sterile processing
sterile processing
By Tony Thurmond , CRCST , CIS , CHL , FCS
Preventing High-Risk Exposures in Sterile Processing
The patients and healthcare workers sterile processing ( SP ) professionals serve each day rely on clean , high-level disinfected or sterilized medical devices and equipment . Many , however , are largely unaware of the routine dangers and risks SP professionals are exposed to in the departments in order to provide those necessary services .
During a typical workday , SP technicians face risks from chemicals , bloodborne pathogens , excessive temperatures , sharps exposure , musculoskeletal injuries and slip-and-fall risks , among other dangers . Each can be detrimental to employee health and safety and , potentially , even to subsequent patients . Fortunately , such incidents can be mitigated with collaboration and broad-scale involvement from the SP team and , as appropriate , interdisciplinary teammates . Medical facilities have an obligation to keep employees safe , but it is also up to each departmental leader to train in safe practices and ensure adherence to them .
Documenting competencies The decontamination area poses the greatest risk for SP employees . The Occupational Safety and Health Administration ’ s ( OSHA ’ s ) Bloodborne Pathogens Standard ( 29 CFR 1910,1030 ) requires that each facility has an exposure control plan that outlines the potential dangers that employees may encounter on the job . When performing decontamination duties , employees must wear appropriate personal protective equipment ( PPE ) that includes gloves , a gown or jumpsuit with sleeves and a fluid-resistant barrier , fluid-resistant shoe covers and mask , and eye-protection ( goggles or a face shield ) that protects from splashes . OSHA requires these items to be provided by our facilities for employee protection . Every SP professional must fully understand how to use chemicals safely and effectively in the department , and they must also know the risks involved when used incorrectly . While these products may do a great job in cleaning and removing soil from instruments , they can be dangerous if used improperly or when a spill occurs . A safety data sheet ( SDS ) must be readily available to technicians to address spills or other exposures . Most facilities have SDSs stored electronically on workstation computers , while others
During a typical workday , SP technicians face risks from chemicals , bloodborne pathogens , excessive temperatures , sharps exposure , musculoskeletal injuries and slip-and-fall risks , among other dangers . Each can be detrimental to employee health and safety and , potentially , even to subsequent patients .“
may depend on a written copy of the SDS to guide them . All SP employees must know where the SDSs are kept and be able to access them readily .
SP professionals should also receive initial orientation of the required PPE for their department , and also know the proper policies and procedures for handling workplace exposures . This includes documented orientation , continued education offerings and a competency to physically demonstrate the necessary actions if an exposure occurs . Continuing education and reviews or competencies should be reviewed periodically and documented for each employee .
Addressing eye and sharps risks
Every SP employee must know where the eye wash station / shower is located and how to use it correctly . There are specific requirements for eye wash stations set forth by the American
National Standards Institute , including the need to have an eye wash / shower available within 10 seconds of travel time , with unobstructed access for areas where potentially dangerous chemicals are used . Eye wash sinks should not be a sink used for decontamination . According to ANSI /
ISEAS Z358.1 , they should be tested at least once a week and for an established period to verify operation and ensure the flushing is lukewarm ( between 60 and 100 degrees Fahrenheit or between 15 and 43 degrees Celsius ). This routine testing should be documented .
Statistics show that 25 percent of healthcare worker sharps exposures happen to support staff such as SP professionals . Most sharps-related injuries are documented in the operating room ( OR ) from cuts with the scalpel or needlesticks . SP professionals who have worked in the discipline for any length of time have likely seen a sharp come to decontamination from surgery alongside the soiled instrumentation ( such as a knife blade , suture needle , drill bit , saw blade ). SP leaders should communicate such incidents with those in the OR so they understand the risks .
Handling instruments in decontamination creates opportunities for injuries as well . At times , items used during procedures are placed in the case cart in an unsafe manner , which introduces the opportunity for injury . It is important to never reach into a pile of mismanaged , disorganized instruments . It is also important to lift each instrument tray individually and always use the handles of the tray . As each tray is removed , it is essential to visually inspect the tray to look for missed needles , blades or instruments protruding from the tray .
Other departmental areas , beyond decontamination , can pose notable employee risks as well . When running the test for sterilization cycles , technicians must wear protective PPE while activating the biological test ampules . Changing the cartridge or bottle for low-temperature sterilizers may seem like a simple task , but also can introduce the risk for dangerous exposure ; therefore , proper gloves , masks and eyewear are essential ( and required ).
Additionally , to prevent unnecessary exposure to contaminated devices , case carts must be designated as “ clean ” or “ soiled .” If a case cart arrives in the SPD unmarked , the contents inside should always be considered soiled .
Preventing workplace exposures is everyone ’ s responsibility , from SP professionals to the surgeon , surgical tech , OR nurse , transporter and employees in other procedural areas of the facility . Ongoing communication and education are critical in keeping the SP professionals and others safe from avoidable harm .
Tony Thurmond , CRCST , CIS , CHL , FCS , is a past-president of the Healthcare Sterile Processing Association ( HSPA ) and an HSPA columnist . He serves as sterile processing manager at Dayton Children ’ s Hospital .
february 2024 • www . healthcarehygienemagazine . com •
23