HSPA - Chapter 1: Introduction to Sterile Processing

Minimally invasive surgery (MIS)

A surgical procedure performed in a manner that causes little or no trauma or injury to the patient; it is often performed through a cannula using lasers, endoscopes or laparoscopes.

What are the benefits of minimally invasive procedures?

Shortened hospital stays

Less tissue damage and bleeding

Smaller amount of anesthesia

Less pain and minimal scarring

Smaller incisions

Reduced trauma

Shorter recovery times

SPD (Sterile Processing Department)

The SPD is the central location for the delivery of soiled (used) medical devices and the distribution of clean and sterile items.

One-way flow of materials

Refers to the movement of products/materials from the soiled area to the clean processing area and on to the sterile storage area.

Physical barriers/ walls used to separate the functional areas of the SPD

These areas include:

Decontamination

Preparation and packaging (prep and pack)

Sterilization

Sterile storage/distribution

Decontamination

To make safe by removing or reducing contamination by infectious organisms or other harmful substances to an acceptable level.

Cleaning

The removal of all visible and non-visible soil and any other foreign material from medical devices being processed.

Why is decontamination an important process?

Items cannot be considered sterile or high-level disinfected if they are not effectively cleaned; therefore cleaning is the first step in the sterilization process.

How may an effective cleaning process be accomplished?

An effective cleaning process may be accomplished with manual and/or mechanical cleaning techniques.

What knowledge is required for SP staff while working in decontamination?

Thorough knowledge and understanding of microbiology

Protocols for waste disposal

Transportation of contaminated items

Operation of equipment used in the cleaning process (washer-disinfectors, ultrasonic cleaners, cart washers, steam guns, and specialty washers)

According to Occupational Safety and Health Administration (OSHA) safety requirements, what special attire must SP technicians wear?

Personal protective equipment (PPE)

Personal Protective Equipment (PPE)

A part of Standard Precautions for all healthcare workers to prevent skin and mucous membrane exposure when in contact with blood and body fluids of any patient.

What does PPE include?

Fluid-resistant protective clothing

Disposable gloves

Eye protection

Face masks

Shoe covers

After decontamination, what area are items delivered to?

After items are safe for handling, they are delivered to the prep and pack area (clean processing area) of the SPD.

What duties are performed in the Prep & Pack area?

Each item should be carefully inspected for cleanliness, proper function and possible defects. Instruments and other devices should be inspected, packaged, and labeled in preparation for sterilization.

Sterilization

Process by which all forms of microbial life, including bacteria, viruses, spores, and fungi, are completely destroyed.

Instructions for use (IFU)

Information provided by a device manufacturer that provides detailed instructions on how to properly use an/or process the device.

Duties of Sterile Storage and Distribution Area

The major portion of the work in this area involves receiving, storing, and dispensing supplies and sterile instruments.

Case cart system

An inventory control system for products/equipment typically used in the OR that involves use of an enclosed or covered cart (generally prepared for one surgical case and not used for general supply replenishment).

Case cart

A cart prepared for an individual procedure. Case carts usually contain all instruments, supplies, and utensils needed for a specific procedure.

Doctor's (physician's) preference card

A document that identifies a physician's needs (requests and preferences) for a specific medical procedure. Preference cards usually contain information regarding the instruments, equipment, supplies and utensils used by a specific physician. They may also include reminders for the staff of the physician's preferences regarding patient draping, instruments and supplies.

Case card pull sheet (pick list)

A list of specific supplies, utensils, and instruments for a specific procedure. SP technicians use these lists to assemble the items needed for individual procedures.

When does personnel working in the Sterile Storage and Distribution Area usually gather instruments and supplies for surgical procedures?

Personnel working in this area usually gather instruments and supplies needed for all scheduled surgical procedures during the day or evening before they will be used.

Supply Chain Management

Department that procures and distributes resources and manages supplies, goods and services to providers and patients (also known as Materials Management Department)

The Processing Cycle

Clean > Inspect > Assemble > Package > Sterilize > Inspect > Store > Inspect > Dispense

Standard Precautions

Method of using appropriate barriers to reduce the risk of transmission of bloodborne and other pathogens. This standard applies to all patients, regardless of diagnosis or presumed infectious status.

