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 .” — Cori Ofstead ,
MSPH
using borescopes . We did this to ensure that the trainees would not be coming into the program already knowing the content , as that would not have allowed us to determine if they developed mastery and retained their skills as a result of the program .”
The research and training team included epidemiologists and board-certified sterile processing experts with extensive experience in infection prevention , endoscope processing , quality management , and competency testing . The workshop was highly interactive and included lectures with slides and printed handouts , demonstrations , hands-on practice , and small group activities , including hands-on practice with endoscopes ( bronchoscopes , cystoscopes , ureteroscopes , colonoscopes , gastroscopes , and duodenoscopes ), magnification systems , and a variety of borescopes used to inspect the scopes .
Workshop participants completed a 78-item multiple-choice pre-test to evaluate their baseline knowledge and skills related to the visual inspection of scopes and risk assessment . They were shown photographs of scopes with and without defects , and asked to identify the type of endoscope , the component shown , and the location and nature of the defects . The test also included questions about visual inspection tools and techniques , standards and guidelines , risk assessment , and communication strategies . At the end of the workshop , participants completed an identical survey and post-test .
The results before and after the workshop were enlightening . Prior to the training , none of the participants achieved a passing score ( 70 percent ), but following the workshop , all of the technicians passed the test , with scores improving significantly following the workshop ( 41 percent versus 84 percent ).
Following the workshop , participants were expected to inspect 10 endoscopes at their healthcare facilities , document their findings , and submit photographs from three endoscopes to verify their ability to inspect endoscopes and identify potential defects . According to the researchers , following the workshop , all trainees identified defects in fully processed , patient-ready endoscopes , including retained fluid , visible soil and foreign debris , dents , scratches , shredded channel lining , and damaged insertion tubes and distal end adhesive . When they observed defects , the researchers report that trainees performed a preliminary risk assessment , informed their supervisors , and recommended strategies for addressing the quality issues . These actions included additional cleaning efforts , participating in root-cause analysis discussions , meeting with facility stakeholders , contacting manufacturers , sending endoscopes out for repair , inspecting additional endoscopes , and trialing new tools and equipment for cleaning , inspecting , and drying endoscopes , according to Ofstead , et al . ( 2023 ).
The researchers note that , “ This program went beyond technical skills to teach how to assess risk , document findings , and communicate with other stakeholders about findings . This empowered trainees to take actions resulting in clinically meaningful reductions in risk , such as recleaning endoscopes with retained soil visible during borescope exams and sending damaged endoscopes for repair . In recognition of these actions , one trainee received an award from the facility ’ s quality and safety oversight committee following their identification of multiple defects considered serious .”
“ Conducting a good risk assessment is an essential part of cementing the processes for training and skill retention ,” Berg emphasizes . “ The risk assessment portion of our research and training was key to a larger Plan , Do , Check , Act ( PDCA ) process and fosters powerful change through thoughtful , detail-driven analysis and communication . We know most sterile processing technicians are passionate , caring and want to do the right thing and develop the technical skills to become their very best . Still , there is always a need for improvement , knowledge growth and skill development . When we see something that is incorrect or questionable , we must seek to address the situation safely , professionally and accurately , and then collaborate as a team for effective solutions . “
A three-hour training “ booster ” session was conducted via Zoom eight weeks after the workshop and included a review of key points , with extra emphasis on topics where multiple trainees had provided erroneous or “ unsure ” answers on the workshop pre-test . The researchers found that improvements were maintained following the booster ( 90 percent ), and that participants ’ confidence levels increased after the workshop and boosters , as the proportion of “ Not sure ” answers decreased and correct answers increased for each trainee .
According to the researchers , on a 4-point scale from “ Not at all confident ” to “ Very confident ,” the workshop trainees reported more confidence in their ability to perform technical skills after training . On a 5-point scale from “ Poor ” to “ Excellent ,” trainees reported higher satisfaction with the new training model compared to previous training they received elsewhere .
Andrew Ghens , the sterile processing professional who participated in this novel training study , explains how the experience shaped his perception of what effective skills training and competencies entail : “ As a sterile processing professional , I ’ ve always had to make sure my skills and competencies are up to date ,” he says . “ One of the main takeaways I had from this study is to retain new skills , as it is important to first realize how much you don ’ t know . The pre-test our study group took really opened our eyes to the content of the skills training and where our areas for improvement lie . The interactive team activities kept us engaged while allowing us to collaborate and enjoy the work . The immediate follow-up test inspired confidence in my new skills . I also think the tests we took at different time periods — following the training — assisted with retention of the skills . Well over a year after the study , I still feel very confident in my ability to perform the advanced skills that were taught to me .”
Ghens says he was surprised by how much the entire group of trainees learned and retained from just a couple of training sessions . “ In any study group , there is usually a percentage of people who don ’ t retain the information given to them , but this was presented in such a way that it made it easy for everyone to participate and get the most out of the study time ,” he says . “ The entire group was excited about their new skills and couldn ’ t wait to take them back to their home facilities and turn them into real-world sterile processing practices .”
Ghens says he is applying the knowledge derived from the workshop experience to his current day-today practices . “ The training I received did spark some
april 2024 • www . healthcarehygienemagazine . com •
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