sterile processing
By David Taylor III , MSN , RN , CNOR
SPD-Related Lawsuits : Who ’ s to Blame and How to Cut the Risks
Recently , a lawsuit was filed against another prominent healthcare organization after patients suffered postoperative complications due to contaminated instruments . The organization ’ s executives , as well as some leaders from other facilities that faced similar legal action , have been quick to admit sterile processing-related process gaps ; however , it is essential to recognize that the blame should not be shouldered solely by sterile processing ( SP ) professionals .
As a healthcare consultant who assists dozens of hospitals across the U . S . each
It is vital that those from the SPD and user areas work together to educate about requests , needs and concerns , and partner to ensure everyone understands their role in effective handling , treatment and processing of reusable medical devices .“ year , find that these so-called SP-related process gaps are often due to system-wide organizational failure . SP professionals across the country are asked to perform many challenging tasks with too few resources and inadequate support . Limited SP staff and instrumentation inventories , inadequate training and outdated equipment are all too common . I ’ ve seen so many SPDs that are woefully undersized and understaffed and have insufficient ( outdated and malfunctioning ) equipment , supplies and training that it ’ s little wonder negative processing outcomes occur .
One SPD I visited recently was so cramped , dated and underserved that the technicians prepared and stored case carts in an unkempt , unrestricted basement hallway . Another I visited did not have enough sinks , failed to use the ultrasonic , and for six months had two broken spray arms in the washer-disinfector . When I presented the concerns to senior leadership , they admitted they were aware , but lacked the budget to replace or repair the equipment . What ’ s more , I ’ ve seen countless instances where SP technicians aren ’ t provided the latest standards and instructions for use ( IFU ), so , they are unaware of the correct processing procedures and best practices .
Equally troubling is that many facility executives and SPD healthcare customers do not understand the many vital processes and practices that must occur in the SPD to ensure successful processing outcomes — and how critical it is that end users manage devices safely and effectively during and after the procedures to assist processing efforts .
Although the SPD , OR and other procedural areas have different functions , they share the same goal : providing the safest , highest-quality patient care . Still , each department bears complex responsibilities and faces different challenges and expectations that can strain interdisciplinary relationships and , at times , lead to finger pointing when device-related incidents arise . It is vital that those from the SPD and user areas work together to educate about requests , needs and concerns , and partner to ensure
. healthcarehygienemagazine . com • april 2023 everyone understands their role in effective handling , treatment and processing of reusable medical devices .
To uncover root causes of device contamination and resulting infections or other related complications , healthcare organizations should perform a multi-departmental process assessments to identify contributing factors for the incident ( s ). Many critical steps must be taken before instrumentation or other reusable devices can be re-sterilized or high-level disinfected , some of which are performed at the point of use .
Point-of-use treatment is an essential preliminary steps to effective instrument processing ; spraying devices with moistening agents or enzymatic solutions whenever appropriate ( or keeping instruments moist by covering them with a sterile water-moistened towel ) prevents bioburden and other material from drying and hardening on devices and making decontamination more difficult . This critical step is , unfortunately , often rushed or skipped altogether , making decontamination far more difficult and potentially impeding the sterilization process .
Device mishandling is another common occurrence by end users in procedural areas . Instruments may be misused , which can lead to breakage or patient injury ; instrument sets may be carelessly mixed , increasing the likelihood for lost or misplaced devices ; heavy instruments may be incorrectly placed atop delicate devices ; cords may be too-tightly coiled ; and more — all of which can contribute to costly damage and negative patient outcomes .
It is also helpful for SP leaders and physicians to work together to optimize instrument sets , remove duplicate or frequently unused devices from sets , and ensure that clinicians are educated on and comply with current standards , IFU and facility policies and procedures .
This means ensuring they handle instruments and equipment with care , promptly returning post-procedure devices to the decontamination area and allowing enough time for instruments to be thoroughly processed for the next procedure .
Patients place their trust and lives in the hands of their healthcare providers . Infections and other negative patient outcomes can arise because of inadequate or incorrect practices , such as those related to instrument and equipment care and handling and processing , but the problem doesn ’ t rest solely on those in the SPD . To mitigate those risks , leaders must encourage interdisciplinary partnerships and proactively assess practices in the SPD and procedural areas to ensure each department has the training , resources and support to perform their duties safely , consistently and effectively .
David Taylor III , MSN , RN , CNOR , is an independent hospital and ambulatory surgery center consultant and the principal of Resolute Advisory Group LLC in San Antonio , Texas . He has served as a contributing author for the Healthcare Sterile Processing Association ( HSPA ) since 2019 .
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