Healthcare-associated infection (HAI)

An infection that is not present when a patient is admitted to a healthcare facility. If the infection develops in a patient on or after day three of admission to the healthcare facility, the infection is referred to as HAI.

Job description

A Human Resource tool that identifies the major tasks performed by individuals in specific positions.

What is the first step in the sterilization process?

Cleaning

What is the area in our department where soiled instruments are received?

Decontamination

Which inventory system is primary used by the department of surgery to ensure that supplies and instruments are prepared for a surgical case?

Case cart system

Which federal agency mandates that employees wear PPE to minimize exposure to bloodborne pathogens?

OSHA (Occupational Safety and Health Administration)

Where are clean instruments found in the CS department?

Clean Processing Area (Prep & Pack)

Which document identifies all of the instrument and supplies that a physician will need for a specific case?

Doctor's (physician's) preference card

One-way flow

Soiled Area (Decontamination) > Clean Processing Area (Prep & Pack) > Sterile Storage Area

What are the different names for Sterile Processing?

Central Processing

Sterile Processing

Surgical Supply & Processing

What does the Sterile Storage Area house?

Instruments/ medical equipment sterilized by the SPD

Instruments/ medical equipment pre-sterilized by another facility

Single use (disposable) sterile items

Where can instrumentation and medical equipment be collected from?

Instrumentation and medical equipment can be collected from different places within the healthcare facilities [e.g., Labor and Delivery (L&D), the Emergency Department (ED) and patient care units like the Intensive Care Unit (ICU).

Is an N95 mask a part of SP technicians PPE requirement?

No

Is it possible that you can wear an N95 mask in decontamination?

Yes; an N95 mask may be required as part of an instrument/equipment manufacturers IFU.

How many instruments must SP technicians be able to identify?

SP technicians must be able to identify thousands of surgical instruments.

While items may be dispensed to all areas of a facility, where is the major focus of the SPD?

The Operating Room

Using analytic skills to solve problems and make decisions is a component of:

Employability

Working in the decontamination area requires:

Knowledge of microbiology

Knowledge of cleaning and disinfecting processes

Instrument identification

SP workflow should move from:

Soiled to clean

True or False: Since Sterile Processing (SP) technicians do not handle money, ethics considerations do not apply to them.

False

True or False: SP technicians practice resource management when they control costs and reduce waste.

True

True or False: SP technicians must be able to identify approximately 100 surgical instruments in order to be proficient in their job.

False

True or False: SP technicians must be able to adapt to change.

True

True or False: Because all Sterile Processing departments (SPDs) structured alike, healthcare facilities use one standard job description for all SP technicians.

False

True or False: PPE is required in the decontamination and sterile storage areas.

False

True or False: Good communication skills are an important part of an SP technician's basic job requirements.

True

True or False: SP workflow can be divided into the handling of three categories of items: soiled items, clean items and sterile items.

True

True or False: The use of good verbal communication skills is the most important and most used skill for SP technicians to provide or obtain information.

False

True or False: Since modern SPDs are virtually risk free, SP technicians need not be concerned with safety practices.

False

Communication Skills

Interact appropriately and respectfully with diverse groups in numerous situations.

Access and use electronically produced information.

Facility Systems

Prevent unnecessary waste and duplication.

Participate in quality improvement activities.

Employability Skills

Using analytical skills to solve problems and make decisions.

Adapting to changing situations.

Legal Responsibilities

Maintain confidentiality.

Operate within the required scope of practice.

Determine when an incident may be reported.

Ethics

Ethics related to knowing the difference between "right" and "wrong".

Respect patient rights.

Promote justice and the equal treatment of all individuals.

Safety Practices

Use Standard Precautions to control the spread of infection.

Apply principles of body mechanics.

Resource Management

Controlling costs and reducing waste

Providing quality service

Practicing time management skills

Identifying and solving potential problems

Using inventory apprpriately

What is the role of PPE?

To minimize exposure to bloodborne pathogens and other contaminants.