Elevating SPD Training: Best Practices Insights from an SPD Educator

  

Martin Li, MA, CRCST, CER, CIS, CHL

Introduction

Designing effective Sterile Processing Department (SPD) training and education programs is crucial for maintaining high standards and ensuring competency. From frequency to credibility, each aspect plays a vital role in the success of the programs. Here are key insights and best practices from an SPD educator's perspective.

Frequency

A successful training and education program must be frequent and regular:

• Annual: According to the Joint Commission, annual training and education are required to support and maintain competency.
• Monthly: Monthly in-services are essential to keep teams well-versed in their instrumentation and the equipment used throughout the department [2].

Reviewing and Revising

Regular review and revision of training and educational materials are critical:

• All materials should be reviewed and revised at least annually to ensure accuracy and relevance.
• Revisions are necessary whenever a device changes, is replaced with a newer model, or when a new instrument or piece of equipment is introduced. Establishing a process to flag needed revisions can ensure timely updates [1].

Vendor In-Service

When updating equipment:

• Request a no-charge quote resulting in a no-charge purchase order from the vendor. This can trigger the inquiry into whether training or educational resources need updating or if an in-service from the vendor needs to be scheduled [2].

Retention

Retention of training material is critical for its effectiveness:

• Regular Competency Checks: More frequent competency checks beyond the annual minimum can help identify and address retention concerns early.
• Coachable Moments: Frequent engagement with the team can create opportunities to address struggles and reinforce training.
• Ensure Uptake: Address avoidance of complex topics or equipment by identifying the root cause of insecurity and providing targeted support [2].

Credibility

Ensuring the credibility of training materials is essential:

• Vendors: Many vendors provide reliable training and educational materials, including free continuing education (CE) tools.
• Applying Knowledge: Review and verify the credibility of resources personally as an educator or manager.
• Collaborate: Managers and educators should collaborate to assess the adequacy and credibility of training materials together [1].

Conclusion

Adhering to best practices in SPD training and education can maximize the effectiveness of the resources used in the department. Key items to keep in mind include:

1. Frequency and Regularity: Annual competency training and assessments are essential for compliance and efficiency.
2. Review and Revise: Regular updates to training materials ensure they remain relevant and accurate.
3. Retention: Effective training requires ensuring that the team retains the knowledge and skills learned.
4. Verify Credibility: Use reliable resources and collaborate to determine the best materials for your department [3].

By following these guidelines, SPD departments can maintain high standards and ensure their staff are well-trained and competent.

References

1. belimed.com - Strategies for Building an SP Education Program
2. steris.com - SPD Staffing & Training - Sterile Processing
3. myhspa.org - PROCESS Online - Healthcare Sterile

 

Roadmap for the HSPA Exam Requirements: A Personal Perspective

Martin Li, MA, CRCST, CER, CIS, CHL

 

Introduction

Navigating the HSPA exam requirements is a critical step in earning your Sterile Processing credentials. As an SPD educator, I've guided many through this process and can attest to the importance of understanding the eligibility prerequisites for the CRCST, CER, CIS, CHL, and CCSVP certifications. This article aims to provide a detailed roadmap to help you plan your certification journey and set the stage for elevating your career in the healthcare industry.

Understanding the HSPA Exam: An Overview

Established in 1971, the IAHCSMM exam (now HSPA) was designed to certify Sterile Processing technicians, proving their competency to provide reliable and competent services. Today, the HSPA administers this certification exam, recognized within the industry as a key credential for Sterile Processing professionals [2].

HSPA Certifications

The HSPA offers various certifications, each validating the expertise of professionals in the Sterile Processing field and enhancing their career opportunities:

• Certified Registered Central Service Technician (CRCST)
• Certified Instrument Specialist (CIS)
• Certified Endoscope Reprocessor (CER)
• Certified Healthcare Leadership (CHL)
• Certified Central Service Vendor Partner (CCSVP)

Eligibility Criteria for the HSPA Exam

Candidates need to fulfill certain eligibility criteria to acquire an HSPA certification. These include completing a prescribed number of hands-on experience hours, such as 400 hours for CRCST certification, and providing proper documentation of this experience [1].

