By Brandon Huffman, BS, CIC, CRCST, CIS, CHL
I have been blessed in my career to have met many awesome operating room technicians and nurses who selflessly volunteer their time and skills to help in sterile processing. As we know all too well in this industry, operating room and sterile processing staff are consistently understaffed. As a sterile processing manager who regularly had trouble tackling the workload with the staff I had, I welcomed help with open arms. Who doesn’t love teamwork right?
Though the help was more than I could ask for to elevate our ability to meet the demand of surgical caseloads, I quickly felt the quality of work decline through incident reports and surgeon feedback. Our wonderful OR techs and nurses were great at assembling trays. They absolutely knew every instrument in the pans. However, what they didn’t know was the bigger picture of what actually takes place during tray assembly – instrument inspection. We had issues with instruments that were misaligned at the tips. Instruments that were missing parts. Instrument stains, pitting and rust that were all missed during the assembly and inspection process. And, I couldn’t help but realize, it was my fault! I graciously accepted the help I was offered without ensuring a full competency was in place. As the leader of the department I contributed to a disservice with not only my helpers and surgeons, but also to the patients we served.
Too often, I come across processes in hospitals and departments that are left unchecked. It’s easy to find competency issues, just listen when a health care professional tells another, “That’s not the way I do it.” Whenever I hear that simple phrase, I immediately question why there could be disparity in how a standard process is completed or whether a standard process exists at all? We are all unique people, and diversity is something we should cherish, but when it comes to medical practice, deviation from a single standard can be life threatening.
Regardless of the accreditation body your organization chooses to follow, competencies are a required and inspectable item. Competencies should be evaluated upon hire, and periodically at certain intervals. They are also required when you have other employees float to your department or if you have traveler positions filled for short periods of time. All personnel working in your department need validated competencies proving their ability to complete the task or job correctly. Think of competencies as a preflight checklist. Before pilots taxi a plane for takeoff, there is a checklist of items and tests to run beforehand. And this does not even cover the extensive hours of classroom and flight time a pilot previously completed. Pilots take every precaution to ensure the plane they take off the ground will successfully land on the ground (on its wheels) without killing the hundreds of passengers on board. We as health care professionals should be ensuring the jobs we perform comply with appropriate steps and measures that are free from gaps in competency.
Are you picking up what I’m throwing down? Making sure your staff and co-workers have been appropriately validated for competencies is imperative. Maybe you are now on board and lack competency tools in your organization. You might be asking, “Where do I even start?” Well, let me introduce you to my best friend Google. All jokes aside, one thing you must understand is you do not have to reinvent the wheel. There are so many competency checklists on the Internet today it will amaze you. My recommendation is to seek some already prepared checklists and use those as inspiration to build your own. Every hospital and department is different. Tailor your checklist to your specific situation. Another option is working with a professional association. You can even join a local chapter through your association and network with other professionals who have successfully created or implemented competency checklists in their organizations.
Lastly, I would like to say that once you have implemented competencies, don’t forget about them! Competencies should be living, breathing documents that change when the work or processes change. I would regularly evaluate my staff to ensure their skills and knowledge of processes were still relevant, and if not, we would revisit the competency checklist for a refresher. They can also be scheduled into your weekly in-service times throughout the year as refreshers and ongoing competency updates. In closing, you can do this! And now that I got that motivational push out of the way I will also remind you that you must do this, because it’s required. Happy competency building!
Brandon Huffman, BS, CIC, CRCST, CIS, CHL, is an infection preventionist.