Intro to Sterile Processing

Intro to Sterile Processing. Module 1-1-1: Overview of Sterile Processing.

Classroom Expectations.

What the Class is and isn’t. This class is designed to give employees who are new to sterile processing a solid foundation of job knowledge to accompany on-the-floor training to help provide those employees with a strong starting skillset. This class is not a certification class. Much of the knowledge here may be helpful for people trying to get certified, but this is not an exam prep course..

Instructor-Student Expectations. As your Instructor, I will: Be respectful of your identity as a human, student, and healthcare worker. Be respectful of your time in class. Be approachable inside and outside of class to address needs. Communicate clearly and teach effectively during class to in-person and virtual students. Provide supplies to facilitate proper study of the course material and other resources as requested. Communicate changes in the class, i.e. scheduling or room changes..

Diversity, Equity, and Inclusion. Each employee brings their own personal culture and knowledge to their job. This is influenced by many things like where people grew up, the languages they speak, gender identity, religion, education, and countless others. It is necessary to respect each other’s differences to create a safe workplace. Each one of us has an obligation to assist in caring for a patient. Refrain from passing judgment or making rude remarks towards others because of their unique circumstances. Contributing towards a negative culture puts walls between each of us and our shared goals of patient care. Understand that everyone is different and therefore has different needs. This is as true for treating patients as it is for employee accommodations. Supporting different people will require different approaches – this doesn’t necessarily mean special treatment..

Facility Expectations.

Professional Expectations. While you are in this class as a student, you are still an employee of your specific healthcare facility. Regardless of where you work, there are still professional expectations you are expected to meet. Some of these include: Arriving to your shift in a timely manner. Being awake and alert for your shift and avoid distractions. Knowing who your leadership is and who to talk to for different issues. Communicating all breaks or departures with leadership. Being responsible and timely with your breaks – don’t take longer than necessary. Calling your leadership ahead of time whenever you will be absent or late. Using clean, hospital laundered scrubs – and replace them when they become soiled. Avoid cell phone usage within the department..

Hospital Policies. Hospital policies are sets of rules put in place that employees are expected to follow to maintain a professional work environment. Not all facilities’ policies are the same, but there will often be similarities. You should be familiar with what your facility specifically requires, but we will go over general guidelines common to most policies.

Hygiene Policy. Apart from taking care of our own health, hygiene is also necessary for our job. Hand hygiene is very important in particular – we need to keep our hands clean but also moisturized to avoid Hand Dermatitis – inflammation and cracking of the skin. Some guidelines to consider: Skin and hair: Must be washed regularly to maintain good health and prevent shedding Fingernails: Nails must be shorter than the fingertips to avoid harboring bacteria Nails must be cleaned regularly and free of debris Nail polish is generally discouraged or only allowed under very specific cases Artificial nails are not allowed Hands: Must be washed regularly and properly Must be moisturized to avoid inflammation Watch Unit 1 video – WHO Hand Hygiene Fragrances: Fragrances should not be used to avoid adverse or allergic reactions from coworkers or patients.

Dress Policy. Specifics of dress policy may vary by facility, but these general guidelines are common: Scrubs must be hospital laundered to control infectious transmission Scrubs can not leave the facility Shoes must only be worn in the hospital Underclothes must be concealed under the scrubs Jewelry must be concealed under the scrubs, including earrings.

Safety Policies. Safety policies will differ based on the expectations of your job role and your work environment. Make sure that you are learning how to keep yourself safe while you work. General guidelines include: PPE and Exposure Safety Learn what PPE to wear and when, and how to don/doff it properly Learn what to do when your PPE is broken/compromised Chemical Safety Learn how to identify and use chemicals in your environment safely Be familiar with how to look up Safety Data Sheets Environmental Safety Be wary of machinery and things such as slipping hazards Practice Traffic Control to reduce unnecessary human and bacterial traffic Personal Safety Always know the locations of things such as eye wash stations and fire extinguishers Be familiar with the emergency codes and protocols in use at your facility.

Other Policies. Policies don’t just lay out what the hospital expects of you; there are policies that tell you what you can expect from the hospital. You can ask your facility’s HR department for specifics but it’s good to be aware of things like: Shift Differentials Charge Differentials Call rotations/Call pay PTO accrual Certification bonuses Clinical ladders/advancement.

Regulatory Expectations.

