5 Best Practices to Improve Sterile Processing Quality

by Raynetta Stansil Independent Healthcare Consultant

Although Sterile Processing Departments (SPDs) are crucial to the day-to-day operations of hospitals and other medical facilities, they are often overlooked in discussions of quality improvement. Hospitals sometimes focus so much on the work of doctors, nurses, and others who directly interact with patients that they forget to prioritize the “behind the scenes” work that takes place in SPDs.

Sterile processing plays an essential role in infection prevention, and by extension, has an outsized impact on patient outcomes. Failing to adhere to proper sterile processing standards can result in surgical site infections (SSI). SSIs not only increase healthcare costs and hospital length of stays, but harm patients and can result in preventable fatalities.

In this article, we review five sterile processing quality improvement best practices to maximize the effectiveness of an SPD. Implementing these strategies will help ensure that surgical equipment and parts have been properly cleaned, sterilized and assembled before any operation, and that you excel on sterile processing quality metrics.

1. Make Sure Your SPD Is Properly Trained

Well-trained technicians are one of the most important aspects of a high functioning SPD. Yet education in many hospitals is lacking. Most facilities do not have a set program for training their SPD staff. Instead, technicians receive on-the-job training and pick up practices and processes from existing staff. Some degree of on-the-job training is always necessary, but it needs to be supplemented with a formal certification course to ensure that proper protocols are followed.

Many hospitals choose to outsource said training to partners such as Surgical Solutions. Surgical Solutions puts each of its technicians through a rigorous three-week training program that includes classroom and onsite training, as well as ongoing CRCST-certification annually through online learning platforms and onsite “refreshers.”

Moreover, education should not be constrained to a single course. It should be ongoing so that staff members are always updated on current and upcoming guidelines. SPD staff should also have some exposure to the operating room and surgical cases to contextualize how the instruments they take care of are used and underscore the importance of their work.

2. Identify Competency Gaps and Rectify Them

As a corollary to developing training for new staff, you should identify and rectify competency gaps among sterile processing technicians. This may take the shape of a course or refresher program in specific domains of sterile processing. For instance, technicians are sometimes assigned specific tasks, such as decontamination or sterilization. This type of specialization can help technicians develop expertise in one domain but simultaneously creates competency gaps in others. Cross-training staff ensures that anyone can step in if help is needed in a particular area.

3. Follow Evidence-Based Standards and Manufacturer Recommendations

Sterile processing technicians should follow evidence-based standards while cleaning, sanitizing or otherwise processing instruments. Given that evidence is sometimes conflicting, we recommend using a set of guidelines, such as those from the Association for the Advancement of Medical Instrumentation (AAMI). However, standardization is not always applicable. Instruments from different manufacturers sometimes have different cleaning and sanitation instructions. All instruments should be taken care of according to the guidelines recommended by their manufacturers.

4. Coordinate Between the SPD and OR Staff

Open communication between the SPD and OR staff is imperative for a properly functioning operating room, and regular feedback can uncover opportunities for improvement. For example, Patricia May, BSN, RN, CNOR, senior nurse specialist at Surgical Directions, a Chicago-based perioperative consulting firm that includes experienced sterile processing leaders, points out that in many hospitals, OR and SPD staff can inadvertently create problems for each other that devolves into a vicious cycle:

“What often happens is that nurses will open up five or six trays for a case, but they will not put every instrument back in the tray it came from,” May explains. “After those trays go through washing and disinfection, SPD staff find instruments that don’t belong in a tray or trays that don’t have all the instruments they need…This reinforces a self-perpetuating problem…When an incomplete tray goes up to the OR, nurses start opening peel packs to find the instruments they need. That creates twice as much work for the SPD.”

5. Align SPD and OR Leadership

SPDs are often overlooked by and isolated from the rest of the hospital staff leading to miscommunication and unintended conflict. In order to coordinate SPD and OR staff, the leadership of those teams should be aligned. For example, having the SPD report to the OR director can ensure that its staff receive the resources and support they need.

Final Thoughts

The best practices listed here can transform an SPD from an overlooked problem to a high-performing center of infection control:

Make Sure Your SPD Team Is Properly Trained
Identify Any Competency Gaps and Rectify Them
Follow Evidence-Based Recommendations and Standards
Coordinate Between the SPD and OR Staff
Align SPD and OR Leadership

If you feel that more improvements can be made, organizations like Surgical Solutions can offer further support by providing mission-critical services for minimally invasive surgeries, including certified sterile processing technicians.