Uncommon sense

July 1, 2016

With greater recognition of the patient safety risks presented by improperly processed surgical instruments and devices, the spotlight on central sterile/sterile processing departments (CS/SPD) grows. Many different parties to the healthcare industry, including hospitals, manufacturers and industry associations, are making concerted efforts to increase CS/SPD education and training, as well as ensure the profession has the resources it needs to successfully protect patients.

In this article, we provide an overview of current CS/SPD state certification requirements, both bills that have passed and legislation currently in progress. We also provide insights from CS/SPD professionals, industry thought leaders and manufacturers on what is needed to advance the profession in terms of establishing a CS/SPD career path, on-the-job training and continuing education. Lastly, we offer resources that CS/SPD professionals can access to expand their knowledge and further their careers in this up-and-coming profession.

The state of certification

At the time this article was written (May 2016), Connecticut, New Jersey and New York require new central service technicians entering the profession to obtain certification in order to work in the profession within those states; however, all central service technicians, whether grandfathered in or not, are required to complete a minimum of 10 hours of continuing education annually.

Josephine Colacci, Esq., Director of Government Affairs for the International Association of Healthcare Central Service Materiel Management (IAHCSMM), notes how there has been progress on the legislative front in both Massachusetts and Pennsylvania as well. According to Colacci, the Massachusetts legislation regarding certification for central service technicians successfully passed out of the Joint Health Care Financing Committee on May 5, 2016.  This legislation is now before the Senate Rules Committee. In Pennsylvania, IAHCSMM continues to meet with legislators serving on the House Health Committee to educate them regarding certification for central service technicians.

Natalie Lind

“The field of healthcare is constantly changing, with new procedures and new medical devices being introduced at a rapid rate,” said IAHCSMM’s Education Director Natalie Lind, CRCST, CHL, FCS. “Those changes have a profound impact on the central service department. All those involved in the reprocessing of medical devices must keep up with changes as they occur. Along with learning about new devices and procedures, we are also evolving in our understanding of the science of sterilization. What was an acceptable practice a few years ago may be unacceptable now. Keeping current is critical for patient safety.”

Grassroots efforts

Bob Marrs

Bob Marrs, Director of Consulting Services/Field Operations for Aesculap, believes hospital leadership in sterile processing, surgical services and administration should be leading the charge for certification.” He states:

“Did you know that the person who cuts your hair, works on your car, does your nails, does your taxes and sells your house all require certification? Yet, the folks who clean, decontaminate, inspect for quality and functionality, sterilize, store and transport the surgical instruments that will go into you or your loved ones’ bodies, does not require certification. How did this happen and how does it continue to happen? In the country that boasts the ‘best’ healthcare in the world, our third leading cause of death is medical errors. What are you doing as a CS/SPD professional to support this effort and to keep the momentum going? Our profession needs this but more importantly, our PATIENTS need this!”

Jo M. Wood

Jo M. Wood, Compliance & Education Supervisor for Boston Medical Center, has taken an active role in supporting the Massachusetts legislative efforts. Wood explains how those working on the Massachusetts legislation spent the first term educating elected officials on the role of CS/SPD. They are now shaping the legislation and moving it forward during the third year.

While most states do not require CS/SPD technician certification at this time, many healthcare facilities are taking the matter into their own hands and requiring it of their CS/SPD employees. For example, Jewish Hospital & University of Louisville Hospital’s CS/SPD department, which was named the Healthcare Purchasing News 2016 SPD Department of the Year, requires all of its employees to earn their Certified Registered Central Service Technician (CRCST) certification within the first 12 months of the hire date (read Jewish SPD bolsters package deal within regional IDN in the May 2016 issue of HPN).

Weston “Hank” Balch

“The impact of a ‘certification culture’ in a department can be earth shaking, sending positive shockwaves into every corner of surgical services,” said Weston “Hank” Balch, CRCST, CIS, CHL, Director of Sterile Processing Operations for Jewish Hospital & University of Louisville Hospital. “Physicians see a commitment to growth in your CS team, nurses and surgical technicians notice the level of professional communication rise among your staff, and the patient ultimately gets a higher and more consistent standard of care with every instrument set. Every hour spent pursuing certification and CS education pays dividends in safe, high quality OR minutes. And that’s a language our C-suite and broader community can understand.”

Stephen M. Kovach

According to Stephen M. Kovach, Director of Education for Healthmark Industries, certification of staff members who reprocess medical devices is the first step towards being considered a professional.

“What amazes me sometimes is that many who work in the field feel that a state must require they be certified before they will take that step, where others realize the importance of certification as it shows they have taken upon themselves to let everybody know that they take pride in saying, ‘I am certified,’” said Kovach.