Regulatory Agencies. In the United States, there are various federal and state agencies that mandate requirements that hospitals must follow. Sterile processing departments must comply with the requirements of several agencies to ensure patient and employee safety among several other factors. Regulations are not voluntary or optional! Hospitals can receive tremendous fines or be shut down depending on the violation..

Federal Agencies. Federal Agencies have a wide scope and influence large portions of our work. Federal Agencies that are particularly relevant to us include: FDA – Food and Drug Administration Authorize and monitor all medical devices Mandates IFU’s be followed for reprocessing CDC – Centers for Disease Control Gives general guidance on sterilization and provides information for specific sterilization protocols for things like Prions OSHA – Occupational Safety and Health Administration Mandates employers provide certain protections to employees working with specific hazardous materials such as blood EPA – Environmental Protection Agency Mandates that biocidal chemicals have instructions, warnings, and exposure advice printed on chemical bottles CMS – Centers for Medicare & Medicaid Services Audits hospitals that receive federal funding, including perioperative infections and practices that can be traced back to SPD.

Professional Agencies. Professional Agencies offer enhanced standards that hospitals can choose to conform to for accreditation and to pursue a higher standard of care. Professional Agencies publish voluntary standards, though federal organizations may adopt some standards as mandatory regulations The Professional agencies most relevant to Sterile Processing include: Association for the Advancement of Medical Instrumentation (AAMI) AAMI ST-79 AAMI ST-91 Association of periOperative Registered Nurses (AORN) The Joint Commission (TJC).

Quality Assurance and Documentation. In order to prove compliance with regulations and standards, we need to perform Quality Assurance and Documentation. Quality Assurance consists of things like testing our equipment, or tracking where instruments go and when errors occur. Documentation is recording all of the necessary information to show records of whether or not trays were processed correctly..

What is Sterile Processing?.

Summary of Sterile Processing. Sterile Processing is the system through which surgical instruments can safely be reused between surgical procedures. It is a cyclical process that is comprised of multiple components, including: Receiving Cleaning Decontamination/Disinfection Assembly Packaging Sterilization Storage Distribution.

Why is Sterile Processing Important?. We help safeguard patient safety by directly preventing infections. We provide critical services to the OR – without our services, surgeons would have no tools with which to perform their job. Other clinics depend on us for instrumentation and equipment for other procedures. Examples of other people we might serve include: Emergency Room Cardiac Catheterization Lab CTICU (Cardio-Thoracic Intensive Care Unit) Respiratory Medicine OPD/OBYGN Labor and Delivery NICU Newborn Nursery.

A Brief History of Sterile Processing. From c. 1700 BCE to today.

Early Antiquity. C. 17th Century BCE, Egypt: What is now known as the Smith Papyrus is written – it is the oldest known surgical treatise on trauma, and may have been a manual on military surgery. In its detailed treatment of patients, it is said that Egyptian doctors used copper to disinfect wounds and water for treatment. This is the earliest known example of surgical site infection prevention. 6th Century BCE, India Sushruta, a famous ancient Indian Physician and the “Father of Surgery,” first proposes in his Sushruta Samhita that diseases are passed on from person to person when performing certain activities in close proximity such as sleeping or eating. This would become the first known reference to Contagion Theory, which holds that diseases are passed directly from person to person through physical contact..

Antiquity. 5th Century BCE, Greece The historian Thucydides chronicles the plague of Athens and documents the earliest known cases of disease passing from one person to another. 4th Century BCE, Greece Aristotle proposes the theory of “Spontaneous Generation” – the theory that certain small, living creatures such as fleas or maggots could arise spontaneously from non-living matter. In lieu of any knowledge of microbiology, this would be the dominant model referred to by science until the advent of Germ theory in the 19th century. Hippocrates, the “Father of Medicine” advances the Miasma Theory of infection, which holds that epidemics of disease are caused by “bad air” emanating from rotting organic matter. This would become the dominant theory of public health and epidemic management until challenged by Contagion theory in the 19th and ultimately being overridden by Germ Theory around 1890. 1st Century CE: Lucretius, Rome Lucretius proposes that diseases not spread by contagions are spread by spore-like “seeds” in the air that are too small to see, offering an explanation for Miasma Theory. This concept of plague-bearing seeds would be referenced by other doctors and scholars over the coming centuries..

Late Antiquity. 2nd Century CE: Galen, Rome Galen was a famous Greek medical doctor who performed surgeries on Roman Gladiators. He performed the first documented attempt at sterilization of instrumentation by boiling instruments in water..