CRCST Certification Requirements

The Certified Registered Central Service Technician (CRCST) certification is the introductory certification for Sterile Processing professionals. The CRCST certification program emphasizes critical roles such as decontaminating, inspecting, assembling, packaging, and sterilizing reusable surgical instruments or devices [2].

Candidates have two paths to qualify for the CRCST exam, which requires 400 hours of hands-on experience in the following areas:

• Decontamination
• Preparation and packaging
• Sterilization and disinfection
• Storage and distribution
• Quality assurance processes
• Equipment [1]

CIS Certification Requirements

The Certified Instrument Specialist (CIS) certification is designed for professionals with advanced knowledge and skills in handling medical instruments within Sterile Processing departments. Candidates must hold a current, full CRCST certification and accumulate 200 hours of practical work experience in a Sterile Processing department [3].

CER Certification Requirements

The Certified Endoscope Reprocessor (CER) certification is for technicians who specialize in reprocessing endoscopes and related devices. Candidates must hold a current CRCST certification and complete a minimum of 400 hours of practical experience in endoscope reprocessing [3].

Exam Registration Process

The registration process for an HSPA exam involves filling out an application form, providing all necessary information, and usually takes three to four weeks. Once approved, candidates receive a scheduling email to book their exam at a Prometric Testing Facility during a 90-day testing window. The exam fee for certifications like CIS and CRCST is $140, including the application processing fee and one exam attempt [2].

Exam Format and Content

All HSPA exams use multiple-choice questions. For instance, the Certified in Healthcare Leadership (CHL) exam includes 150 questions to be completed in 120 minutes. The CRCST exam assesses knowledge in seven key areas: cleaning, decontamination, disinfection, preparation, packaging, documentation, and sterilization [2].

Scoring and Passing the HSPA Exam

HSPA exams require a minimum passing score of 70% or higher. For example, the CRCST exam requires candidates to secure a scaled passing score of 70, with each correct answer being worth one point [3].

Preparing for the HSPA Exam: Tips and Resources

Engaging in practice tests from providers like iPrep and Exam Edge can simulate the CRCST test environment and highlight areas needing further study. A solid study plan, including using the Certification Handbook and Exam Content Outline, taking courses like Purdue University’s CRCST preparation course, and combining hands-on experience, self-study, and practice tests, is essential for exam success [1].

Maintaining Your Certification

To maintain certifications like CRCST, CIS, and CER, candidates must earn specific annual continuing education (CE) credits. For example, CRCST requires 12 annual CE credits focusing on sterile processing advancements. These credits can be earned through technical or community college courses related to Sterile Processing, submitted with an official transcript for approval [5].

Exam Day: What to Expect

Prometric Testing Facilities worldwide offer HSPA exams year-round. Candidates should arrive at the testing center at least 30 minutes before their scheduled exam time for check-in procedures. A valid form of identification is required for admission [3].

Handling Exam Results

CRCST exam results are provided immediately after completion, displayed on the screen, with an email notification also sent to the candidate. Successful candidates receive a certification package within two weeks. Those who fail can retake the exam after a six-week waiting period and upon payment of a non-refundable fee [2].

Career Opportunities and Benefits of HSPA Certification

Securing an HSPA certification like CRCST enhances professional credibility and paves the way for career growth opportunities. Benefits include increased professional credibility, a competitive position for job openings, and the ability to provide reliable services meeting healthcare facility expectations [4].

Summary

This guide provides an extensive overview of the HSPA exam and various certifications offered by the Healthcare Sterile Processing Association. I've covered all essential aspects, from eligibility criteria, exam format, and scoring to supporting your certification and handling exam results. Obtaining an HSPA certification is a significant step toward advancing your career in healthcare. It strengthens professional credibility and opens new opportunities in sterile processing departments. As healthcare evolves, the need for certified professionals continues to rise, so take a step toward certification and contribute to ensuring the highest patient safety standards.