Speaking on the professional value of certification, Joel Benge, CRCST, CIS, CHL, OR Liaison for Sterile Processing, Jewish Hospital & St. Mary’s HealthCare in Louisville, Ky states:

Joel Benge

“Being triple-certified as a sterile processing technician lends me a great deal of credibility within my own department and amongst the OR staff. The education I have received allows me to communicate professionally and technically (when needed) with my peers and with the OR. Each day when I interact with OR staff, I am dealing with certified, educated individuals who know his/her given field. I can more effectively gain their trust and respect — and I can more effectively meet their needs and answer questions — when I am also a certified, educated expert in my own field.”

Industry support

Thomas Overbey

Thomas Overbey, Director of Marketing for Ultra Clean Systems, encourages CS/SPD professionals to get involved in certification efforts on the state level. He also urges manufacturers to support state CS/SPD legislative efforts as well.

“The days of certification are coming — it’s just a matter of when,” said Overbey. “Don’t wait for the ‘when’ — go ahead and make this the best process you can today because it’s all about patient safety. CS/SPD professionals shouldn’t lead the certification charge alone. Industry also needs to get involved. My personal goal is to help steer Florida to become the next certified state.”

Shawn M. Flynn

In the state of Tennessee, Senate Majority Leader Mark Norris and Shawn M. Flynn, Co-Founder/SVP of Customer Operations for Restore Medical Solutions, carried out a campaign that led to passing of Senate Bill 2581, which requires new central sterile technicians entering the profession to pass a nationally accredited central sterile exam. All central service technicians, whether grandfathered in or not, are required to complete a minimum of 10 hours of continuing education annually. Tennessee Governor Bill Haslam signed the bill on April 27, 2016, and it goes into effect on January 1, 2017.

“When Senator Norris and I were discussing the background of the OR-SPD relationship, the Senator quickly understood that there was a ‘gap’ in the circle of care and that we could impact positive change through legislation,” said Flynn. “Advocacy, in my opinion, begins with creating that spark necessary to accomplish the change you desire. Our current and future patients depend on industry professionals and subject matter experts having the specialized skills necessary to aid in combating HAIs/SSIs. They also need to be vigilant in raising the bar for central sterile technicians.”

Building a CS/SPD career ladder

Many feel it is important to take a step back and build a better support network for those entering CS/SPD, in addition to those already working in the profession. Wood explains how it is difficult to attract and retain talented CS/SPD technicians because many young people don’t know the field exists, the career ladder is not well defined and the profession is underrated.

“Every hospital has its own CS career path and it varies widely,” said Wood. “You end up with people who make great techs but then they want to grow out of CS and go someplace else because there is no line of sight for advancement. You can only have so many managers in the world so where do you go from there? How do you keep those quality people within the profession? More and more as people begin to accept CS as part of the surgical team — and I think required certification bills are going to help that — people will be a little more inclined to seriously consider CS as a career path.”

Another challenge according to Wood is that many healthcare facilities do not employ a formal CS/SPD educator. Furthermore, those in educator roles have limited resources at their disposal to train their staff members.

“My facility has a very robust CS training program, but while I was attending the IAHCSMM conference this year, I discovered not every department has someone in the educator position. So who does that work fall to? You can train on the fly but it may be more difficult to be proactive. Speaking as an educator myself, there is no formal training available for CS educators. I have to go out there and find the information myself and determine the best way to teach it out to our team. I’ve thought about taking college courses for classroom teachers but they don’t correspond well to our role.”

Balch points out that while the model of a dedicated CS/SPD educator is successful in many contexts, CS/SPD front-line technicians must become “continual self-educators” and certification supports this. He states:

“What certification brings to the table is the ability to spread out this expertise to every team member in the department, so each individual can become competent enough to hold an in-service on how to inspect bipolar forceps or train each other in process improvement techniques,” said Balch. “Successful onboarding programs for CS departments should include a certification study component that allows technicians who are not already certified to prepare for the exam during their orientation period, so that they can sit for the exam as soon as possible.”

“Preparation is key in any endeavor,” said Lind. “Those wishing to enter the field of central service must understand the requirements of the job and be prepared to meet those requirements. Certification helps those aspiring for a career in central service to enter employment with an understanding of the job tasks and requirements. Those currently employed in central service will benefit from both certification and continuing education. Certification helps the CS professional understand why each step in the process is important, and it helps keep both patients and employees safe.”

Kovach points out that those CS/SPD professionals who have achieved certification have a competitive edge when seeking employment.

