Special Edition on Sterile Processing Imperatives Special Edition- Sterile Processing Imperatives | Page 18

required collaboration between staff of different disciplines.
As Geerligs, et al. (2018) observe, “Lack of interdepartmental
collaboration, miscommunication, and fragmentation
between practitioners could serve as a significant barrier
to successful implementation. Environments that promoted
open and clear communication motivated staff to take on
challenges, and feel safe about reporting errors or issues,
resulting in more successful implementation.”
  Interestingly, audits, accreditation requirements or
assessments by an external body were strong influencers of
motivation and commitment to the intervention, according
to the researchers, “particularly if perceived as contributing
to better institutional outcomes. The perception of external
obligations alone was considered a source of motivation as it
encouraged management support for staff who were trying
to implement the intervention.” According to the researchers,
healthcare professionals who viewed implementation as
part of hospital policy or standards was a strong facilitator
to lasting change.
 Healthcare Hygiene magazine spoke with epidemiologist
Cori Ofstead, MSPH, president and CEO of Ofstead &
Associates, Inc., specializing in designing and conducting
real-world studies to validate healthcare guidelines, treat-
ments and product claims. Ofstead shares her perspectives
on implementation science in the framework of sterile
processing, and the need to rethink the approach to ensuring
compliance with best practices.

HHM What is your opinion of how well sterile processing
professionals can keep up with the rigors of their profes-
sion, in terms of the torrent of information, guidelines
and recommendations that inform their practice?

Cori Ofstead (CO): There is certainly no shortage of
evidence addressing sterile processing practices. We know
that endoscopes and surgical instruments are commonly not
properly processed for use, even though adequate training
programs exist. But everyone is becoming bombarded by
information and they cannot absorb all of it. What we have
discovered is that people respond to this by shutting down,
more actively ignoring the onslaught of new data,  and
rejecting information that is contrary to what they have
been believing and doing all along. And so, more data and
more evidence is not necessarily helpful. The other thing that
we must face in public health is that receipt of information
does not change behavior. So, even if we get the evidence in
front of people, that is not going to be enough. We believe
in education, and it is fun to watch the light bulbs go on
among sterile processing professionals. However, if we look
at the evidence with open eyes, educational programs alone
are rarely effective if we want people to change what they
have been doing.

HHM So, you are talking about behavior modification?

CO: Here’s a public health parallel that might be useful:
if we think about behaviors that impact our health such as
smoking and diet, I would say that almost all adults know
that there is evidence indicating that smoking is bad for you,
or that it would be good to get fresh air and exercise. We
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know that; however, having that information is insufficient
to make a change. And fear is also insufficient to make
a change. It is also true in our workplace, because once
habits are in place, it’s tough to change them. If you are in
the healthcare sector, I think there is an extra layer to that
behavior. Many of us in healthcare
are here because we want to help,
we believe that we can do something
I think the onus is on
that will ultimately improve people’s
lives. We would never do anything
those of us in the field
knowingly that jeopardizes patient
and the professional
safety. So, if someone comes along
and presents you with data that shows organizations and
what you have been doing is harmful,
it creates what is called “cognitive societies to figure out
dissonance.” If we’re telling you that how to repackage
what you have been doing for 20 years
information and
is wrong or could hurt patients, that
raises questions about your value as give healthcare
a healthcare professional and human
professionals solid
being—and you wouldn’t do anything
instruction in
to hurt patients, so it can’t be true!
In order to not have that conflict,
meaningful ways. ”
we tend to put up a wall against
information that says what we have been doing all along
is not good or proper. That’s when it’s not about giving
people more evidence, but instead, packaging evidence
in ways that are easy to understand, relevant and presents
real-world evidence that will resonate with end users. It
needs to be visually appealing and emotionally compelling
as well as actionable.

HHM Do comprehension levels factor into the success
of implementation science in healthcare in general and
sterile processing specifically?

CO: Maybe. I think it is critical to view the circumstance
from the eyes of the practitioner and give them what they can
easily comprehend and use successfully. That is true not just
for the sterile processing professional but also for frontline
clinical staff, infection preventionists and other stakeholders.
We must recognize how busy we all are and how entrenched
in our silos we are. Research data published in peer-reviewed
journals are necessary for formulating guidelines, but it is not
enough. I think the onus is on those of us in the field and the
professional organizations and societies to figure out how
to repackage information and give healthcare professionals
solid instruction in meaningful ways. The challenge is, we
have all this data and it’s not having an impact. Designing
and conducting great studies is not going to be enough.
Before we do more of that, we need to figure out how to
make the evidence more accessible to people so that at the
end of the day, they can make practices safer for patients
and we can improve the work environment for them.

HHM How can that best be accomplished?

CO: The approach we are taking is what we are calling the
five pillars of quality assurance.  I think the root of successful
sterile processing is to empower professionals to secure the
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