Curing the Sterile Processing Department Staffing Crisis

Sterile processing departments (SPD) are among the unsung heroes of infection prevention in health care. Like other non-clinical departments, the importance of SPD in the essential functions of cleaning, disinfection, and sterilization and overall impacts on the functioning of a health care facility can be overlooked. Lapses in proper techniques or breakdowns in practice in SPD can seriously impact patient safety and outcomes. Infection preventionists must advocate for their colleagues in SPD and understand the challenges they are currently facing.

The staffing shortages that have plagued health care since the COVID-19 pandemic also extend to ancillary departments, such as environmental services and sterile processing. There are many impacts that staffing shortages can have on SPD departments, including burnout, lower productivity, and poor quality. First, due to high turnover, the present staff is often called upon to work more shifts and constantly train incoming staff. Stress and burnout can occur, which results in decreased morale. Also, fewer staff means less productivity. And as surgical cases have increased with the elimination of COVID-19 restrictions, the demand for reprocessing cannot be sustained. This decrease in productivity could result in increased instances of immediate-use steam sterilization (IUSS) or shortened sterilization cycles to have instruments for following cases, even if not completing proper practices with vendor instruments.

Patient safety and quality are also at risk with staffing shortages. Improperly sterilized and disinfected instruments can lead to health care-associated infections and have been implicated in severe outbreaks of multi-drug resistant organisms. Certification of sterile processing technicians has been growing as a requirement for health care facilities. It is one way to ensure the most qualified staff performs the critical roles needed to keep up with the increasingly complex instruments and manufacturers' instructions. However, as staff turnover increases, it becomes more work for employees to gain the knowledge and skills needed to become certified.

Without a strong, well-trained SPD staff, procedures and surgeries can grind to a halt, hospital revenue will decrease, and patients are at risk for disease and pathogen transmission. Infection preventionists must collaborate with their SPD partners to be a resource as they take on the challenges ahead to overcome the staffing shortages.

“One of the biggest challenges faced by sterile processing departments today is a shortage of technician talent,” says Robby Miller, BSHA, CRCST, CIS, CER, CHL, SPD manager for CommonSpirit Health at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona. “Staffing shortages have the potential to result not only in processing inefficiencies which can cause procedural delays but also critical issues such as processing failures resulting in regulatory non-compliance and a threat to patient safety. A strong, skilled, competent team of SPD staff performing essential invasive medical device reprocessing is critical to quality patient-centric outcomes.”

Essential knowledge for an infection preventionist is to have a basic understanding of the workflow and key steps during cleaning, disinfection, and sterilization. Develop relationships with your SPD department, shadow staff, and learn the pain points and where process change needs to occur. The IP can then advocate for resources and link patient safety outcomes to staffing shortages. They are planning for process change to help the workload, such as how the surgery schedule is intended and acquiring instruments for the most frequent types of procedures to decrease the need for Immediate Use of Steam Sterilization (IUSS). Another option is to research disposable instruments (scopes, intubation blades, bronchoscopes) to reduce the need for reprocessing. SPD leaders can develop career ladders to show staff that their education and skills can build cross-training of SPD staff so they can have competencies to perform all department tasks, from decontamination to packing and sterilization. Still, it is also so they can see how each step of the process impacts the department.

Without a strong, well-trained SPD staff, procedures and surgeries can grind to a halt, hospital revenue will decrease, and patients are at risk for disease and pathogen transmission. Infection preventionists must collaborate with their SPD partners to be a resource as they take on the challenges ahead to overcome the staffing shortages.