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Occupational Exposure in the SPD : Real-World Research Reveals Splash Hazards , PPE Shortages
By Kelly M . Pyrek
Confirming that sterile processing department ( SPD ) personnel are routinely doused with potentially infectious material during routine decontamination tasks , a team of researchers is drawing attention to the lack of research around this occupational exposure , highlighting the fallacy of the 3-foot droplet dispersal standard , and pushing for better personal protective equipment ( PPE ) in this barrier protection-depleted time due to COVID-driven shortages .
Researchers Cori Ofstead , president and CEO of Ofstead & Associates , and her colleagues conducted a pilot project to identify reprocessing activities that generate splashes , determine how far droplets can travel in decontamination areas , and assess PPE exposure during routine activities . The team says that the effectiveness of protective measures for sterile reprocessing personnel has not yet been systematically evaluated in real-world settings and were surprised and dismayed by the lack of evidence on this topic despite the known risks around decontamination and reprocessing activities in the SPD .
Also , there appear to be little to no data around occupational exposures of sterile processing personnel in EPINet data from the International Safety Center , which serves as a clearinghouse for metrics relating to sharps injuries and bloodborne pathogen exposures . However , any observer in the SPD knows that splashes occur daily .
The lack of peer-reviewed evidence in the literature served as a major impetus for Oftstead ’ s latest study .
Ofstead says she has long championed under-researched challenges in the SPD , which she says is partly due to the admiration she has for these professionals .
“ The critical role of sterile processing has been under recognized and undervalued in many organizations ,” Ofstead says , “ Even though in my view , the SPD provides the foundation for safety In healthcare institutions and the success of every surgery or medical procedure depends on the work they do . However , they ’ re often tucked away in the basement of the facility and people don ’ t think about them . We ’ ve learned that there ’ s a widespread lack of real-world research on how things work in
Our research is intended to prompt people to rethink strategies and protocols for effective sterile processing that will get the instruments where they need to be , but also are humanly possible and not going to break the human in the process .”
— Cori Ofstead
sterile processing , including the instructions for use ( IFUs ) — can they be read and understood ? Are they able to be implemented by a human ? And if so , do the IFUs work ?”
Ofstead continues , “ Our research is intended to prompt people to rethink strategies and protocols for effective sterile processing that will get the instruments where they need to be , but also are humanly possible and not going to break the human in the process . I got upset because we heard from the grounded , hard-working people in the field about the extent of the shortages of PPE and other critical supplies like disinfecting wipes and hand hygiene supplies . Shortages were hitting SPDs hard because supplies were being diverted to other units that were thought to be at the highest risk . But what happened is that SPDs didn ’ t have adequate supply of some PPE at all , or they received Ill-fitting , poor-quality gowns that weren ’ t fluid-resistant , and gloves that don ’ t fit , and no disinfecting wipes for the SPD .”
As Ofstead , et al . ( 2022 ) explain in their study , “ Personnel working in sterile processing or endoscope reprocessing departments are also at high risk of exposure to tissue , blood , and patient fluids during the decontamination of reusable medical instruments and equipment . Manual cleaning generally involves immersing instruments in water with detergent and scrubbing , brushing , flushing , suctioning , and using power-spraying systems to remove blood , tissue , and patient secretions .”