We have been in crisis situations where we are overwhelmed with patients, trauma, mechanical issues and/or weather events and we have policies and procedures in place to direct us on how to respond. Suddenly, this time we have no surgeries, except for emergencies. Because fewer were driving, auto accidents were minimized. For the most part the world was shut down. It was eerie. This represented a very different form of crisis for which we did not have policies.
What did your department do with this opportunity of time? Many checked for outdated instruments, trays and supplies, then cleaned the department and/or reorganized. Education is always important. Did you take this opportunity to have education sessions or work on getting staff certified? It was also a good time to review manufacturer instructions for use (IFU) to ensure proper instrument care and testing verification products are on hand to meet the instruments’ IFUs. Were staff reduced due to lack of work or reassigned to help with COVID-related issues in other departments?
We all had to be ready to respond to the unknown.
As the world began to re-open a fraction at a time, we found ourselves responding to new issues on a daily or weekly basis. The personal protective equipment (PPE) shortages emerged early on. What processes were put into place to extend the wear of PPE? How uncomfortable were you with this situation? We were told to sterilize selected masks – mainly N95 respirator models. My first instinct was to go back to the basics that I learned and taught: You can’t sterilize it if it isn’t clean. There was no IFU on how to clean a disposable mask. Manufacturers scrambled to devise methods to “clean” and sterilize masks. Gowns were also in short supply. The cost of an isolation gown jumped to $10.00+ from 50 cents each. Considering the volumes of gowns, the toll this had on the budget was enormous. Next were gloves. Were you asked to reuse gloves to have something to use rather than running short or having nothing at all?
One positive: Respect
One of the benefits that surfaced during the pandemic is that SPD was recognized by senior leadership for the importance of the work the department produced. This is a recognition that we want to keep in place. As we emerge from the pandemic, it’s important that we work to retain that vision of your importance. How will you ensure leadership understands the needs of the department to perform according to standards set by regulatory and standards-setting bodies, such as AAMI, AORN, FDA and others? How do you engage physicians who do not understand the effort and time necessary to clean and disinfect, test, assemble, sterilize and have ready instruments for each tray? Because orthopedic surgeons have many implant trays, for example, this may be a good time to get leadership and the physicians to understand the process of having multiple vendor trays per surgery and how that affects the SPD’s function and staffing.
The relationship between Infection Prevention (IP) and SPD became more important, too. When considering how to address the PPE shortages, IP was the expert and helped direct the right decision at that point in time because it consistently changed, based on their knowledge and that of their colleagues around the country.
How was your relationship with IP prior to the pandemic? Have you taken the opportunity to understand each other’s role to promote supporting each other? Have you created a bond that will enable SPD to be supported in the future by IP? This relationship is not always what it should be. I hope that this pandemic has offered the time to build this relationship and ongoing support for the needs of the department and any issues that arise. [Editor’s Note: See “Infection Prevention, SPD: United we withstand,” April 2021 Healthcare Purchasing News, pp.14-19. (https://hpnonline.com/21213928)]
How do you make these changes sustainable? How has the past year prepared SPD to respond to that next crisis?
