Adhering to IFUs; developing SP staff productivity standards

March 23, 2020

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Q We have handpieces and the IFU states to sterilize them at 270 F for 15 minutes. We have Dynamic Air Removal but it does not use those exposure times and temps. I found a pouch but the IFU states it has been tested for double pouching in the Gravity cycle for 270 F/15 min. Even though the IFU for the handpieces does not state whether they go in a double pouch, can we still do this? I guess my question is, can any instrument be double pouched if the peel pouch IFU has been tested this way?

A If a pouch manufacturer has Validation for double pouching for the sterilization method and parameters you are using, then any device or instrument with an IFU stating the same sterilization requirements should be able to be double pouched.   

It is essential that you follow the IFU including the sterilization requirements. In the March CS Solutions column, I addressed the topic of double pouching. To read it, visit https://hpnonline.com/21126087

Q I am an RN and recently started a new position in the sterile processing department as the education and quality assurance specialist. The director requested that I establish productivity standards for staff output performance. I spoke to a QA specialist from another hospital within our health system, and she suggested I begin by gathering statistics related to patient days, bed capacity vs. ORs, average daily census and surgical case load. For the novice that I am it seems a bit overwhelming and like that information might not lead to what I need to get for sterile processing staff productivity. Where would you suggest I start? And what should I include from the list she suggested?

A In my many years in the profession, I have visited and consulted for many ORs and sterile processing departments, and one thing I have found is that as much as you think they are alike they are different. While they may share many commonalities the scope and span of their duties and responsibilities varies widely. Obviously, I know little about the specifics of your department to be able to give you detailed advice to get to where you may want to be. That said, one thing that seems to be a common thread amongst sterile processing departments is the responsibility of reprocessing surgical instruments.

In the suggested list your colleague provided, it appears to me that surgical case volume would likely be a key indicator for workload productivity for a sterile processing department. You must of course be mindful that surgical case volume itself does not take into consideration the difference in complexity of instrumentation required from one type of surgery to another. For example, one procedure may require one minor set containing noncomplex general instruments while another procedure may use eight sets of very complex, multi-part specialty instruments, implants and accessories totaling a few hundred pieces.

Case volume and the nature of a procedure could vary greatly from one day to the other, so you will need to factor this into the development of your statistical formula and adjust accordingly. Monitoring the number of trays processed daily would be a good index. Based on the complexity of sets you could categorize sets as A - for very complex, B - standard and C – simple. A representative number of staff at different skill levels would be accessed to determine the length of time it takes them to reprocess sets in each category. From this information, you could establish a standard of performance that would be utilized to determine actual daily workload output. There are software programs available that allow you to enter your information into the system for routine productivity monitoring. The information garnered can provide you with individual performance as well as allow you to determine needed resources such as staffing, instrumentation and processing equipment in order to proficiently meet customer needs. 

About the Author

Ray Taurasi

Ray Taurasi is Principal, Healthcare CS Solutions. His healthcare career spans over five decades as an Administrator, Educator, Technologist and Consultant. He is a member of AORN, SGNA, AAMI and a past president of IAHCSMM. Taurasi has been a faculty member of numerous colleges teaching in the divisions of business administration, nursing, and health sciences. He is the author of numerous articles and textbook chapters; he is a frequent speaker at national and international healthcare conferences. 

Note to readers from Ray Taurasi - In 2021, my life’s career path will transition to one of new opportunities and adventures. As a result, after nearly 19 years and 225 CS Solution columns, this edition will be my last.

“All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves; we must die to one life before we can enter another.”– Anatole France

I wish you and your loved ones a healthy and joyful holiday season and a beautiful New Year! God Speed, Ray

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Image courtesy of Kat Velez, LeeSar Regional Service Center, Fort Myers, FL, HPN’s 2017 SPD of the Year
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