Following the recent NBC Today Show segment “Today Investigates: Dirty Surgical Instruments a Growing Problem in the OR”
……..the question of Mandatory Certification for CSSD/SPD
technicians has become a hot topic. I have always been a proponent mandatory certification for technicians, so when Infection Control Today asked for input on this matter I was quick to jump on my “soap-box” and elucidate my sentiments. Lo and behold what I said must have made struck a chord because it got published (either that or only a few people answered ICT with their ideas).
Those who know me will tell you I’ve never been thrilled with “blowing my own horn”. Even though I might be a “Big Mouth from Dirty Jerzey”
(something I’m proud of) I am a true believer in Humility. That being said I have decided to post my thoughts on mandatory CSSD/SPD Certification here because I truly believe not until every single person, from the managers down, who work in CSSD/SPD get certified (and continue to update certification through education) will things in the realm of surgical instrument processing improve.
I am amazed that there should be any question on whether or not Sterile Processing Technicians should be certified. If I was going for plastic surgery I can assure you that I would be looking for a surgeon who was board certified, knowing that they demonstrated excellence in
their specialty. Should not health care institutions be looking for the same excellence in those that care for their surgical instrumentation?
Speaking for myself, I began working as a Sterile Processing Technician twenty five years ago and have seen significant and drastic changes in the processing of surgical instruments in that time. I must say here, that I was fortunate enough to have worked with people to whom I will
be forever grateful, because they foresaw the day when certification would be mandatory in my home state, and so in 1991, I attended a sterile processing educational course, sat for the exam and having passed, first received my certification. Within another 10 years those who had advised me to first do so, were correct and New Jersey became the first state to mandate certification.
Certification mandates in other States, should use those of New Jersey as an example, that all who work in the department from management down, be certified. It is all well and good that some believe that only an R.N. can hold the position of management in Sterile Processing, but an R.N. with no experience or education in Sterile Processing is like asking a Sterile Processing Technician to be first assist in Total Joint Surgery. (I hope I haven’t ruffled any feathers here, I am just speaking from experience).
Getting certified is only the start, keeping certification requires continuing education, which is imperative to keeping up with the changes in the field. The increasing complexity of surgical instrumentation, the different modalities required to care for them, along with the ever changing regulations on their care can only be acquired this way. (Yes word of mouth could do, but wouldn’t you feel more comfortable if someone were shown the way to clean a complex robotics instrument through an accredited educational course then from Mary on the 3-11 shift?)
Here, I would like to bring up recognition and compensation. How many people outside of health care even know that there is such a thing as a Sterile Processing Technician or Department, I can’t tell you how many times I have had to explain to people just what I do for a living, In
fact it wasn’t until a recently that Sterile Processing got mentioned on the News, and that was not in the most flattering of lights. Most of us who work in the field do it because it is what we love to do and we know that our job is the first defense against infection. A Sterile Processing Technician is expected to give 100% all the time, we know that there is no such thing as almost clean or almost sterile, that there is no such thing as “sterile soil”. Technicians are expected to remember (or at least know where to find) the cleaning, packing, and sterilization instructions for over a thousand instruments that they encounter every day. We need to know how they function properly, which ones need to be disassembled for cleaning, reassembled for sterilization, if there are any special packing/containment requirements their mode of sterilization (or High Level Disinfection) and if they need to be run in a “special” or “extended” sterilization cycle. Yet for all this knowledge and hard work, technicians are seldom compensated properly and most could be making more money flipping burgers or waiting tables.
Surgical Instrumentation is becoming more and more complex, many institutions will more than happily get the latest surgical instruments to
placate a surgeon or so that they can tout how they do “fill in the blank” surgery, but few take into consideration whether or not they have the capability to clean and sterilize these instruments.
Instrument manufacturers themselves need to take into account whether or not their instruments can be cleaned properly. The cleaning challenge of the arthroscopic shavers and many surgical suction devices mentioned on the “Today Show” and at the FDA/AAMI workshop’s this past year was a design flaw, these devices contain a dead end that trapped tissue, blood and body fluid, it is next to impossible to get a brush into this “dead end” and once the proteins in the soil here denatured it would take a blow torch to remove it
I foresee a day when “visually clean” will not be clean enough and that some regulatory standards will be set on what “clean” is. We have already begun to move in that direction with the testing of endoscopes for residual protein, hemoglobin and carbohydrates, can the testing for residuals on surgical instrumentation be that far off? Just another task to add to the myriad of things a Sterile Processing Technician must do during the day.
So the question is, why hasn’t Certification for Sterile Processing Technicians been mandated
earlier? A Hairdresser or Barber needs a Certificate (license) to do their job and Heaven knows they get paid better….isn’t it high time that the people who are the “first level of defense against surgical site infections” be certified and get compensated for the job they do?