opportunities

We asked 2024 Sterile Processing State of the Industry Survey participants to identify the most common problems they see in SPD. Participants were able to select three choices.

  • Space: 52.17%
  • Equipment: 38.37%
  • Management: 27.98%
  • Work Culture: 33.27%
  • Pay & Benefits: 72.97%
  • Training & Education: 45.37%
  • Compliance: 16.64%
  • Ergonomics: 13.23%

 

Actionable insight: Issues regarding space, equipment, and compliance could be the source of workarounds and shortcuts being taken in sterile processing departments. If you’re seeing shortcuts being taken or an increased lack of compliance, assessing your space, how it’s utilized, and whether the equipment your team has at its disposal will likely serve as a good starting point toward addressing compliance concerns.

 

Listen to your team

We asked participants, “What is a problem that should be easy for sterile processing departments to resolve today?” and gave them a text box for free responses. Several themes emerged from the free responses, with some participants mentioning more than one problem in their replies.

  • Training & Education: 66.96%
  • Equipment & Technology: 10.49%
  • Staffing & Workload: 9.15%
  • Compliance & Standards: 6.92%
  • Communication & Coordination: 6.92%
  • Process Efficiencies: 3.35%
  • Quality Control: 1.12%
  • Safety: <1%
  • Resource Allocation <1%
  • Culture <1%

 

Actionable insight: Many participants cited training & education as an easy problem to solve in the SPD. Asking your team what kind of training or education they’d like to see offered then leveraging free training provided by industry resources can help fill education gaps and let your team feel heard. Developing a consistent training schedule will help teams feel supported and well-trained, helping to build & maintain their industry knowledge and confidence.

 

Ready to turn even more insights into action items for your department?

These actionable insights are just the tip of the iceberg; to maximize what was learned in the 2024 Sterile Processing State of the Industry Report for your department, check out our other blog posts detailing findings and takeaways ahead of the 10.1.24 publishing of the report:

Interested in using pre-built assessment tools in your department right now?

Scan or click the QR codes below for access to free tools that can help you assess your department:

SPD Ergonomic Checklist       Luminosity Compliance Checklist

2024 Sterile Processing State of the Industry Report – Executive Summary

Posted on by Megan Pietura

Pure Processing’s annual industry reports provide useful insights, trends, and challenges through the eyes of sterile processing professionals working in SPD daily. Through these responses and insights, managers and leadership can open a window into what SPD professionals are seeing and thinking in new ways, and across the country. This year’s 2024 Sterile Processing State of the Industry Survey (results used to create the 2024 Sterile Processing State of the Industry Report) incorporates the responses from 569 SPD or SPD-related individuals from across the United States. This executive summary highlights some of the major themes and challenges identified within the 2024 Sterile Processing State of the Industry Report.

 

Patient Safety

The importance of sterile processing’s role relative to patient safety is top of mind for SPD professionals, in more ways than one. Not only was a shared sense purpose regarding patient safety something that participants considered to be a major factor that made a department great to working, but the way their work contributes to patient safety is a core facet of why they enjoy working in sterile processing, generally.

 

Training & Education

Training & education was a common theme throughout the survey and report. Key considerations participants mentioned were consistency of training & education opportunities, access to training & education on-the-clock, getting hands-on training with instruments and equipment from vendors, and determining competency more than once a year.

68.29% reported their department putting a strong emphasis on training education. Educators were considered to have the most influence on training & education in departments. Surprisingly, 12.94% of “Other” responses indicated that no one was influencing education in their department.

 

Pride in SPD

Pride in the work they do and knowing the impact they have was shared among many of the participants. Even while acknowledging things like challenging, physically demanding work, poor compensation, and lack of appreciate & recognition, pride in the service they provide for the hospital, OR, and patients was on full display.

 

Pay & Compensation

As many in sterile processing can likely relate to, pay & compensation arose as a concern and common problem in the 2024 Sterile Processing State of the Industry Report. Key concepts in this area focused on the importance of the role SPD plays in a healthcare setting, the level of knowledge and expertise required to execute the job effectively, and the compensation of other healthcare positions, such as scrub techs, being disproportionate to theirs.

 

Entering the Industry

With referrals by friends or colleagues, moving from another department within their facility, and pursuit of a career in SPD accounting for 62.57% of entrances into the industry, managers are probably still well-suited utilizing their professional network to identify their future teammates.

 

Leaving Sterile Processing

While many expressed an enthusiastic, committed disposition toward sterile processing and their time in it, they didn’t shy away from acknowledging what drives people out of the industry, aside from compensation. Lack of appreciation was the top reported reason for SPD professionals to leave the industry, followed by the physical demands of the job, with lack of upward mobility and a career ladder coming in third.

Leadership & Management

Leadership & management styles were pointed throughout the report, with areas of opportunity emphasizing consistent accountability of all teammates, advocating for SPD teams, creating opportunities for teams to grow professionally, and facilitating good communication.

One other key point made was the need to have leadership with a background in sterile processing, with many denoting the frustration that comes with reporting to someone that is perceived to lack an understanding of all that their department is doing.

Misunderstood

In many respects, participants felt that their sterile processing departments are fundamentally misunderstood. Misunderstood by executives, by OR staff, and even their leaders. Aspects surrounding the perceived misunderstanding include what exactly SPD does, the impact it has on facilities, the way they contribute to patient safety, and the knowledge required to do the job well.

Many participants noted their disappointment in the perceptions that SPD are “dish washers” and that their work is effectively entry-level, despite the certifications, education, and experience that contributes to successful execution of SPD’s responsibilities.

 

Interested in getting more insights from the 2024 Sterile Processing State of the Industry Report? Check out other blog posts detailing results from the report ahead of its 10.1.24 publishing!