IAHCSMM VIEWPOINT


Power of competency checklists for Sterile Processing


by Tony Thurmond, CRCST, CIS, CHL I


t’s important to assess how competencies are used in the Sterile Processing (SP) profession. Are they viewed as a neces- sary evil or do SP professionals embrace the opportunities competencies can provide? ANSI/AAMI ST79, Section 4.2.2, states that “the responsibility of sterile processing should be assigned to qualifi ed individuals who have demonstrated competence in all aspects of sterile processing.”


Document learned skills ualifi cations of P professionals include demonstrated knowledge of and docu- mented competencies in the tasks they perform as well as working knowledge of the SP environment. “Documented” is an important distinction because if it is not documented, there is no evidence that proper training and demonstration of that training occurred. Undoubtedly, surveyors will ask to see the orientation checklist for an employee as well as further documented competencies for each employee. A competency checklist must be developed and maintained in each of the following SP areas: 1. Decontamination: Competency must be shown in sorting, disassembling/reas- sembling, manual and mechanical cleaning methods, microbicidal processes, equip- ment operation, standard- and transmis- sion-based precautions, and engineering and work practice controls.


2. Instrumentation: SP professionals must know the names and descriptions of instrumentation, and the inspection points of each instrument. Other competencies include proper preparation and packaging methods for sterilization.


3. Sterilization/High-level disinfection (HLD): Competencies should cover all ster- ilization practices and principles, including steam, low temperature, ethylene oxide, and HLD processes.


4. Worker safety and environmental safety: SP professionals should be able to demon- strate how to properly handle emergent situations, environmental hazards and other patient safety scenarios. More competencies can be developed for specific equipment and instrumentation and can include proper cleaning techniques, sterilization and maintenance of each. It’s important to recognize that a completed competency does not ensure a technician


is competent. The proper skills learned and used effectively in day-to-day operations are what make for a competent technician. Dur- ing the competency review, some technicians may correctly demonstrate how to perform a task, but then return to their bad habits after the review.


Start with new employees Competency checklists may vary for each department and equipment. Department design will dictate processes and work ow necessary for competencies to be completed. An orientation checklist, used for new hires in the department, should come fi rst. The new employee should work with a competent technician who is willing to train and has the necessary skills to properly onboard the new team member. The orientation checklist is typically completed after 90 days of employ- ment to help verify the skills learned. If the employee has demonstrated they have retained the training information provided and demonstrates a willingness to continue building upon their skills, this should be documented during the 90-day period. If areas of weakness or areas where the information was not retained are noted, the supervisor should review the train- ing process. The supervisor may need to review the preceptor or trainer to determine whether the proper information was given and whether there is an area in the training process that could use some improvement. If no areas of improvement are needed in the training process and the preceptor is providing proper, effective training, it must then be determined whether the new hire can be successfully trained and prepared for their role. Every employee learns at their own pace, but they must demonstrate the desire to learn and do their best if they are to move past their 90-day review and continue to grow in the role. It is recommended that the employee both verbalize and demonstrate the task(s) being evaluated. Upon completion of the onboarding process and 90-day review, if the employee fails to grasp the information and shows little sign of succeeding in the role, it is best to reconsider their employment.


Review and repeat An effective competency checklist is thor- ough and written in the order of the pro- cess or work ow of the desired skill being reviewed. Each item to be reviewed must


38 January 2021 • HEALTHCARE PURCHASING NEWS • hpnonline.com


be well understood and/or demonstrated. The checklist should indicate whether the demonstration is verbal or physically car- ried out, and the task must be marked as satisfactory or unsatisfactory (with each task initialed by the person reviewing it). Compe- tency checklists should also include an area for comments that can highlight suggested training or positive feedback for employees who demonstrated aptitude with a particular task. Competency reviews of each technician must be reviewed by a competent technician, educator or manager who also has demon- strated working knowledge and expertise of the area being reviewed/assessed. The checklist must be signed by both the evalua- tor and the individual being evaluated. After the review, the competency must be placed in the employees fi le where it can be accessed for review as needed.


At minimum, the checklists should be


reviewed every six months to determine areas in need of improvement, and manag- ers should ensure the checklist is current and factors in any equipment changes or standards updates that could impact cur- rent practices. Actual completion of compe- tency checklists should be done at least once a year (more often if a process is complex). If an increase in errors occurs, it is prudent to perform a competency and checklist review to help identify areas in need of attention. Note: Competency checklists may be developed from instructions for use of SP-related products or equipment, or from published standards such as those from the Association for the Advance- ment of Medical Instrumentation (AAMI), the Association of periOperative Registered Nurses (AORN) and others. IAHCSMM provides some examples of competency checklists for its members on its website that can be tailored to individual SP departments. Visit: https://www. iahcsmm.org/resource-documents/cs-sample- documents.html. HPN


Competency checklists and reviews provide opportunities for improvement within the depart- ment and can help standardize how tasks and processes are performed – both of which can spur performance improvement and error reduction that enefi ts the epartent, its cstoers an, most importantly, the patients.


Tony Thurmond, CRCST, CIS, CHL, is IAHC- SMM’s immediate Past-President and serves as Central Service Manager for Dayton Children’s Hospital.


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