There’s a reason why Sterile Processing Departments (SPDs) are often referred to as “the heart of the hospital.” This is where all of a healthcare facility’s soiled surgical instruments and other devices go for cleaning and sterilization, ensuring they’ll be ready to use during future procedures. Additionally, the SPD plays a crucial role in maintaining patient safety by helping lower the risk of healthcare-associated infections (HAIs).
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As with any department, SPDs face challenges during their day-to-day operations. However, given the critical role they play in keeping healthcare facilities running smoothly, it’s important for SPDs to have a set of solutions to their most common hurdles. Here we’ll detail those obstacles and highlight some of the most effective techniques SPDs can use to overcome them.
While preparing instruments and equipment for future use is the main focus of SPDs at Ambulatory Surgery Centers (ASCs) and hospitals, these departments oversee much more than sterilization. Some of the other processes that an SPD oversees include:
Since following proper sterilization guidelines is tantamount to maintaining patient safety, an inefficient or ineffective SPD can present certain risks for the patients they serve as well as the healthcare facilities themselves. For patients, these risks include higher infection rates, procedural delays and low satisfaction, while hospitals and ASCs can experience damaged reputations and even receive citations and fines from regulatory authorities.
So, what types of challenges are SPDs most likely to encounter? These nine are the most common:
Whether this manifests in the form of shortages or insufficient training opportunities for current employees, staffing presents a significant challenge for SPDs. While crises such as technician shortages lead to staff burnout and delays in processing, the consequences that come with a lack of training can be more disastrous. Sterilization errors lead to an increased risk of infection for patients.
Overcoming the Challenge
Make a concerted effort to retain current staff members. Recognizing hard work, revisiting compensation packages and offering opportunities for professional development all go a long way toward keeping top talent around for longer.
A disorganized SPD is one where it’s easier for mistakes to happen. Standardized instructions and processes help reduce the risk of making costly errors and help to keep team members accountable.
Overcoming the Challenge
Industry standards and regulations are in place for a reason: They help keep patients safe. Adopting best practices when it comes to the proper handling, cleaning and sterilization of instruments will help reduce the potential for HAIs.
Though older equipment may score a few points for its familiarity, this is where the list of benefits ends. Antiquated sterilization technology is much more prone to malfunctions and becomes less effective over time, making its use an unreliable solution for SPDs. Additionally, not having enough equipment to meet demand is an equally devastating problem, resulting in postponed procedures and unhappy patients.
Overcoming the Challenge
While investing in new equipment comes with a high initial cost, it saves healthcare facilities much more than money in the long run. Newer sterilization technology is more dependable and won’t cost hospitals and ASCs as much in lost time due to maintenance outages. Many modern sterilization solutions are energy efficient, meaning less power consumption and lower energy bills.
Once surgical instruments go through the sterilization process, it’s crucial that they remain sterile before re-use. Many SPDs have digital instrument tracking systems in place to ensure control over their inventory. However, for SPDs that keep track of their sterilized stock on paper, the opportunity for human error increases.
Overcoming the Challenge
In addition to making inventory management easier, implementing a software-based tracking system comes with extra benefits for hospitals and ASCs. Increased operational efficiency, the ability to keep more accurate records and heightened accountability within the department are all added bonuses.
All too often, SPDs outgrow their allotted space within a healthcare facility and run into the issue of finding a storage solution that’s sufficient in terms of size and conditions for maintaining sterility. Sterilized instruments are highly sensitive to the surrounding environment and outside factors such as moisture and improper handling can greatly reduce their shelf life.
Overcoming the Challenge
One of the ways that SPDs can work around this challenge is by thinking proactively when planning for the future. To determine how much space may be needed down the road, take a look at the healthcare facility’s projections for growth year over year or metrics surrounding processing demand fluctuations.
Whether due to aging sterilization infrastructure, staffing shortages or a lack of training, some SPDs struggle to comply with industry regulations. Falling short of these standards carries serious consequences for healthcare facilities and can lead to loss of accreditation or hefty penalties and fines.
Overcoming the Challenge
Running a compliant SPD requires commitment and coordination and some of the actions that SPDs can take to ensure compliance include standardizing procedures, creating an in-depth and comprehensive training program for new technicians and making sure that documentation of everything from sterilizer records to preventative equipment maintenance is meticulous.
While quality management systems (QMSs) are prevalent in healthcare facilities, their migration to the SPD has taken some time. In a department where attention to detail is so crucial, it’s important to foster a culture where quality is front and center. In SPDs where this is lacking, it’s much harder to realize when a process goes wrong or violates an established best practice.
