Sterile processing (SP) professionals are in high demand these days due to a mix of retirement, transitioning to other career fields and the so called “Great Resignation” that was largely spurred by the pandemic. It’s an eye-opening development and one that should make every health care organization take notice because of an essential fact: the critically important work that takes place in the sterile processing department (SPD) remains and must be performed by well-trained, qualified and dedicated professionals.
Further compounding the challenges is that many organizations are seeing a slow trickle of new hires, many of whom have little or no SP experience. I applaud any SP manager who is willing to hire inexperienced technicians because there are many individuals who want to work and become key contributors to the department; however, the secret to those employees’ (and the department’s) success lies in proper training and adequate time and attention given to various aspects of professional development.
In some SPDs, inexperienced technicians may be paired with more veteran teammates for training. Other departments may instead (and unfortunately) slowly introduce new hires into the fold in the hopes they will eventually learn and adapt to the discipline’s various roles and responsibilities. Still others may introduce new employees to one area within the department but fail to complete dedicated training in other areas of the department. None of these approaches to new employee training are ideal. Focused training is necessary to bring employees up to speed and ensure they have the knowledge and skill sets to become productive members of the team and promote quality customer service and patient safety.
A proper training program involves orientation, initial evaluation, probationary period evaluation, competencies, continued education and annual reviews. Such a program should also include proper documentation at each interval because training without documentation will not provide proof of proper training. The Association for the Advancement of Medical Instrumentation’s ANSI/AAMI ST79:2017 and 2020 amendments offer guidance for the education and training of SP personnel. What follows are more details about the various aspects of an effective training program.
Orientation: New employee orientation covers all tasks performed in the SP area. This includes an orientation of the department and review of organizational policies and procedures regarding infection prevention, safety, proper attire, personal hygiene and compliance with state and federal regulations. Failure to start training with this type of orientation could result in failure to protect an employee from unsafe conditions or work practices.
Initial evaluation: An initial evaluation of one’s skills should be performed within the first week of an employee’s start date. If a new employee is experienced in the role, it will still be important to assess whether techniques are performed to standards and to focus on any areas where further training is needed. A new employee who is inexperienced in SP, on the other hand, should not be expected to be able to demonstrate how to inspect instrumentation or properly run a sterilizer load. The initial evaluation will allow the leader or educator to document a starting point and allow for the development of a training program to familiarize the new employee with departmental and facility processes.
Probationary period evaluation: With any orientation period, there is a probationary period where the new employee received adequate time to demonstrate they are learning the processes and retaining the information. The new technician should not immediately be expected to perform on his or her own or be independent in all tasks. During the probation period evaluation, however, the tasks they are capable of doing well should be documented along with the tasks that will require further training or more experience. Proper and thorough documentation is required and must be filed with the employee’s training records.
Competencies: Competencies are documented records that demonstrate skills and knowledge; some competencies are required in order to comply with federal regulations or accreditation agency requirements. Individual competencies are designed to be renewed periodically to assure knowledge (with the intent of reducing or preventing errors). They may also be used to document whether training was successful and to track performance and growth. Competencies can be evaluated by demonstration, written assessment, verbal interview and observation, both announced and unannounced.
Continuing education: SPDs must provide educational opportunities to staff for continued growth and development. Mandatory education (such as bloodborne pathogens and fire safety) must be completed promptly and updates to regulations and standards must be delivered as soon as an update is released. Other continuing education opportunities could involve new equipment or instrumentation and their instructions for use (IFU).
Annual reviews: Skills attained during the employee’s training period will be reflected in their evaluation. Did the employee complete their education in a timely manner? Were there tasks that were successful in competencies, but errors that still occurred during the period of evaluation? Annual reviews can be opportunities to identify areas for improvement, but it is recommended that improvement areas be identified and addressed as they happen instead of just during the annual review.
The ever-evolving SP profession provides many training and educational opportunities, and SP leaders must be open to advancements, new information and new methods for increasing technicians’ knowledge and professional growth. These leaders (or dedicated SP educators) must develop comprehensive training and education for their staff members and help prepare their teams for any challenges that may arise. The SPD’s interdisciplinary colleagues and patients will benefit greatly by this commitment to quality training and professionalism.
– Tony Thurmond, CRCST, CIS, CHL, FCS, serves as central service manager for Dayton Children’s Hospital. He is an HSPA past-president and currently serves on HSPA’s board of directors.