Middle Ages - Renaissance. [image] • 1025: Ibn Sina (Avicenna), Samanid Empire • Writes The Canon of Medicine which would become the most authoritative medical text in the western world until the 1 6th century. In it, He writes that diseases can be transmitted from one person to another through breath adding to miasma theory. He also adds to Contagion theory and noting that people can get sick from exposure to dirt and water. • 1347: Crimea • Genoese Traders returnina to the Mediterranean from the port citv of Kaffa in Crimea brina what would come to be called the to Europe, killina unto(d millions. While abstracr medical theories such as Miasma Theory and the Theory of Tumours would remain common medical practice, the mass death caused by the plague spurred scientists and doctors to begin studying the body more directly, laying down the foundation of anatomical knowledge that would bring people closer to understanding disease in the Renaissance. • 1546: Girolamo Fracastoro, Italy • Girolamo is a physician and atomist who published some of the earliest known work on He publishes a book claimng diseases are causes by the "seeds" mentioned as early as Lucretius, but they can cause infectivity directly or indirectly, and do not need to be spread through the air, but could also lie dormant on surfaces and Infect people over lengths of distance and time previously unknown. Despite being the closest to modem germ theory one could aet without microbiology, Miasma theory remains the dominant method of infection contror..

Age of Enlightenment. 1679: Denis Papin, England Papin was a French physicist and inventor. In 1675 he travelled to London to work with Robert Boyle and developed the Steam Digester, a device that used an artificial vacuum and steam to render the fat from bone for bonemeal production. The same operating principles established in this invention would be used in the later development of the modern Autoclave and Pressure Cooker. 1683: Antonie Van Leeuwenhoek, Netherlands Studies optics to develop powerful lenses to better inspect linen fabric than magnifying glasses at the time – becomes the “father of microscopy” after discovering microbes..

19th Century - I. 1862: Louis Pasteur, France Through studying fermentation of wine, Pasteur discovers that the growth of micro-organisms is what causes beverages to spoil. Pasteur postulates that invasion of micro-organisms is responsible for infections in humans. He performs multiple experiments that disprove the previous theory of “Spontaneous Generation” and forms the foundations of modern Germ Theory. 1865: Joseph Lister, Scotland Lister reads Pasteur’s published findings during a time where he was struggling with controlling post-surgical infections in his patients. He was immediately inspired and began to develop what would become modern Aseptic Technique. 1879: Charles Chamberland, France Begins research that leads to the development of the first “Autoclave,” from Greek Auto and Latin Clavis, meaning “Self-Key” referring to its self-locking mechanism..

19th Century - II. 1892: Dmitri Ivanovsky, Russia Dmitri, a Russian Botanist, is sent to investigate a tobacco disease ravaging plantations in Crimea and Ukraine. He performs experiments on tobacco plants and finds that the disease is caused by a miniscule infectious agent even smaller than bacteria. These agents are later referred to as viruses and the modern field of virology is born. 1894: Johnson & Johnson develops the first industrial Steam Sterilizer. 1899: Charles Truax, USA Charles Truax, owner of one of the largest instrument manufacturers in the US, publishes “The Mechanics of Surgery.” This book goes in extreme depth and detail about the manufacturing of modern instruments. Charles was among the first to make instruments completely out of stainless steel and to design instruments to be easily cleaned, or what he referred to as “Aseptable.”.

20th Century. 1962: Robert McDonald, USA First patent for Ethylene Oxide Sterilization granted. 1968: Dr. Spaulding, USA Dr. Spaulding proposes a classification of medical devices and disinfection methods and publishes them under Chemical Disinfection of Medical and Surgical Materials. This refined framework is still used as a base today for modern research and regulations in the field. 1976: FDA, USA Medical Device Amendments are made to the original 1938 Food, Drug, & Cosmetic (FD&C) act. Notable Changes include: Classification system for medical devices based on the Spaulding Classification. Establishes regulatory pathways for new devices to be approved for use through Premarket Approval Establishes Postmarket requirements including manufacturing processes and adverse event reporting to the FDA Authorizes the FDA to ban devices.

Turn of the 21st Century. 1990: FDA, USA Safe Medical Device Act (SMDA) is passed to improve postmarket surveillance of medical devices, obligating healthcare facilities to report adverse events and requiring manufacturers to increase postmarket surveillance. It also authorizes the FDA to recall devices and impose civil penalties for violations of the FD&C act. 1993: FDA, USA First H202 Sterilizer is introduced after FDA Approval. 2003: FDA, USA First Ozone Sterilizer is introduced after FDA Approval..

End of Module.