CS/SPD certification unabated by pandemic-related restrictions

July 26, 2021

Are Central Service/Sterile Processing & Distribution (CS/SPD) department professionals keeping up with certification during the pandemic?

Based on insights gleaned from interviews with CS/SPD staff members and product, supply and service vendors the answer is a resounding “yes.”

During the past 18 months, despite layoffs and furloughs of CS/SPD staff at some health systems and hospitals, many other healthcare organizations have made the smart decision to keep staff members on board and spend the downtime from lower surgical volumes focused on education.

CS/SPD department educators, leaders and the technicians themselves have certainly faced roadblocks along the way, most notably restrictions on in-person gatherings that put a halt to classroom education and supplier in-servicing. But a shift to virtual learning filled in the gaps in many cases, enabling teachers to teach and students to learn.

While the pandemic has presented challenges, it has also prompted innovation and change. An emerging trend has been for hospitals to recruit and train staff members from within, encouraging employees in other departments to switch to a career in sterile processing.

CS/SPD professionals are also taking education and training into their own hands, spurring the launch of companies aimed at helping colleagues get certified and advance in their careers.

The show must go on

Despite the pandemic-related pauses on elective surgeries, CS/SPD professionals continued to pursue certification and renewal both to meet state/employer certification requirements and further professional growth.

In fact, the need for certification and education increased over the past 18 months with greater awareness for the role that the CS/SPD plays in healthcare delivery, explains Damien Berg, CRCST, AAMIF. Berg served as Regional Sterile Processing Manager for UCHealth in Northern Colorado before joining the International Association of Healthcare Central Service Materiel Management (IAHCSMM) as Vice President of Strategic Initiatives in June 2021.

“We have seen a focus on cleaning and disinfecting (for obvious reasons) more now than ever,” said Berg. “Having certified and educated staff on the basics and some advanced principles of what we do has proven to be a value add for the healthcare team. With that said, Sterile Processing leadership must ensure they are communicating with hospital leadership and sharing the education and success stories so they have the needed support and funds.”

Mary K. Lane, CSPDM, CSPDS, CSPDT, MK Lane SPD Consulting, points out how it is less time-consuming and expensive for a CS/SPD professional to renew certification than it is to prepare and retake the exam, prompting many to keep up with their continuing education units (CEUs).

“A large majority of staff that were not certified used their time to attend online CEU presentations and/or webinars to gain a better grasp of concepts so they could prepare to take the certification exam as soon as possible,” she added. “For the most part, SPD staff are committed to learning and advancing in the field.”

The CS/SPD Educator

Ideally, every CS/SPD would have someone in the Educator role to train staff members, support certification efforts and offer professional development guidance.

Sinai Hospital, Lifebridge Health in Baltimore, MD has the benefit of a dedicated Educator, as well as a Quality Assurance (QA) Specialist, according to Steven J. Adams, CS/SPD Manager, Central Sterile, RN, CRCST, CIS, CHL, CER. Adams is also President of the Maryland Association of Sterile Processing Professionals (MASPP) and IAHCSMM Past President.

“This enables us to focus on issues and needed QA initiatives, then gear our educational efforts based on these focused needs. In addition, we routinely schedule two-to-three in-services per month, which involves bringing in vendors to explain their products and offer instruction on new equipment. We had recent renovations which involved replacing every piece of equipment in department - or our own internal needs by an Educator or Manager to explain new/improved processes and so on,” Adams said.

In many other cases, CS/SPD Educators are a valuable but scarce resource in the field.

“While some Sterile Processing departments have a dedicated Educator, most often, the Manager or Supervisor of the SPD is responsible for creating an education plan for their staff in addition to managing day-to-day operations, staffing and putting out fires,” explained Linda Homan, RN, CIC, Senior Manager of Clinical Affairs, Ecolab Healthcare. “Vendor partners recognize the value of education and many offer courses related to their area of expertise that can help fill the need for ongoing education in this critical department.”

Opportunity for improvement

While the volume of surgical trays coming from the operating room (OR) into the CS/SPD slowed, many departments took the opportunity to accelerate education for staff members in pursuit of certification.

