Make Personal Protective Equipment Fit Sterile Processing

Creating change within the sterile processing (SP) profession begins with asking the right questions in order to gain a better understanding of where process improvements can best be made to benefit SP professionals, their customers, and the patients on the receiving end of the SP department’s (SPD’s) instrumentation and services.

Having served in the SP profession in various roles for many years (from frontline technician to educator and, finally, leader) I saw, felt, and experienced what it was like to work in every area of the department. When it comes to the challenging environment of decontamination, especially, and the knowledge and skills needed to ensure all employees wear personal protective equipment (PPE) effectively, safely, and consistently, I’ve made some observations over the years—namely, that properly donning (putting on) and doffing (taking off) all these layers of PPE can sometimes collide with other departmental needs and challenges, such as time and space restrictions and the ongoing and ever-evolving need for supplies, equipment, staffing, and education.

The decontamination area is the first stop in the detailed process of providing clean, properly functioning, disinfected, and sterile medical devices for patient use. At the same time, this area poses the greatest risk to the technician thanks to the potential exposure to blood-borne pathogens and other microorganisms. Additionally, there is the potential for physical injuries if SP professionals in the decontamination area are improperly or inadequately trained and equipped to deal with these challenges. Leaders must ensure that all staff SPD members not only are provided with the correct PPE but also are well trained on how to use it safely, consistently, and effectively.

Recent study data published in the December 2, 2021, issue of the American Journal of Infection Control (AJIC)—“Droplet Dispersal in Decontamination Areas of Instrument Reprocessing Suites”—highlighted how medical device processing professionals may be exposed to tissue, blood, and patient fluids despite the use of PPE. These eye-opening findings suggest the need for more research to support evidence-based guidelines and instructions for safe processing, and also serve as a stark reminder that SP professionals need access to the proper equipment, training, and support to help ensure they remain as safe as possible in the workplace. As this study demonstrates, the historical experience of “doing things the same way we have always done them” is not enough. We must look beyond at the hard data and always be thinking of ways to improve in the name of quality and safety.

Advancing Discussion

Many of us who have worked in the decontamination area can attest to the challenges of this environment as well as to the real and perceived risks associated with decontaminating instruments and devices used in patient care. This AJIC study elevates the discussion significantly because it has provided solid scientific findings to substantiate discussions and concerns from those in the SP profession. Equally important, this first real-world study that evaluated PPE effectiveness involved collaboration between frontline SP technicians, Healthcare Sterile Processing Association (HSPA) members, and the scientific research community.

HSPA, the professional association that provides certification, education, advocacy, and support for SP professionals worldwide, is certainly taking note of these study findings and is working to remind its 40,000 members and certification holders (as well as others within the general SP community) of the critical importance of process improvement and proper PPE supplies, support, and ongoing training (HSPA was formerly known as IAHCSMM—the International Association of Healthcare Central Service Materiel Management).

Study coauthor and HSPA member Marie Brewer, CST, CRCST, CIS, CHL, CER, GTS, CSSGB, SP, manager at UnityPoint Health, St. Luke’s Hospital in Cedar Rapids, Iowa, tells Infection Control Today® that “collaboration with Cori Ofstead and associates made it possible scientifically to explore and document the aerosolization risks in a real-world decontamination environment. This research is important because the data clearly demonstrated the need to redesign PPE and improve decontamination protocols to reduce blood-borne pathogen exposure risk to technicians.”

This study and the significance of its findings are already changing the dynamics of the conversation regarding the risks SP professionals face in reprocessing areas. These important discussions are opening up greater dialogue on what we know (and do not know) and why we cannot rest on our laurels when it comes to employee safety, knowledge growth, and risk mitigation. Within HSPA, these study findings and conversations strengthen our resolve to ensure that our education and training are aligned with the new scientific knowledge.

This scientific knowledge will allow the industry to develop new technologies, solve problems in practical ways, and help frontline SP professionals make better, more informed decisions. It is the successful combination of products and the adoption and application of science-based practices that will help this industry rise above these challenges and protect our frontline technicians. I am excited to know that we are at the forefront of essential scientific discovery, where data and newfound knowledge will contribute to new applications and training that will be a game changer for our profession’s future.

What to Do Now

To best understand why solid research and collaboration are so essential to the future of our profession, we SP professionals must first understand our role in the science of what we do every day. We must embrace that we are a participant in science; our participation gives us a sense of belonging within our chosen profession—an ability to belong to something bigger than ourselves. We are participating in the future and that future is happening now. It is not about what we know (or think we know), but about how we think and apply our knowledge that is so powerful.

Science is about asking questions in the quest to objectively discover what is true. The vital research between Ofstead and Associates and HSPA members like Marie Brewer (and many others who have opened their doors for critical studies) is helping put the essential pieces together now so we as a profession can broaden our knowledge and face the next challenges with science- and data-driven insight, discipline, diligence, and vigilance.

Communication on what SP professionals do on a daily basis and the whys behind it is paramount to ensuring the highest level of safety and service quality. Knowing what we want to measure is the first part; doing what we need to do comes next. We want all SP technicians to be empowered to see and participate in change and to maintain a hunger to learn and grow for the sake of oneself, the team, the customers, and the patients. This hunger for knowledge and truth, even difficult truths, is what will help capture more attention for the discipline, spearhead more studies, research, and education, and ensure that all SP professionals receive the proper training (and provide return demonstrations of the training received) to ensure that PPE and other essential supplies, equipment, and devices are used safely and optimally.

This AJIC study has shown the critical gaps regarding PPE and practices currently in use while also underscoring the risks and challenges SP technicians face in the decontamination areas in particular. Although more work needs to be done to instill process and equipment improvements, it is essential that SP professionals know the important role they can play right now in bringing about positive change that will help keep them and their colleagues and peers safer in the workplace. The information provided in the AJIC study allows us all to proactively reflect on our own practices and processes. In the near future, we will surely have more information and recommendations, but in the meantime, I encourage all SP professionals, especially those in leadership positions, to read the AJIC study, ask questions within the department, and be part of the educational process regarding proper PPE use.

I believe it is every leader’s duty to deliver quality education consistently and in meaningful ways that resonate with employees. If we can help communicate and show the science and the value of our profession, then that is what we must do for the greater good. Proactive planning, practice, and open dialogue across all stakeholders will advance our profession and improve safety and outcomes for our SP technicians, health care customers, and patients.

Damien Berg, BA, BS, CRCST, AAMIF, serves as vice president of strategic affairs for the Healthcare Sterile Processing Association (formerly IAHCSMM).