Pam Neiderer: The Evolution of Sterile Processing in Ambulatory Centers

March 20, 2012

Sterilization

We have come a long way with evidence-based learning in the world of sterile processing. Nurses and sterile processing staff now have the benefit of many organizations that offer guidelines and education for sterile processing.

Unfortunately, there are still small ambulatory surgery centers (ASCs) that do not have experienced sterile processing technicians or access to experts in the field to guide them. Shortcuts in the cleaning process occur due to the pressure of rapid turnover times and the increasing the number of procedures done in a short amount of time. It is here that errors are made or a lapse in knowledge occurs. National media outlets have reported several violations in sterile processing and procedures, and many centers have felt the ramifications of this across the nation.

As a result, the Centers for Disease Control has gotten involved in the regulation and inspection of ASCs. They now use a very comprehensive checklist for their inspections, which are unannounced, keeping everyone on their toes. It is an excellent method to help ensure that everyone is prepared and has consistent techniques. ASCs are now all inspected with the same guidelines. The challenge now is how to enable ASCs to maintain this level of preparedness.

Compliance in any organization begins at the top with the administrators and board of directors. It is their responsibility to enforce, promote, and support proper technique. Historically, the sterile processing department, otherwise known as central supply, was merely thought to be the area to get clean instruments. We now realize the importance of this department and the necessity of qualified technicians.

While it may not always be profitable for an ambulatory center to hire a person specifically for this position, one person should still be responsible as team leader to ensure proper processing of the instruments. This responsibility extends much further than maintaining sterile instruments. This position incorporates the skill set necessary to maintain the efficiency of the sterilizers.

Sterilizers must be checked with regard to dynamic air testing, biological, and integrator testing. This department is also responsible for maintaining the decontamination of medical equipment used in patient care. To further complicate the processing of instruments, manufacturers must validate which process is appropriate for their instruments. Cycles have gone from one size fits all, to multiple variations in load time and drying time.

Gone are the days of sterile processing simply being a part of an OR nurse or scrub technician’s on-the-job training. It is now a very complex function requiring specific training. In an ideal world, it would be a requirement for personnel working in sterile processing to become certified. At the present time, there are few centers for this education. I would encourage everyone to get involved in legislation to enforce certification. This legislation also needs to provide reasonable tuition restraints for this to be feasible.

 Pam Neiderer, RN, BSN

Director of Surgical Services

Memorial Hospital and the Surgical Center of York

pneiderer@mhyork.org

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One Comment on “Pam Neiderer: The Evolution of Sterile Processing in Ambulatory Centers”

  1. Anonymous Says:

    I have to echo Pam’s post. With the greater attention to proper reprocessing of surgical instruments by CMS, the state of practice has been greatly upgraded in many outpatient facilities.

    Reply

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