They are St. Anthony Hospital’s infection prevention agents – otherwise known as the sterile processing department – and they play a crucial role in the delivery of safe patient care.
Their jobs – and the jobs of sterile processing departments across the country – are done behind the scenes and often underground. Their time is spent precisely and meticulously ensuring that every single instrument used during any hospital procedure is processed, sterilized and prepped for use. And although they’re less visible than surgeons, nurses or surgical staff, without the sterile processing department, it’s safe to say the rest of the hospital would be unable to function.
“Everything we do touches the patient. You can have the best surgeons in the world, the most phenomenal nursing staff at the best hospitals. But if we don’t do what we need to do – all that care, all that treatment, all that time – patient safety would be greatly impacted,” says Damien Berg, Infection Prevention manager at St. Anthony.
Damien – a 23-year veteran of sterile processing – runs the day-to-day operations for the Level One Trauma sterile processing department at St. Anthony Hospital in Lakewood, Colorado. His team handles a huge volume of surgical instruments and medical devices on a daily basis – and upwards of 12,000 instrument sets each month.
It’s an industry in which process is king, and attention to detail is compulsory. Which is right up Damien’s alley. His motto? Making sure the surgeons have what they need, when they need it; that it works; and that it’s sterile.
It’s his team’s duty to make sure absolutely no contaminants are present on any of the surgical tools. If one step is missed, patients could be at risk for surgical site infections – infections that occur after surgery in the part of the body where the surgery took place. Damien is humbled on a daily basis to know how much responsibility lies on the sterile processing staff.
The journey of a medical instrument through a hospital looks something like this: After each instrument is used, it is sent to the sterile processing department. The instrument is then properly decontaminated and cleaned, sifted through a mechanical or manual cleaning process and disinfected. Then, clean items are inspected, given a function check, and assembled and prepared for use, storage, or further processing – like sterilization. Finally, items are transferred to the sterile storage area until it is time for them to be used again.
As many as six individuals in the central sterilization department share the responsibility of ensuring a single instrument’s readiness for reuse.
As technology evolves, so does the job of the sterile processing technician. Medical instrument technology and engineering has changed greatly over the years to advance patient care. Devices have become much more complex and intricate, which allows for a multitude of patient benefits, from helping medical staff see our insides better; to not having to open up patients as widely; to shortening the amount of time a patient spends in surgery. But all this advancement also can create challenges: These very sophisticated and elaborate instruments are sensitive, and can be extremely difficult to clean and sterilize.
Take, for example, the endoscope. Doctors use many types of specialty endoscopes – small, flexible, long tubes with lights and cameras – to get a close-up look at different internal parts of our bodies. The most familiar specialty endoscope is likely the colonoscope, which is used to look inside the colon during a colonoscopy. Endoscopes have a light source, biopsy needles and other tools that can be used to take tissue samples.
Janet Prust is director of standards and business development for 3M Health Care. She says endoscopes are tricky to clean and disinfect because they are very long – a meter or more – and have very narrow channels that are one to three millimeters in diameter.
“There is a channel for the surgeon to view through, and a separate one that’s used to pass surgical instruments through and draw fluids and blood,” says Janet. “It’s these long, narrow channels, the tiny connection ports with complicated shapes and the multiple accessories that make these instruments difficult to clean.”
It’s the role of the central sterilization team to have a current understanding of the evolution of the instrumentation. Education, certification and training are a continuous part of a sterile processor’s job.
“The extent of what we need to know can be mind boggling,” says Damien. “Sterile processors have to know everything from gynecological instrumentation to robotic instrumentation – and understand everything about how each instrument works so we can properly clean it. The treadmill is always moving, and it’s our job to keep up with it.”
It’s a tough gig with a host of challenges. If the sterile processing team doesn’t have a 100 percent success rate every single day, the results can be devastating. And it’s a job that doesn’t get a lot of attention. Most sterile processing departments are isolated – both physically and organizationally – from the rest of the hospital. All of these factors can result in a high rate of employee turnover.
That’s why the role of the department manager is such an important one. Not only do good managers set the tone for culture and morale, they also advocate for their teams on a daily basis – working with hospital leadership to deepen the understanding across the organization about daily work volumes and productivity, the need for resources and training, and the key role the sterile processing team plays in ensuring patient safety.
Damien believes a sense of ownership and pride in a technician’s work is essential. He says that’s what allows his team to work behind the scenes so the surgeons and nurses can deliver outstanding care.
“We can’t put our heads in the sand and say we just do sterile processing,” he says. “We have to be proud of what we’re doing. We’ve got to beat the drum every chance we get to say we are patient advocates, not just people washing instruments. We are here for patient care. That is our purpose.”
Health care professionals, explore training materials and fresh perspectives about infection prevention and other areas that impact your job, as well as thoughts on professional development.