Solutions for easily boosting capacity in backlogged sterile processing departments

It is a scene that is all too familiar in sterile processing departments: case carts pilling up in decontamination, while scheduled surgeries are delayed or postponed due to backlogs in reprocessing. Those backlogs are often created by bottlenecks that can easily be adjusted or eliminated with a few uncomplicated solutions.


Sterile processing backlog area 1: Soaking

The most common sterile processing bottlenecks occur during the soaking and precleaning processes.

Soaking and precleaning is critical for patient safety. ANSI/AAMI ST79: 2017, 7.5.1 states “presoaking instruments moistens and loosens the soil, thus making the cleaning step more effective and efficient.”1 Additionally, device instructions for use (IFU), such as robotics, can require soak times of up to 30 minutes. Flexible and rigid scopes can be even more demanding when delayed reprocessing occurs, requiring a minimum of one hour of soaking, and up to ten hours for some gastrointestinal scopes.²

Many reprocessing departments do not have enough sink basins to dedicate tor instruments with extended soak times. Additionally, many sink basins are not wide enough to accommodate soaking larger instruments or trays, leading to more reprocessing delays.

Robotic instruments and scopes are inherently difficult to clean. Properly soaking the instrument loosens and removes gross bioburden to make the cleaning and rinsing process more effective. If proper protocols are not followed during the precleaning process, that can add additional delays to an already bottlenecked process. So how do departments prioritize basin space and while meeting standards and guidelines?

Options to accommodate medical device soaking requirements

Mobile carts are a quick fix for departments that do not have extra space or resources for a renovation. Departments can create a dedicated soaking space during peak processing times by incorporating a sink insert into a mobile cart or integrating a mobile sink basin. Sink inserts and mobile carts are available in a variety of sizes to accommodate robotics, rigid and flexible scopes, as well as separate areas for ocular instrument reprocessing.

Mobile carts are available in multi-tier options so that departments can soak multiple sets of instruments at once within a small footprint. The mobility of the carts also makes it easy to store the cart and sink inserts when not in use or utilize it for vertical storage options as a place to store soaking containers when not in use.


Sterile processing backlog area 2: Flushing

Properly flushing instruments during the precleaning process can create backlogs when volume of lumened instruments and processes for flushing are considered.

Lumens must be flushed with highly efficient practices, so time-saving measures can be difficult to implement without the expense of quality. Contact, friction, and fluidics are necessary to properly remove bioburden from lumened instruments and scopes.

  • Specific contact times are required by detergent IFUs to effectively dissolve and loosen bioburden deposits such as blood, fat, and tissue
  • Friction, by brushing or flushing, facilitates the separation of bioburden from its points of attachment on internal device surfaces
  • Often, brushing or flushing alone does not remove hard, stuck-on bioburden. By integrating fluidics, or a high volume of fluid under pressure, those volumes ensure that detergents and residues are completely flushed from interior channels and lumens

Traditional tools to flush lumened devices such as syringes and spray guns may be a simple, cost-effective option. However, cost-effectiveness should be balanced with efficiency and effectiveness.

Syringes may be a simple, traditional solution. But pulling liquid and plunging it into each instrument for a specified number of times is a time-consuming process. And no two technicians’ flush instruments in the same way, every time. That can lead to practice discrepancies from shift to shift.

Similar to syringes, spray guns cannot clean more than one channel at a time, and require technicians to use both hands, which decreases the ability for technicians to multi-task.

Alternatives to flushing with syringes and spray guns

Automated flushing systems effectively address the issue of throughput by enabling simultaneous flushing for multiple channeled items or ports with much less connection or disconnection time. One automated system can allow technicians to flush up to 5 items at a time. Output can be doubled or even tripled multiple systems are installed at sinks.

By automating the flushing process, departments can also ensure that devices are consistently flushing at the proper volumes per instrument IFU and ANSI/AAMI ST79:2017 flushing and rinsing standards. Automated systems provide options for flushing for specific amounts of time at specific volumes so that contact time IFUs are met. Additionally, treated and untreated water and cleaning solutions can be integrated into the system to aid in loosening bioburden and assuring pre-cleaning protocols are met.

Automated systems are adaptable to a wide variety of instruments:

  • Orthopedic
  • Endoscopic
  • Robotic
  • Ocular
  • Laparoscopic devices
  • Suction tips
  • And more

These flushing systems ensure automated, consistent flushing for your full channeled instrument inventory.


Reducing reprocessing bottlenecks NOW

When departments are already challenged with time constraints, fast, affordable solutions are the easiest way to increase capacity. Large-scale renovations are not always necessary. Instead, simple tools such as mobile carts, sink inserts, and automated flushing systems can be easily installed and implemented to alleviate backlogs and reduce processing times. More care can be taken to deliver safer outcomes for staff, instruments, and patients when departments do not feel rushed to provide case carts quickly.

Explore mobile cart, sink insert, and automated flushing system options to increase your sterile processing capacity!


Learn more about reducing backlog stressors and earn free CEUs. Visit our educational program, Finding Your Happy Medium for more details. Follow us on Facebook and LinkedIn for #LearnMoreMonday educational content.


