sterile processing
By David Taylor III , MSN , RN , CNOR
Enhanced SPD Cleaning Practices Aid Infection Control Efforts
Although environmental services ( EVS ) professionals are responsible for more thorough departmental cleaning , it is still the role of every SP profession to ensure that their workspaces are kept clean , and orderly and that trash and other debris are picked up from floors and other surfaces , and properly disposed . ”
Preserving our commitment to patients requires significant moral courage and years of exceptional preparation . Today ’ s sterile processing ( SP ) technicians practice in very complex , stressful environments , which can lead to missed steps or complacency and create the potential for a high-risk environment that can jeopardy employee and patient safety . SP professionals are exposed to potentially deadly bloodborne pathogens , healthcare-acquired infections ( HAIs ), and a host of other environmental exposures . Operational factors and clinical characteristics in sterile processing departments ( SPDs ) can influence outcomes , including the risk for surgical site infections ( SSIs ) and an increase in morbidity and mortality rates .
Cleanliness is imperative in any healthcare setting , and in the SPD , that pertains to instruments , equipment and the environment itself . Unfortunately , nosocomial infections continue to harm patients . SSIs alone continue to affect 2 percent to 5 percent of surgical patients . 1 It is estimated that 40 million to 50 million surgical procedures are performed annually in the U . S . 2 Statistically that totals 800,000 to 2.5 million SSIs per year , which cost U . S . hospitals an estimated $ 3.3 billion , extend hospital lengths of stay by 9.7 days , and increase the cost of hospitalization by more than $ 20,000 per admission . 3 How many of those infections are attributed to SPD is unknown ; however , failing processes , missed steps or poorly managed departments can be a factor .
SPD cleaning often falls short
In the second half of the 19 th century , Florence Nightingale ’ s developed the environmental theory focusing on external conditions that suppressed or contributed to disease or death . Using mathematical statistics to prove cleanliness made a difference ; she found that soldiers were 10 times more likely to die from “ filth diseases ,” such as cholera , dysentery , typhoid and typhus , than those who were injured by bullets or cannon fodder . 4-5
Although environmental services ( EVS ) professionals are responsible for more thorough departmental cleaning , it is still the role of every SP profession to ensure that their workspaces are kept clean , and orderly and that trash and other debris are picked up from floors and other surfaces , and properly disposed . Unfortunately , in my consultant role , I ’ ve seen countless instances where SPDs and other areas where instrument reprocessing occur are not being cleaned and maintained properly . In fact , when working with numerous clients throughout the country over the past several years , I have rarely seen SP staff damp-dust their workstations or even restock their supplies as they should . I ’ ve also witnessed sticky substances from tape and chemicals are often found on various surfaces ( workstations , instrument pans and baskets , computers , and even on instruments ) and unclean and clutter workspaces are all too common — and many facilities fail to notice .
Work areas ( decontamination , assembly / sterilization and storage areas ) must be cleaned daily , prior to the start of each shift . Individual workstations should be cleaned daily and as needed . Sticky residues , tape and other substances must be removed prior to cleaning devices and other surfaces to ensure the appropriate chemicals used for cleaning come in contact with the surface . Equipment should also be wiped down daily , and areas behind and around processing equipment should be free from dust , dirt , dead insects , wrappers and other debris .
Budgets ’ impact on cleanliness
Hospital procedural areas are revenue generators . In some cases , surgical services can generate twothirds of topline revenues and as much as 60 percent of an organizations margin . 6 As reimbursement opportunities continue to erode , hospitals are faced with making difficult decisions to maintain their budget , and non-revenue-generating departments , such as the SPD , may face the most budgetary restrictions . If budgets affect hiring , for example , there may be too few technicians in the department to keep up with the instrumentation volume and also properly and consistently maintain the departments . It ’ s a slippery slope that can negatively affect employee and customer satisfaction , while also increasing the risk for contaminated surfaces and devices .
Daily , weekly and monthly cleaning should be supported by shift leaders . They should ensure employees across all shifts understand the cleaning requirements and why they are so important to infection prevention and patient and staff safety . Documenting routine cleaning is important and SP supervisors and managers should consistently review cleaning logs to ensure they are being maintained .
www . healthcarehygienemagazine . com • december 2022
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