“When you are looking for a position in this field, the interviewer knows you have a basic foundation of knowledge so your training curve at the facility will be shorter as you apply your knowledge to their specific process,” said Kovach. “You have an understanding of why you need to follow the instructions for use (IFU) or why you need to put an indicator into every item sterilized. Overall, certification lets everybody know that the certified person has taken pride in what they are doing and we all know that improves patient outcomes and that is what it is all about.”

Resources for CS/SPD professionals

“What makes this industry really exciting right now is that it is finally coming to the surface,” said Wood. “Over the past two years we’ve determined what we really need in terms of resources to advance the profession. Now we are paving the way to greater patient safety.”

Overbey urges CS/SPD personnel to join and be active in the various professional organizations (e.g., IAHCSMM, AAMI, CBSPD, AORN) to maximize their knowledge, have an impact on the industry and increase the safety of patients.

“Continuing education is a must in healthcare, and that’s certainly the case for central service,” said Lind. “Not keeping abreast of changes has the potential to cause harm to a patient or coworker. There are so many opportunities to gain knowledge and expertise in the field of central service. Whether it is an article such as this one, standards and regulation information, internal in-services or information provided by outside sources, savvy professionals will take advantage of every opportunity to learn. It is that type of thirst for knowledge that will help prepare them for additional responsibilities and career advancement.”

Here are just a few of the industry resources available to CS/SPD professionals who are seeking to gain certification, advance their knowledge and training, and earn continuing education credits.


The Aesculap Academy has a world-wide reputation for medical training of physicians, senior nursing staff and staff in OR, anesthesia, ward and hospital management. The courses consist of hands-on workshops, management seminars and international symposia. Courses are of premium quality and accredited by the respective medical societies and international medical associations.

Case Medical Inc.

Marcia Frieze

“The need for SPD training and certification has become not just a requirement but a necessity. There is simply so much information to learn to keep up with new technology and challenges,” said Case Medical CEO Marcia Frieze. “We are committed to education and training as well as developing products that meet the needs of SPD professionals.”

According to Frieze, Case Medical supports these efforts with educational programs on-line and on-site, as well as in-services with its clinical specialists to reinforce best practices. The company’s online Case Academy features programs with CEUs for CS/SPD and other healthcare professionals who wish to further educate themselves and their teams.

Circle of Care

Circle of Care, an organization whose objective is the reduction of healthcare-acquired infections (HAIs) through education and collaboration, is actively involved in organizing interprofessional collaborative educational (ICE) conferences in various cities throughout the U.S. with industry organizations such as IAHCSMM, the Association of periOperative Registered Nurses (AORN), the Association for Professionals in Infection Control and Epidemiology (APIC) and the Association of Surgical Technologists (AST).

Kisha Miller

Circle of Care also offers an on-site and e-learning certification preparatory course tailored towards CS technicians with years of on the job experience and knowledge but no formal theoretical training. The course provides CS professionals with the skills necessary to provide excellent patient care and opportunities for career advancement. The e-learning courses are available 24/7 and are accessible on any device. According to the organization’s Founder and Director of Collaborative Education Kisha Miller, Circle of Care’s online program is comprehensive, affordable, convenient, and effective. She states:

“As a result of CS professionals obtaining certification, job-related knowledge and skills acquired are actively transferred to the point of care to meet the growing demand and complexities of the CS department. The organizational benefits range from highly engaged employees, improved clinical processes and improved quality patient outcomes. Everybody wins!”


Through its website www.crazy4clean.com, Healthmark Industries offers fun and educational games focused on proper cleaning of surgical instruments. All of the company’s educational games and departmental in-service programs feature continuing education credits (CEUs) from both IAHCSMM and the Certification Board for Sterile Processing and Distribution (CBSP). Participants receive a free CEU credit after completing the quiz at the end of each game.

Mobile Instrument Service and Repair

Mobile Instrument Service and Repair offers educational programs which offer one credit towards IAHCSMM, CBSPD annual certification. The company’s programs cover general and laparoscopic instrument care and handling, rigid and flexible scopes, powered surgical equipment, electrosurgical equipment, and video equipment. Mobile Instrument combines its CE programs with hands-on education focused on reducing repairs and proper inspection of surgical devices and instruments. According to Product Manager Lisa Hawley, clinical staff benefit from the CE credits and the facility benefits from better equipment readiness, reduced downtime, and reduce inventory and repair spend. The company also provides online learning tools for its customers with staff who are studying for their certification.

Ruhof Healthcare Corp.

Ruhof Healthcare presently offers a program of free accredited continuing education at both national and local trade shows for nurses and CS/SPD technicians alike. According to Marketing Manager Noreen Costelloe, these CE opportunities have been very well received. As a result, the company is setting up online CE programs to help its customers benefit by continually advancing their knowledge. “We strongly believe that ongoing education, training and mentoring are critical to the success of any clinical department,” said Costelloe.