Overcoming the challenge
A QMS is used to document processes, procedures and responsibilities to improve policies and objectives within a department. And implementation goes a long way toward helping SPDs meet regulatory requirements and improve efficiency.
Open communication between the SPD and operating room (OR) is crucial to maintaining patient safety. Poor relationships between these two departments can not only impact patient outcomes but result in a compromised quality of care and lead to decreased productivity as well.
Overcoming the Challenge
Establishing (or re-opening) the lines of communication between the SPD and OR can go a long way toward building a solid working relationship. In some cases, all it takes is finding time for representatives from each department to meet and work through any barriers face-to-face.
Whether it’s because of a shortage in reliable equipment, staffing or funding, SPDs suffer when asked to operate using limited resources. Increasingly, sterilization teams are asked to do more with less which can lead to errors as a result of cutting corners, skipping important steps in processes or rushing to meet demands.
Overcoming the Challenge
Using techniques such as Lean problem solving, to streamline processes can help eliminate some of the strain. However, in some scenarios, it may make sense to present a case for additional resources to the healthcare facility’s management team.
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Proper cleaning of surgical instruments/devices is vital to ensuring patient safety, longevity of instrumentation, and so much more. It all starts with the reprocessing equipment in your sterile processing department (SPD), the chemicals used throughout the decontamination process, and having a level of awareness regarding the chemistries used.
In this edition of our newsletter, we will cover the chemicals primarily used in your department and the pH scale among the various cleaning chemistries employed. We will also walk you through the types of surgical instrument cleaning chemistries, focusing on enzymatic, neutral, alkaline, and specialty chemistries.
pH Scale and its Importance:
Before delving into the specifics of cleaning chemistries, it is essential to understand the pH scale. The pH scale measures the acidity or alkalinity of a solution on a scale from 0 to 14. A pH of 7 is considered neutral, while values below 7 indicate acidity and those above 7 indicate alkalinity. In the context of surgical instrument cleaning, the pH of the cleaning chemistry plays a crucial role in achieving optimal results without compromising the integrity of the instruments.
Enzymatic Detergents:
Enzymatic detergents are a staple in surgical instrument cleaning. They are characterized by a neutral pH, typically hovering around 7. This neutrality ensures compatibility with a wide range of materials, preventing corrosion or damage to delicate surgical instruments. Enzymatic detergents contain specialized enzymes that break down and remove organic debris, such as blood, tissue, and other bodily fluids, from the instruments. This enzymatic action enhances the cleaning efficacy, making these detergents highly effective in preparing instruments for sterilization.
Neutral Detergents:
Like enzymatic detergents, they also maintain a neutral pH, ensuring they are gentle on instruments. With a pH of around 7, neutral detergents are suitable for a broad spectrum of materials. They excel in removing general contaminants like dirt and oils from surgical instruments. The neutral pH is particularly advantageous when dealing with sensitive instruments or those with intricate designs, as it minimizes the risk of corrosion or damage during the cleaning process.
Alkaline Chemistries:
In contrast to enzymatic and neutral detergents, alkaline chemistries are characterized by a higher pH, typically around 11. The increased alkalinity enhances the cleaning power, making these detergents effective against stubborn contaminants, including mineral deposits and inorganic soils. Alkaline detergents are commonly used in cleaning processes that require more aggressive action, such as removing calcified deposits on surgical instruments. However, caution must be exercised when using alkaline chemistries on certain materials, as the higher pH can potentially lead to corrosion or damage over prolonged exposure.
Specialty Chemistries:
Beyond the three primary categories, specialty chemistries are designed for specific cleaning challenges. One notable example is de-scalers, which target and remove scale deposits that can accumulate on instruments over time. These scale deposits, often composed of minerals, can compromise the functionality of surgical instruments if not addressed promptly. De-scalers typically fall within the alkaline category but are formulated with a focus on scale removal, showcasing the adaptability of cleaning chemistries to specific needs.
Instrument Staining
It is of note that when it comes to the chemicals you use, following manufacturer IFUs is always the best practice; typically, that goes without saying. However, adding more solutions than IFUs call for to minimize smells or seemingly help remove debris more efficiently can be tempting, but this can usually do more harm than good.
Here are a few colors of instrumentation staining and what they could mean.
• Brown/Orange: High PH
• Dark Brown: Low PH
• Bluish/Black: Reverse plating due to mixed metals during the cleaning process
• Multicolor: Excessive heat
• Light/Dark Spots: Water droplets drying on the surface
• Black: Contact with ammonia
• Gray: Excessive use of rust remover solution
• Rust: Dried on blood or bioburden
As you navigate the best solutions for your facility, we hope this 101 information helps you remain mindful in your reprocessing efforts.
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