identify areas of improvement before they become problematic . SPD techs should remember that their behind-the-scenes work is just as crucial as the operating team ’ s , and managers should establish a rigid continual quality improvement ( CQI ) process to weed out process shortcomings . After all , unsafe , missing or contaminated surgical instruments can spell disaster for the desired patient outcomes , the true measure of quality care .
Where the SPD Can Invest in Itself to Invest in Quality
The SPD should do more to contribute to patient outcomes and quality than just help physicians ’ days run smoothly ; it must also invest in itself and its people , and limit mishaps in the areas under its control .
Human Factors That Can Affect Quality
The first step of investing in the SPD is establishing the high standards that the team should strive to meet , and then empowering the team to meet them . To empower our teams , we must invest in their education , core competencies , and skill sets by providing training and education . A commitment to education validates that your facility is committed to quality and adherence to protocol , reinforces industry best practices , and allows a team to build solid onboarding training processes .
Another crucial investment is the investment in the correct tools , equipment , and adequate space and time for an SPD to get the job done well . By arming your team with the right tools for the job and the training on how to use them , an SPD can reduce the human errors that can affect quality . Remember , gone are the days of purely manual cleaning tools ; new technologies and advances in medical device manufacturing necessitate a whole new and ever-evolving skill set that we must impart to our teams .
Environmental Conditions That Can Affect Quality
Environmental conditions that affect quality include temperature and humidity , type of water used for cleaning , an SPD ’ s layout , and more . While an SPD cannot control the weather , it can and should control the temperature and humidity in its department . Pay close attention to these variables and meet the specific standards in general work areas , decontamination stations , sterilization equipment access rooms , sterile storage , and personnel support areas as outlined by AAMI ST79 and
The Joint Commission . Each room or area should have independent temperature and humidity monitors and the daily conditions should be recorded by personnel . This tracking allows personnel to detect unwanted changes in conditions that may affect process results . Generally speaking , work areas should be comfortable enough for workers but cool and dry enough to minimize bioburden .
Also consider the type of water used for cleaning and decontamination as well as air flow in the facility . While tap water may be used for initial rinsing , final rinses should be performed according to the standards provided in the manufacturers ’ instructions for use ( IFU ). The IFU may call for deionized , distilled , or reverse osmosis water depending on the instrument . Air flow must pass from the preparation and packaging area to the soiled and decontamination areas , and not the other way around , to prevent the spread of contaminants .
The ideal SPD layout should be designed to separate areas in which contaminated items are received and processed from the areas in which clean items are packaged , sterilized , and stored . Functional work areas should be physically separated by walls or partitions to control contaminants during the phases of reprocessing . The distance between related work areas should be minimized and the workflow should provide adequate space . Pedestrian traffic should be restricted to authorized staff , who should wear protective equipment when necessary .
Environmental factors also include exposure to ergonomic risk factors on the job that may lead to musculoskeletal disorders ( MSDs ) of the upper extremities , back , and lower extremities . Workstations should be ergonomically designed and specific to the work being performed . Stools should be available in the work area as standing in static positions for long periods of time can cause muscle fatigue and pooling of blood in the lower extremities , while hard floors can create trauma and pain for the feet . The work areas should be cleaned and free of clutter , carts , tables , mobile equipment , and instrument trays should be organized to ensure there is adequate space for the staff to maneuver , queue trays , or r access the sinks during peak workload times .
Processes That Can Affect Quality
When it comes to sterile processing , the ever-enduring rule of thumb is always to follow the manufacturers ’ IFUs and ensure that there is enough time allotted to do so . As mentioned above , technological advances of surgical instruments have made cleaning and sterilization more complex than ever before , and the only true way to keep up is to follow IFUs . Also , attention to detail is key . Shortcuts and rapid turnovers lead to process failures and improperly cleaned and sterilized instrumentation . Collect daily statistics on items that are requested most often and use the data to support the purchase of additional instrumentation to limit tight turnarounds . Reprocessing without following the appropriate steps will most likely render an item unsafe for use on patients .
Equipment and Required Materials That Can Affect Quality
The use and function , recalibration , ongoing periodic cleaning and maintenance , and contractor servicing of any and all tools and equipment should be done according to manufacturers ’ IFUs . Establish appropriate records and tracking methods to be sure everything is done in accordance with these instructions . Take part in the purchasing and acquisition of new instruments and equipment and provide feedback on what ’ s doable within your department ’ s current constraints .
In summary , while the nitty gritty of staff education , department environmental conditions , decontamination processes , and SPD equipment may happen out of patients ’ sight , a commitment to all four more often than not yields the result we ’ re all looking for : a safe and quality medical treatment experience .
Reflect on these things the next time you ’ re part of a team that ’ s treating patients . Are you treating them the way you would want to be treated ?
Mary Olivera , MHA , CRCST , CHL , FCS , has actively participated in the monitoring , surveying and training interdepartmental staff in the proper cleaning , decontamination and sterilization practices and has been highly committed to the standardization of interdepartmental processes . Currently , she is the president and CEO for OSPECS Consulting , LLC . a company dedicated to facilitating process re-engineering in healthcare organizations .