Key Takeaways

• HSPA Certifications: The HSPA exam certifies Sterile Processing technicians with various certifications including CRCST, CER, CIS, CHL, and CCSVP. These certifications are essential for enhancing ability and career opportunities in the field.
• Eligibility: To obtain HSPA certifications, candidates must complete specific hands-on experience hours and pass respective exams. The CRCST exam, being a foundational certification, requires 400 hands-on hours [1].
• Maintaining Certifications: Certifications like CRCST, CIS, and CER require earning annual continuing education credits through specific activities, such as college courses related to Sterile Processing [5].

Sources

1. myhspa.org - Become Certified
2. myhspa.org - Certified Registered Central Service Technician (CRCST)
3. myhspa.org - Certified Healthcare Leader (CHL)
4. myhspa.org - Certification Overview
5. myhspa.org - Renew Your Certification

 

Quality Assurance and Documentation for Using IUSS - Immediate Use Steam Sterilization

 

Martin Li, MA, CRCST, CER, CIS, CHL

Sharing my personal notes

As an SPD educator, it's crucial to emphasize the importance of strict adherence to protocols when performing Immediate Use Steam Sterilization (IUSS). This ensures patient safety and maintains compliance with regulatory standards. Below are my notes in searching guidelines for providing quality assurance and thorough documentation during the IUSS process.

Pre-Sterilization Process

1. Cleaning/Decontamination:
• Instruments must be cleaned and decontaminated in the Sterile Processing Services (SPS) or an appropriate negative pressure-soiled utility room equipped with a sink in the OR.
• Transport the instrument to the OR in a contained system to maintain cleanliness.
2. Preparation for IUSS:
• Place the instrument in an appropriate rigid container designed for IUSS, using a Class V or VI chemical indicator.
• Seal the rigid container and apply the necessary filters. Ensure the container is not locked to prevent potential shelf placement if the item is not used.
• Do not use wrappers for the IUSS process.
• Select the appropriate IUSS cycle based on the manufacturer's Instructions for Use (IFU). If processing multiple items, use the most rigorous cycle values.

Post-Sterilization Process

1. Verification and Documentation:
• Verify sterilization parameters using the mechanical printout. If any parameters are not met, the item must not be used.
• Promptly remove the sterile item from the autoclave using heat mittens or gloves and transport it to the OR.
• Place the rigid container on a clean surface, and remove the lid aseptically using heat mittens or gloves.
• The scrub person should verify the color change of the internal chemical indicator and remove the item aseptically. The item must not be used if the indicator shows an inappropriate or no color change.
• Complete the documentation of the IUSS cycle.

Quality Assurance Cycles

1. Daily Biological Indicator (BI) Testing:
• Run a BI test daily for each cycle type and temperature, as pre-vacuum and gravity processes require different indicators. Use Geobacillus stearothermophilus spores to challenge the sterilization process.
• Document the results of BI testing, including incubation time based on the cycle type.
2. Record Keeping:
• Save all items related to the sterilizer load, including the mechanical printout and internal chemical indicator.
• Document patient information, case details, surgeon, date/time of IUSS, and load number per facility policy.
3. Documentation Log:
• Ensure access to complete sterilization records, including:
• Items processed.
• Load number and mechanical printout.
• Chemical indicator results.
• Cycle parameters, date, and time.
• Operator information (who initiated and removed the items).
• Reason for IUSS.
• Results of the DART/Bowie-Dick test if using a pre-vacuum cycle.
• Results of the most recent BI testing.

Documentation for OR Nurse Manager Records

1. Traceability and Compliance:
• Record the medical record number and patient name for traceability, along with the staff member's name performing the IUSS process.
• Document the date, time, load number, OR number, autoclave ID, cycle duration, temperature, items sterilized, and reason for IUSS.
• Verify and document that sterilization parameters were met.
• Include names of staff operating the sterilizer and removing the processed items.
• Report any potential sterilizer failures to SPD/Nursing/Surgery leadership.
2. Monitoring and Reporting:
• Use Class 5 or 6 chemical integrating indicators within each sterilizer container or tray.
• Monthly, report the total number of IUSS cycles, types of instruments processed, and reasons for cycles to the Infection Control office or IUSS Usage Review committee. The committee reviews these reports to determine necessary actions to prevent recurrence.

