When I asked the simple question "What is patient safety?" the response I received was that medical errors, incorrect medication, missed diagnosis, etc. were an issue. Of course that wasn’t what I was looking for so I asked a second question, "How does patient safety relate to Sterile Processing?" I got the normal response regarding the verification of the sterilizers, verifying sterilization cycles, and conducting sterilization testing.

But what about all the other little things we do daily to protect the patient? Do you check each and every time the wrapped items that you send out of your department for holes, load control label and tape is securely applied? Do you check your case containers for broken or missing locks and load control tags? How about your peel pouches? Loaners? Do you have a good process in place to recall items that were sterilized internally? These are some issues that assure patient safety and cannot be taken lightly.

In order to make sure that we have the patient’s safety in hand we must have a clear picture of what is actually happening. Because the hands-on worker is in the best position to identify issues and solutions, we need to meet with them and discuss patient safety as it relates to our department. Monthly meetings should be conducted and re-enforce that we are the first line to infection control and that we can help to prevent patient hazards. Ask the staff to identify what quality assurance practices you currently have in place. Make a list and ask can these ever be bypassed and what safeguards can we put in place to assure that items won’t be bypassed? Can we implement a double-check to assure that these won’t happen? The purpose of this discussion is to get associates to start thinking about what we can change in our current process that will assure a fail-safe process.

This is not a one-time meeting but one of several because we all know change does not happen over night, it takes work. Patient safety only happens when everyone looks at ways to do things differently and we must constantly question if we can do things in a better, more efficient, safe manner. At no time do I believe that an associate comes to work to do a bad job or to make an error, we all make mistakes and we should learn from them. The most competent associates can make mistakes and accidents do happen despite our best intentions. We need to look at ways to assure patient safety and forget the finger pointing. Take the situation and ask why did it occur and how can we prevent it from happening again?

We need to establish a culture where associates are able to report both adverse events and close calls without the fear of punishment. We must remind our associates that a single sterilizer malfunctioning or human errors that go undetected could cause hundreds of hospital infections. If there is a manager or director that thinks they can do it on their own by creating policies and procedures, I wish them luck. We need our associates input to see if we lack processes and what would be the best way to improve. The sterile processing department must function as a team and at the same time they need to review concerns, issues and process changes as a team. We need to evaluate the processes, review/edit current policies and procedures, implement change, set consequences for failing to perform per the department standards, reward associates that perform to department standards and the most important factor of all, we need to continually review and assure that the process change is working.

Sample of patient safety items:

• Lack of education

• Holes/Rips in wrap

• Load control labels

• Integrity of the peel pouches/wrappers

• Tape adhered to packages

• Locks on container

• Properly sealed peel pouches

• Lid of container on correctly

• Legible writing

• Proper identification

• Indicator strip visible and change to appropriate color

• Instruments are open in peel pouches

• Cleanliness of department

• Temperature of department

• No food or drinks in department

• Recall process

How many times do you hear, "I would never have surgery here?" Did you ever bother to ask them why? Most of the time it is because they have seen or heard something that is questionable from a patient safety aspect. This could be another meeting where you could get your associates to share information that you could pass on to your executive team. If you can get your associates to come back to your hospital for surgery then you must be doing the right thing to make them feel secure.

I am no expert when it comes to patient safety however I know that I would and have had surgery at my hospital because I know that the associates are here for the patients and their safety. HPN