By Bryant C. Broder, CSPDT, ACSP
The principal challenge posed to healthcare professionalsworking under the umbrella term of central services is how to effectively manageand perform the multi-dimensional responsibilities of the job. Whether yourdepartment is called Central Services, Central Supply, Sterile Processing,Reprocessing, or any other of a host of names, we are all fundamentally involvedin the same business: the reprocessing, decontamination, assembly, andsterilization of surgical instrumentation, supplies, and equipment. Whew! And ifthat isn't enough, some of us also are responsible for monitoring clinicsterilization practices, laundry, and the dispensing/charging of patient caresupplies, equipment, floor instrumentation, and let's not forget, budgets. Nowonder we go home feeling tired.
Consider the multitude of activities conducted within the CS/SPD. Theknowledge base required to carry out our duties can be daunting. Here are someideas to assist you as you rise to meet the challenge.
Education is the key to meeting the challenge. The best thing we can do toensure safe and effective practice is to focus on education. Not to say we willever know everything, because we won't. So, it is the learning process inwhich we must involve ourselves. We must learn something new, or at least tryto, every day. It may be a new instrument or piece of equipment, a newprocedure, a new virus, or an old germ. The important thing is to look foropportunities to learn something new.
Your hospital's infection control practitioner (ICP) can help facilitate theeducation cause, whether it is in the form of mentoring, self-study, inservicetraining, or networking. A collaborative relationship needs to be establishedbetween the ICP and CS manager. At one time or another, the ICP and CS managerare going to have to draw upon one another for support, whether it involvesgetting ready for a JCAHO inspection, dealing with the reuse of single-usemedical devices, providing educational sessions on nosocomial infections, oraddressing a decontamination/sterilization concern.
This support can arrive in many ways. Advocacy is one. The ICP, generallyhaving the ear of the quality management department and administration, can helpadvocate the need for the CS professional to be certified through an accredited,competency-based training and certification program. The ICP can help explainthe criticality of the CS profession. They are not just the "peopledownstairs." CS professionals handle highly sensitive equipment,instrumentation, supplies, and processes to support the surgical arena.
CS professionals are on the front line of the fight against infection. Ifyour hospital does not have a fully staffed, trained, and compensated CSdepartment, it is setting itself up for failure.
Key areas to focus on for the ICP and CS manager are the decontamination andsterilization processes. This is where the CS manager can help the ICPunderstand the complexity of the instrumentation, as well as the efforts that gointo preparing a tray for sterilization and the biological monitoring systemused. The ICP may know all the bugs, but the CS professional knows where theyare hiding in the instrumentation and is charged with making the equipment andinstrumentation safe for handling. Together, the ICP and CS manager are a greatone-two punch on the front line. Inviting the ICP into CS is always veryenlightening for both parties. The CS professional will have the opportunity toshowcase his or her department, and review sterilization equipment and thebiological monitoring processes with the ICP. Needlesticks, sharps disposal,blood and body fluid precautions, and of course handwashing, are all appropriatetopics of conversation at this point.
Some educational opportunities will require an understanding of computerapplications. Not just the standard offerings from the major software producers,but hybrid software programs that perform instrument tracking, productivityanalysis, and financial analysis. Sharing data with the ICP via computerprograms will lead to a better understanding of how one profession can assistthe other. This is the information age; the more information you have the betteroff you'll be to serve as a resource, to problem solve, and to provide supportfor other departments. Accurate information is the best information and if youwant the most accurate information on bugs, go to someone who tracks them for aliving. The Sherlock Holmes in the fight against nosocomial infections is yourmost valuable resources--the hospital's ICP.
Another method of support for the CS manager and ICP is participating as amember of a professional association. The Association for Professionals inInfection Control and Epidemiology (APIC) and the American Society forHealthcare Central Service Professionals (ASHCSP) are some of many nationalgroups. Additionally, these organizations generally have regional or statesocieties in which individuals can participate. The benefit derived from being amember and attending a local or national conference is immeasurable. Theknowledge gained by learning something new and being able to take that back toyour institution is extremely valuable. Not to mention the benefit gained fromestablishing a network of individuals that can be contact to provide answers toquestions either by e-mail or by logging on to a list-serve, bulletin board orchatroom. Through your interactions you will have developed your own expert peerlist, and you won't have to reinvent the wheel. As well, you'll become a hugeasset to your institution. There again, everyone may not see the benefit tothese types of educational sessions. That's another way the ICP can help CSadvance the profession. Together we can get the best people, the best practices,and the best results to raise the standards of healthcare.
Bryant Broder, CSPDT, ACSP, is the manager of surgery processing at St.Mary's Mercy Medical Center in Grand Rapids, Mich and is president-elect toASHCSP.
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