By following these guidelines, OR and SPD staff can ensure the efficacy of the IUSS process, maintain exacting standards of patient safety, and comply with documentation requirements.

Sources used:

1.         Joint Commission - Instrument Reprocessing - Immediate Use Steam https://www.jointcommission.org/standards/standard-faqs/ambulatory/infection-prevention-and-control-ic/000002122/

2.         AJIC - Immediate use steam sterilization: Moving beyond current https://www.ajicjournal.org/article/S0196-6553(13)00006-0/fulltext

3.         ASC Quality - Immediate-Use Steam Sterilization Policy https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fascquality.org%2Fwp-content%2Fuploads%2F2024%2F02%2FImmediate-Use_Steam_Sterilization_P_P_Template-3.doc100.docx&wdOrigin=BROWSELINK

4.         Quizlet - Chapter 13 Point-of-Use Processing Flashcards

5.         ANSI/AAMI ST79:2017/(R)2022

 

Understanding GHS and OSHA Hazard Classification: Essential Knowledge for SPD Operations

 

Martin Li, MA, CRCST, CER, CIS, CHL

Introduction to GHS and OSHA

The Globally Harmonized System of Classification and Labeling of Chemicals (GHS) and the Occupational Safety and Health Administration (OSHA) standards are critical frameworks for managing chemical hazards in Sterile Processing Departments (SPD). Understanding these systems ensures that SPD personnel can safely handle, store, and dispose of chemicals, minimizing risk to health and safety. GHS classifies hazards into two main types: physical hazards and health hazards.

 

 

 

GHS Physical Hazards

GHS criteria for physical hazards are based on measurable characteristics or reactions in specified environments, providing a quantitative approach to hazard classification. This method ensures uniformity and reduces personal interpretation, making classification more consistent across different contexts.

Examples of Physical Hazards:

• Explosives
• Flammable Gases
• Flammable Aerosols
• Oxidizing Gases
• Gases Under Pressure
• Flammable Liquids
• Flammable Solids
• Self-Reactive Substances
• Pyrophoric Liquids
• Pyrophoric Solids
• Self-Heating Substances
• Substances that emit flammable gases when in contact with water
• Oxidizing Liquids and Solids
• Organic Peroxides
• Corrosive to Metals [1].

GHS Health-related Hazards

GHS health-related hazard criteria standardize the classification of chemical hazards, facilitating better risk management and communication.

Examples of Health-related Hazards:

• Acute Toxicity
• Skin Corrosion or Irritation
• Serious Eye Damage or Eye Irritation
• Respiratory or Skin Sensitization
• Germ Cell Mutagenicity
• Carcinogenicity
• Reproductive Toxicology
• Target Organ Systemic Toxicity (Single and Repeated Exposure)
• Aspiration Toxicity [3].

Importance of GHS and OSHA Standards in SPD

The adoption of GHS by OSHA ensures that all chemical manufacturers prepare labels and Safety Data Sheets (SDS) according to standardized criteria. This alignment improves safety by providing consistent hazard information and reducing confusion in international chemical trade and transport [2].

Utilizing Safety Data Sheets (SDS) in SPD

Safety Data Sheets are critical tools for SPD staff, providing comprehensive information about chemical hazards and safety measures. An SDS typically includes:

1. Identification: Chemical name and recommended uses.
2. Hazard Identification: Potential hazards and precautionary measures.
3. Composition/Information on Ingredients: Chemical composition details.
4. First-Aid Measures: Immediate medical care instructions.
5. Fire-Fighting Measures: Guidelines for handling chemical fires.
6. Accidental Release Measures: Steps for managing spills or leaks.
7. Handling and Storage: Safe handling and storage instructions.
8. Exposure Controls/Personal Protection: Recommended safety measures.
9. Physical and Chemical Properties: Characteristics like boiling point and solubility.
10. Stability and Reactivity: Information on chemical stability and potential reactions.
11. Toxicological Information: Health effects and symptoms of exposure.
12. Ecological Information: Environmental impact details.
13. Disposal Considerations: Proper disposal guidelines.
14. Transport Information: Transportation regulations.
15. Regulatory Information: Relevant safety, health, and environmental regulations.
16. Other Information: Additional data including preparation and revision dates [4].

