Q: Certified Surgical Technologists

I am trying to convince our finance folks that staffing sterile processing department with surgical technologists will increase patient safety and decrease case delays. Can you tell me if the certified surgical technologists have a role in your sterile departments?

A: I need to respectfully disagree. While surgical techs may know their instruments well, there is much more to our profession than the instruments. Your money would be better spent by paying your sterile processing techs more, certifying them and including them in every aspect of “surgical services.” We are critical in the fight for infection control, as is environmental services. Here at our facility, new OR nurses and scrub techs must spend days in the sterile processing department to get a better understanding of how vital our working relationship is to surgical services and how best we can work together as a team and make no mistake, we are a team. Every day I meet with the OR director, the OR clinical manager and materials management. We go over the OR schedule three days out to review instrument needs, conflicts in equipment needs and incoming loaners. We are well respected and included in decisions that affect the day, as we should be. Truthfully, every director of surgical services would be smart to spend one whole day in SPD and I implore you to do so. I apologize if I sound like I am preaching, that is not my intent. Again, your money would be better served in sterile processing.

A: Our sterile processing utilizes certified surgical technologists and we have a lead to help streamline processes and stay compliant.

A: We do not use certified surg techs in sterile processing. We do ask that our sterile processing staff get certified within two years of hire.

A: Our SPD is staffed with certified SPD personnel. Our surgical techs only scrub at our facility and are not trained in sterile processing.

A: We use certified sterile processing technicians and they perform at a very high level! We rarely have any issues due to their work performance.

A: We do not, but our CPD specialists are certified.

A: I don’t believe this will solve your problem. Probably a certified CSP manager and an educator would be a better solution.

A: I agree, we have the same set-up at our facility. Our perioperative clinical nurse leader supports the educational needs of the department and we hired a certified manager of CSS with all staff certified upon hire or mandatory certification within one year. The manager attends our weekly OR Operations meeting, and our monthly Surgical Services meeting is attended by physicians, nursing managers, directors, COO, etc. This team is integral to the business of surgery and must sit at the table.

Q: Block Charges

Some anesthesiologist prefer to place blocks pre-operativerly in the holding area. Other times blocks are performed in the surgical suite. When the blocks are done in the suite this increases OR time. Is there a way to charge for the block pre-operatively? Should the OR time start after the block is placed even if it is done in the suite?

A: If the block is done in the pre-op or holding area, it can be charged for.

A: OR time is OR time. If the block is done in OR, it is part of the OR time. Most of our blocks are done in pre-op in order to expedite the schedule.

A: Agreed – and you cannot charge for it as a separate procedure if it is done in the OR