STERILE PROCESSING and standard manner as well as sustain


what has been taught,” she commented.


Beyond the CS/SPD It’s not just CS/SPD professionals who can benefit from enhanced education and training, explains Leslie Kronstedt, CRCST, CHL, CIS, President Elect of the Western Wisconsin Chapter of the International Association of Healthcare Central Service Materiel Management (IAHCSMM). “Knowledge is a pow- erful tool; it becomes apparent that there are gaps when some don’t know what quality/ste- rility assurance means or how to establish it within their departments,” said Kronstedt. “It becomes


Leslie Kronstedt


necessary to recognize that you may need to educate infection control, perioperative services, and risk management on han- dling different quality and sterility assur- ance events.”


Kronstedt notes how each department owns its own piece of the quality/sterility assurance continuum, thinking about it in their own way. It ranges from the mechani- cal/ temperature gauges used during sterilization to measure time, temperature and pressure to chemical indicators (CI) and biological indicators (BI). With regards to sterile storage, quality/sterility assur- ance for perioperative means looking for holes, tears and moisture in wrapped sets, she explains. “Many SPDs are using process improve-


ment events to create effective and positive change,” said Hadley. “Working collab- oratively with the OR and other customer departments to refine or completely revise existing processes can greatly impact effi- ciency and improve quality and customer and staff satisfaction.”


Detailed documentation With internal and external surveyors applying more stringent quality/sterility assurance standards to their inspections of CS/SPD operations, Lane says CS/SPD professionals have to be more meticulous in their data collection to prove compliance at each stage of reprocessing.


“This will likely require additional documenting from SPD staff and retention of additional record keeping,” she stated. Kronstedt says data collection is required to manage both simple and complex pro- cesses in the CS/SPD. She notes how main- tenance records must be kept from the time instruments arrive in the department to the time they are sterilized and stored.


“Every sterilization load will have data detailing the sterilization process if param- eters have been met and accountability for who has handled the processes in place,” she said. “In the event of a recall, there must be a system in place for finding and reprocessing the items in question and who needs to be notified when such an event occurs. Even the room maintenance records must be maintained and recorded to ensure that temperature or humidity within the room doesn’t compromise sterility.” According to Kronstedt, gaps in quality/ sterility assurance occur when each hospi- tal’s CS/SPD has its own unique methods of documenting this critical information. “There is a lack of comprehensive national quality programming that makes policies and procedures universally handled identically,” she explains. “This allows gaps to infiltrate the system leading to a breakdown in patient safety. If any- thing has been identified in the healthcare system, the best way to prevent errors is to have continuity across the board. This removes doubts and creates standardiza- tion that is not going to vary from organi- zation to organization.”


Don’t skip the basics


When educating CS/SPD staff and other stakeholders on ways to improve qual- ity and safety and achieve and maintain the sterility of instrumentation, leaders shouldn’t skip the basics: Hand and instru- ment cleanliness. Both factors can help minimize the risk for healthcare acquired infections (HAIs), while maximizing the opportunity for high quality patient outcomes. “Hand hygiene plays a critical role in all infection prevention efforts and is an important indicator of a facility’s commit- ment to patient safety and quality healthcare,” said Jaimee Rosenthal, Acute Healthcare Market Director, GOJO Industries. “In departments like CS/SPD, where there is a strong focus on safety, quality and risk-reduction, basic protocols for infection prevention can play an out-sized role. Ensuring staff are performing hand


Jaimee Rosenthal


hygiene, with products that are designed for healthcare environments, prior to the start and at the completion of any task is important to reducing the potential for germs that may cause illness.” When it comes to the quality and steril- ity of instruments, the following has often been referenced and is worth repeating:


32 January 2022 • HEALTHCARE PURCHASING NEWS • hpnonline.com


“An instrument can be clean without being sterile, but it can’t be sterile without being clean,” commented Noreen Costelloe, Director of Marketing, Ruhof Corporation. “This statement supports the well- known fact that cleaning—the removal of organic and inorganic debris from an instrument or device should precede all disinfection and sterilization processes,” she said. “Failure to do so can interfere with microbial inactivation and can com- promise the disinfection or sterilization process, placing patients at serious risk. Therefore, one key area that CS/SPD professionals must address as part of their quality assurance plan for sterilization is the monitoring ofand verification that instruments and devices have been prop- erly cleaned.” Costelloe points to how leading industry associations recommend verification test- ing of instrumentation, medical devices and endoscopes to ensure cleanliness has been achieved prior to sterilization. “The Association of periOperative Registered Nurses (AORN) recommends ATP as one of the valid qualitative tests that can be used to assess cleaning effi- cacy, stating further that such testing will allow the tracking and trending of perfor- mance as part of a quality program. The Association for Advancement of Medical Instruments (AAMI) also recommends rapid, easy to perform and sensitive verifi- cation testing such as ATP for the detection of organic residues on instrumentation while the Centers for Disease Control and Prevention (CDC) endorse the use of ATP testing as a method for evaluating environmental hygiene,” Costelloe cited. As Costelloe explains, an ATP Contam-


ination System is a quick, easy to use and a reliable monitoring tool used to detect Adenosine Triphosphate (ATP), the uni- versal energy molecule found in all animal, plant, bacterial, yeast and mold cells. In addition to its use in the CS/SPD, ATP can also be used to test non-critical surfaces throughout a healthcare facility. “Product residues, particularly blood and bio burden, contain large amounts of ATP while microbial contamination contains ATP, but in smaller amounts,” she added. “An ATP Contamination Monitoring System measures the amount of contaminants present after cleaning and with integrated software enables data tracking to focus on process improvement efforts where they’re needed most.”


CS/SPD: 2022 and beyond The COVID-19 pandemic has driven significant change in healthcare delivery over the past two years. The CS/SPD has


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