Conclusion

Understanding and adhering to GHS and OSHA hazard classifications are essential for maintaining safety and compliance in SPD operations. By effectively utilizing Safety Data Sheets and following standardized protocols, SPD personnel can ensure a safer working environment and enhance overall operational efficiency. I suggest including such contents into SPD training programs.

References

1. osha.gov - Hazard Communication - Globally Harmonized System
2. osha.gov - Hazard Communication - Overview
3. era-environmental.com - GHS Hazard Classification: Everything You Need to Know
4. insights.regencysupply.com - How to read a Safety Data Sheet (SDS) - Regency Insights Blog
5. drs.illinois.edu - Chemical Hazard Classification (GHS)

 

Understanding and Utilizing Safety Data Sheets (SDS) in Sterile Processing Department (SPD) Operations

Martin Li, MA, CRCST, CER, CIS, CHL

 

Photo from OSHA.gov

 

What is a Safety Data Sheet (SDS)?

A Safety Data Sheet (SDS) is a detailed document provided by chemical manufacturers that communicates essential information about chemical substances used in various operations. It includes details about the chemical's properties, potential hazards, handling procedures, and emergency control measures. These sheets are crucial for ensuring workplace safety and compliance with regulatory standards [1].

Importance of SDS in SPD Operations

In the context of Sterile Processing Departments (SPD), SDS are indispensable. They help staff understand the risks associated with chemical agents used in cleaning, disinfecting, and sterilizing medical instruments. Adhering to the information provided in SDS ensures that personnel can handle chemicals safely, reducing the risk of accidents and exposures [2].

How to Find an SDS

To locate an SDS for a particular chemical, staff can access various resources. Manufacturers and suppliers often provide these documents with their products or make them available on their websites. Additionally, comprehensive databases such as OneSource can be used to search and retrieve SDS for numerous chemicals. Ensuring that these sheets are easily accessible in the workplace is crucial for immediate reference in case of an emergency [5].

How to Use an SDS

Using an SDS effectively involves understanding its structure and content. Typically, an SDS is divided into 16 sections, covering:

1. Identification: Provides the chemical's name and recommended uses.
2. Hazard Identification: Describes potential hazards and precautionary statements.
3. Composition/Information on Ingredients: Details the chemical's composition.
4. First-Aid Measures: Outlines immediate medical care instructions.
5. Fire-Fighting Measures: Provides guidance on handling fires involving the chemical.
6. Accidental Release Measures: Describes how to respond to spills or leaks.
7. Handling and Storage: Offers instructions on safe handling and storage practices.
8. Exposure Controls/Personal Protection: Recommends safety measures to minimize exposure.
9. Physical and Chemical Properties: Lists characteristics like boiling point and solubility.
10. Stability and Reactivity: Discusses the chemical's stability and potential reactions.
11. Toxicological Information: Details health effects and exposure symptoms.
12. Ecological Information: Addresses environmental impact.
13. Disposal Considerations: Provides disposal guidelines.
14. Transport Information: Covers transportation regulations.
15. Regulatory Information: Lists safety, health, and environmental regulations.
16. Other Information: Additional data, including preparation and revision dates [3].

The Role of SDS in Training and Safety

SDS are also valuable educational resources for SPD staff. Regular training sessions on how to interpret and apply the information in these sheets can enhance safety awareness and preparedness. By integrating SDS information into daily operations, SPD teams can ensure that all staff members are knowledgeable about the safe use of chemicals and prepared to handle emergencies effectively [4].

In conclusion, Safety Data Sheets are vital tools in SPD operations, providing essential information for the safe handling of chemicals. By ensuring easy access to SDS and incorporating their use into regular training, SPD leaders can significantly enhance workplace safety and compliance.

