Elevating Your SPD for the Sake of Your Patients

By Michele DeMeo

If you are reading this magazine, you value infection prevention and control. This article fits into that passion for one simple reason: sterile processing departments (SPDs) are pivotal to this value. The SPD critically serves surgical patients with instrument and other durable equipment for patients throughout the hospital.  You can hardly get any closer to patients than inside of their sterile cavities. 

Even as intimate and complex as the work our facilities' SPDs get, not all of our departments, technicians or managers are as prepared for this critical responsibility as they can or should be. The function of sterile processing is one of those areas in a hospital or surgical center that often flew under the radar until now.  For good reasons, emphasis is currently being placed more on this unique department. It is now to time to take it even further; our infection preventionists should consider collaborating with this imperative department.

Before we can elevate sterile processing for our patients, we must ensure the very foundation of this department is in place and well honed.  This is where infection preventionists can play a vital role.  By collaborating with SPD and its leadership, you can start the process of linking the two specialties with the goal of not only learning from each other, but also strategizing to improve your patients outcomes and reducing infections. 

Making sure your SPDs foundation is well established, we should discuss some of the criteria that contributes to determining this:

- A solid and well educated staff body

- A good understanding and adherence to established standards and best practices and regulations

- A competency program that is robust, current and effective

- A continuing (and consistent) education program that includes all aspects of sterile processing and is conducted with the different skills sets and learning styles of the department members in mind

- A comprehensive competency program

- Enough resources: staff, processing materials, space, instruments, the right type and amount of processing equipment, reference materials, etc

- Processes that work with current department and facility operational norms and functions that work with the entire system (consider systems thinking)

- The right type of chemicals and processing solutions and used in the correct fashion

- Access to and use of the physicians procedure and preference cards and the daily surgical case schedule

While we have just discussed some of the criteria that help to determine whether your SPD has a solid foundation, we have not discussed how to assess these considerations. This is where the infection preventionist has the most opportunity to be of service and lend their clinically experienced eye. With this in mind, the question becomes how you begin, especially, if you have no previous experience reviewing this technically diverse department and its functions. 

It begins with a well-organized assessment. This assessment can take several potential shapes, but it must be comprehensive, action-orientated and broad reaching for effective use. This will require some prep work and not randomly tour the sterile processing department and asking a few important questions. It must be throughout and designed around an assessment plan. Otherwise, you risk obtaining fragmented information that is unable to link appropriately to the departments internal or external functions and the overall system. To prepare and build the plan to be as organized and comprehensive as possible, consider the following:

- Create or obtain an assessment template to include gathering basic and more detailed department and functions information such as total FTEs, roles, types of functions, areas of service, types of sterilization and high-level disinfection options used and/or available for use, hours of operation, off-hours procedures for processing and other clinical needs, biological tests practices, staff competencies and tools, etc.

- Consider conducting a SWOT (Strengths Weaknesses Opportunities Threats) analysis. This will help to drive the direction for most critically needed attention.

- Identify the most imperative tasks and function within the department, such as processing implants or extended cycles and consider performing a FMEA (Fail Modes Effects Analysis). This proactive tool is used to help identify important steps within processes that are most likely to fail. Correction is conducted before a potential breakdown occurs. Conducting both the SWOT and FMEA with the leadership and staff of SPD and other primary stakeholders is best, to be as effective as possible.

- Review sterilization industry standards, best practices and regulations. Compare these to observed practices and identify absent, incorrect or disjointed findings. Then include this into your assessment document. 

- Do not hesitate to contact industry experts, many will be more then willing to help lend some advice.

- Request SPD manager or director to assist you in creating an appropriate action

All of this background and preliminary work is needed to be able to establish where the department is currently in terms of readiness and opportunities for improvement. By partnering with the SPD team and leadership and other stakeholders from the very beginning you can start the joint collaboration of great patient care delivery. No department can work in isolation, including Infection Prevention or Sterile Processing. Both are heavily dependant on the other and both can benefit from the expertise of the other.  It will be through a strong joint effort that improvement can be not only made, but also sustained.

Michele DeMeo is the sterile processing manager for Memorial Hospital in York, Pa. and an independent consultant. She can be contacted directly at mdemeo@mhyork.org or (717) 849-5355.  With 18-plus years of experience in the field of sterile processing and materials handling in the healthcare environment, she is active in AORN, IAHCSMM and is a voting member for some AAMI working documents.  In addition, she is a member of the Device Good Manufacturing Practice Advisory Committee for the FDA.  DeMeo has also authored numerous articles and was a speaker at the 2011 ICT Virtual Event.