Looking for more blog topics like this? Read 3 Ways Height Adjustable Sinks and Tables Improve Sterile Processing Workflow



  1. ANSI/AAMI ST79:2017 – Comprehensive guide to steam sterilization and sterility assurance in health care facilities. Accessed November 17, 2020.
  2. Benedict M. Delays in Endoscope Reprocessing … and the Biofilms Within. Accessed November 18, 2020.—Delays-in-Endoscope-Reprocessing-FINAL-APPROVED-single-page-version.pdf









Central sterile processing education and training are key to reducing HAIs

For decades, reusable medical devices have been the culprit of healthcare-associated infections (HAIs).  Each day, approximately 1 in 31 U.S. patients has at least one infection in association with his or her hospital care,1 underscoring the need for improvements in patient care practices in U.S. healthcare facilities.

Sterile processing departments play a crucial role in patient safety outcomes. The risk of infection and death increases dramatically if instruments are not thoroughly cleaned and sterilized. In addition to understanding the patient safety element of sterile processing, technicians are also required to understand every inch of a surgical instrument to thoroughly clean and sterilize the device for use on the next patient.

Properly trained sterile processing technicians are critical

Better patient care begins with properly trained sterile processing technicians. Technicians require the most up-to-date information to properly do their jobs.

As medical procedures evolve, so do technology and instrumentation. Keeping up to date with reusable medical devices advancements requires continuous knowledge. Risks increase without the latest industry standards and manufacturer instructions for use (IFU). The safety risk to staff and patients cannot be understated.

According to the United States Bureau of Labor Statistics, there are 50,550 instrument specialist technicians, with job growth expected to increase 20% by 2022.2 That means there are 50,550 different ways an instrument could be cleaned. Inconsistent cleaning practices can be avoided, and patient outcomes can be improved by providing training and education on best practices, national standards, and manufacturer IFU. These must become a mandatory part of every sterile processing department’s quality protocols.

Consistent sterile processing training improves outcomes

Departmental best practices can be improved by consistently providing training and in-service opportunities to staff. This helps avoid medical device reprocessing issues such as dirty instruments that can lead to HAIs.

Sterile processing products such as sterilizers, automated flushing pumps, inspection technology and more are constantly evolving to improve processes and effectively clean and sterilize instruments. Best practices are followed more consistently, and technicians are more confident in the ability to perform their duties when they are properly trained.

Providing ongoing education and certification opportunities to all staff is another way a department can improve not only patient safety but staff safety as well. Educational offerings come in a variety of options, but we will focus on two of the most common: Continuing Education and Certification.

Sterile processing continuing education

Continuing Education (CE) programs offered by facilities, associations, and vendors provide departments with the opportunity to keep up to date with:

  • The latest industry trends
  • Standards and regulations
  • Recommended practices
  • Manufacturer IFU

Vendors and industry associations are a great resource when it comes to obtaining CE credits. This year has also seen an increase in virtual opportunities to easily receive CEs. Social media platforms like Facebook and LinkedIn have many sterile processing professional groups where CE resources are shared. Vendors and industry associations such as IAHCSMMASTAORNSGNA and others also have resources on their website in which to find CE opportunities.

Sterile processing certification

Professional certification requires technicians and staff to take educational courses and exams to assure they have met competency-based standards to perform their jobs. Certification opportunities abound through IAHCSMMCBSPD, community and junior colleges, and other outlets.

Several states understand the importance of the critical tasks that sterile processing technicians are faced with and now require sterile processing technicians to become certified. To become a sterile processing technician in Connecticut, New Jersey, New York and Tennessee, you must be certified. Certification requires technicians to take courses in order to pass a certification exam.  Certification ensures departments are performing their duties through high standards.

CBSPD offers the following certifications:

  • Certified Sterile Processing and Distribution Technician (CSPDT)
  • Certified Ambulatory Surgery Sterile Processing Technician (CASSPT)
  • Management in Sterile Processing (CSPM)
  • Flexible Endoscope Reprocessors (CFER)
  • Certified Surgical Instrument Specialist (CSIS)

IAHCSMM offers the following certifications:

  • Certified Registered Central Service Technician (CRCST)
  • Certified Instrument Specialist (CIS)
  • Certified Endoscope Reprocessor (CER)
  • Certified Healthcare Leader (CHL)
  • Certified Central Service Vendor Partner (CCSVP)

In addition to enhancing patient and staff safety, sterile processing training, education, and certification opportunities provide an outlet to network with other professionals to learn from each other.

Establish a continuous sterile processing training methodology in your department for future growth and adherence to best practices. Now is the time to support your technicians with additional learning opportunities to strengthen the team and improve patient outcomes. Those are the keys to reducing HAIs!


Earn CE credits and certification through Pure Processing! Visit our Educational Resources page for more details. Follow us on Facebook and LinkedIn for #LearnMoreMonday educational content.



  1. Centers for Disease Control and Prevention (2018). 2018 national and state healthcare-associated infections progress report. Accessed on October 12, 2020.
  2. Gooch, K (2015). 15 facts, statistics on central sterile departments and technicians. Beckers Hospital Review. Accessed on October 12, 2020.