References

1. osha.gov - Hazard Communication Standard: Safety Data Sheets
2. stericycle.com - The Purpose and Importance Of Safety Data Sheets (SDS)
3. safetyskills.com - The Purpose and Importance of Safety Data Sheets
4. insights.regencysupply.com - How to read a Safety Data Sheet (SDS) - Regency Insights Blog
5. blink.ucsd.edu - Safety Data Sheets (SDS) Explained

 

Ensuring Excellence: The Role of The Joint Commission in Healthcare Facilities and How SPD Leadership Can Prepare for On-Site Inspections

Martin Li, MA, CRCST, CER, CIS, CHL

 

 

Introduction

The Joint Commission plays a crucial role in maintaining high standards in healthcare facilities by providing accreditation that signifies excellence in patient care and safety. This accreditation not only enhances the reputation of healthcare organizations but also drives continuous performance improvement.

The Role of The Joint Commission

1. Setting Standards: The Joint Commission establishes comprehensive standards that healthcare facilities must meet. These standards cover a wide range of areas including patient care, medication safety, infection control, and emergency preparedness [5].
2. Accreditation and Certification: Achieving Joint Commission accreditation signifies that a healthcare facility adheres to high standards of patient care and safety. This process involves rigorous evaluation and provides an objective assessment of the facility's performance [1].
3. Performance Improvement: The Joint Commission's standards focus on state-of-the-art performance improvement strategies, helping healthcare organizations to continuously enhance their processes and outcomes [1].
4. On-Site Surveys: The on-site survey process is data-driven and focuses on patient safety and quality. Surveyors evaluate actual care processes and technology to ensure compliance with Joint Commission standards [2].

Preparing for On-Site Inspections: Guidance for SPD Leadership

Scenario 1: Mock Survey Simulation

In a bustling Sterile Processing Department (SPD), the leadership team decides to conduct a mock survey to prepare for the upcoming Joint Commission on-site inspection. The team gathers early in the morning, and the SPD manager assigns roles to simulate the presence of surveyors. The mock survey begins with a thorough inspection of documentation, ensuring all maintenance logs and sterilization records are up-to-date and readily accessible.

Throughout the simulation, staff members are quizzed on their knowledge of high-risk, low-frequency events, such as handling sterilization equipment failures. The team practices responding to potential surveyor questions, refining their communication skills and ensuring they can articulate their adherence to protocols confidently. This proactive approach helps identify gaps in processes and provides an opportunity for corrective actions well before the actual survey [4].

Scenario 2: Interdisciplinary Team Preparation

A month before the scheduled survey, the SPD leadership organizes an interdisciplinary team meeting, involving representatives from infection control, nursing, and biomedical engineering. The objective is to align all departments on the preparation goals and ensure seamless coordination. Each department presents its readiness plan, highlighting areas that need attention.

The team conducts a walkthrough of the SPD, examining every aspect from the cleanliness of workstations to the proper labeling of sterilized instruments. They cross-check their procedures with the latest Joint Commission standards, ensuring no detail is overlooked. Regular training sessions are scheduled to keep the staff updated on best practices and regulatory requirements. This collaborative effort fosters a culture of continuous improvement and readiness, ensuring the department meets and exceeds accreditation standards [2].

In conclusion, the Joint Commission plays a vital role in ensuring healthcare facilities provide safe and high-quality care. By adhering to their standards and preparing thoroughly for on-site inspections, SPD leadership can contribute significantly to maintaining excellence in healthcare delivery.

References

1. jointcommission.org - Benefits of Joint Commission Accreditation
2. jointcommission.org - On-site Survey Process Fact Sheet
3. onlinenursing.duq.edu - Nurse Leaders Preparing for Joint Commission Inspections
4. reliasmedia.com - The Return of Onsite Surveys: Prepare with Tips, Best…
5. jointcommission.org - Standards for Joint Commission Accreditation and ...
6. vanguard-fire.com - What to Expect From A Joint Commission Survey