Filamentous material , bioburden and defects within the lumens and channels of endoscopes can be identified through visual inspection using a borescope . All images courtesy of Healthmark Industries Inc .
actionable defects that could interfere with processing effectiveness in all endoscopes . They added that “ Infection preventionists have a critical role to play in supporting processing personnel now that standards , guidelines , and manufacturer instructions recommend enhanced visual inspection of every endoscope , every time .”
Despite these and similar findings reported in the medical literature , visual inspection is not always well represented in curricula for sterile processing technicians , even though “ Sterile processing personnel are expected to inspect diverse endoscope models , reliably identify defects , interpret findings , and take actions such as recleaning or assessing damage to determine whether repairs are necessary . Their role also includes notifying stakeholders and helping to assess risk when issues are identified ,” according to Ofstead , et al . ( 2023 ), who add that it “ shifts the responsibility for developing and implementing training programs onto technicians , educators , and managers who are already overburdened by time and resource constraints .”
Sterile processing technicians often hear the precepts that bear repeating , such as “ if it can ’ t be cleaned , it can ’ t be sterilized ” but in an under-resourced department , it can be easy to tune out , and knowledge or practice gaps can persist .
“ Many factors can be called into question , so we must always ask where the gaps lie ,” Berg emphasizes . “ Is it the training , environment , medical devices , equipment used to clean and process the devices , for example — or a combination of those factors ? HSPA felt it was important to explore the training aspect first so we could obtain that data and evidence and give sterile processing professionals a research-based point of reference to assist with real-world tools and processes and ensure training is not the weak link . Once training is addressed , sterile processing professionals can turn their attention to other factors that may need addressing in their departments ( e . g ., environmental issues , challenging devices and equipment , staffing challenges . All aspects are critically important , but continuing education , skill development and knowledge retention are the underlying foundation for service excellence and positive outcomes .”
A Better Way for SPD Techs to Learn
To address this gap , the Healthcare Sterile Processing Association ( HSPA ) Foundation provided funding for the development and evaluation of a new model for educating certified sterile processing professionals that supports mastery and retention of knowledge and skills . This model was based on previous research that found hands-on training for medical students and healthcare professionals resulted in better comprehension and skills development compared to lecture or demonstration alone , and improved skills , confidence , and rate of successful credentialing .
As Ofstead , et al . ( 2023 ) explain , “ Studies have demonstrated that testing before and after training supported learning outcomes and knowledge retention for undergraduate nursing students and physicians completing CE workshops . Therefore , HSPA ’ s new training model incorporated testing , lectures , demonstrations , hands-on practice , and a ‘ booster ’ ( refresher ) to enhance learning and retention of new skills . This model was initially evaluated for training on visual inspection of endoscopes and may be expanded to include additional sterile processing skills .”
“ This program was designed to incorporate several aspects of best-practice training on complex technical skills ,” confirms lead researcher Cori Ofstead , MSPH . “ A key feature of the program is the use of testing as bookends for the training , as there ’ s solid scientific evidence that pre-testing supports engagement by learners . This seems to be due in part to the learners realizing that they have gaps in their knowledge or skills and paying attention to key content covered in the pre-test . Then the test given at the end of the training serves two purposes . Of course , it allows evaluation of knowledge and skills . But more importantly , it cements their learning by having trainees think critically about what they just learned . When they realize that they now know the answers , it gives them an ‘ Aha !’ moment and a little burst of joy — just like we get when we put a jigsaw puzzle piece in place or figure out a word puzzle . That emotional reaction enhances memory and also helps build their confidence in their ability to implement the new skill they ’ ve developed .”
Nine certified sterile processing technicians who already had 400 hours of hands-on experience and who were employed full-time at a facility that processes at least 10 flexible endoscopes , were selected for the pilot program . To ensure trainees were not already experts in endoscope inspection , candidates who were certified in endoscope processing or had previous formal training on visual inspection of endoscopes were excluded .
“ The particular skill we selected for the pilot test of our training program ( visual inspection of flexible endoscopes using magnification and borescopes ) was something that hadn ’ t previously been recommended in standards / guidelines and wasn ’ t covered in the core training that sterile processing techs receive ,” Ofstead says . “ In fact , we specifically excluded any potential trainees if they were certified in endoscope reprocessing or had received training specifically on visual inspection
16 • www . healthcarehygienemagazine . com • april 2024