Putting the CS in C-suite

Sarah B. Cruz, CSPDT, CRCST, CHL, CS Education Program Development Coordinator for The Bone & Joint Institute at Hartford Hospital in Hartford, CT, joined the hospital at the beginning of the pandemic. She said the health network worked diligently to keep all CS/SPD staff members employed full time, including travelers, and refrained from cutting their hours even through the pause in elective surgeries.

“We knew that when cases were on full blast again it would be like opening a fire hydrant rather than slowly turning on the faucet,” said Cruz.

Under her leadership, they instead performed a “complete department overhaul,” raising the profile of the CS/SPD among hospital leaders and establishing an institution of education.

“We put the CS in the C-Suite,” said Cruz. “While our Chief Surgeon was already a huge fan of our department and served as our champion, we worked diligently to build rapport with other individuals at the director level and up. COVID allotted us a big opportunity to reposition Sterile Processing as a profession and not just a job in our facility.”

One of Cruz’s first major tasks was to create an onboarding pathway for new CS/SPD technicians to transition from orientation to working independently within six months of hire.

During the pandemic, The Bone & Joint Institute onboarded six new CS/SPD technicians with a variety of experience levels and directed them through this newly established pathway. Cruz also created a certification pathway for current department technicians to comply with Connecticut’s requirement that technicians become certified within two years of hire.

To strengthen the relationship between the CS/SPD and OR staff, Cruz launched an “I Love Doctor” campaign where the CS/SPD chose a doctor each month and focused on his/her instrument issues. For example, in February 2021 they selected surgeon specific sets to address with the doctor, vender representatives, Sterile Processing system super users and OR staff.

Quantifying return on investment (ROI) from CS/SPD educational initiatives was a critical success factor, according to Cruz. For example, she and her team documented the success of their six-month onboarding program, tracking its impact on error and defect rates.

“We brought our work down to the qualitative level because we all know C-suite’s language is graphs, tangible evidence and overall cost analysis,” Cruz added.

Defining defects

HPN’s 2021 SPD Department of the Year Bayhealth in Dover, DE, made tremendous cultural, performance and structural improvements during the pandemic. According to Bayhealth’s Vice President, Resource Management Brian Dolan, the health system retained all of its full-time CS/SPD staff members and engaged them in quality control initiatives during the down times.

When a set error occurred prior to the pandemic, Dolan said the immediate response was to lay the blame at the feet of the CS/SPD. To truly get down to the root cause of issues, Dolan and his team instituted a process by which CS/SPD leaders investigate whether staff members had followed manufacturer instructions for use (IFU) when processing instruments and define whether an issue reported by the OR was truly a CS/SPD defect.

“In some cases, we have found the defect was the result of a system-related issue or another department outside of the CS/SPD contributed to its occurrence,” said Dolan. “In other cases, the defects were related to lack of IFU understanding on the part of our customers. We have reeducated them on the importance of IFU adherence. While they want us to process an instrument one way, the IFU is the source of truth and our team follows that standard.”

According to Dolan, much of their work has been around educating CS/SPD professionals so they feel empowered to ask the right questions, own their work and feel confident in their responses.

“A lot of it goes back to leadership’s influence,” said Dolan. “We not only empower our staff through education, we also back them up and serve as a support system. They are confident that leadership looks out for them.”

Knowledge is power

Sharon Greene-Golden, oneSOURCE consultant and Manager Adventist Health Care Shady Grove Medical Center in Rockville, MD, says her CS/SPD team aggressively pursued CEUs in the past 18 months. They established Tuesdays, Wednesdays and Thursdays as their learning “knowledge is power hours,” garnering over 50 CEUs from March 2020 through May 2021.

“In my 30-plus years of working in this field, I found the time during this pandemic to be the most educational across the board from what was offered in the hospital, from vendors and our associations,” said Greene-Golden. “We took this opportunity to complete annual competencies while staying abreast of all information from oneSOURCE, HPN, 3M, STERIS, Case Medical and many other vendor companies. We were front-line essential workers determined to come out of the pandemic more educated and aware of our profession and the role we play each day.”

According to Greene-Golden, her hospital system supported her team in these educational activities and was willing to pay for CEUs when they were not offered for free.

“What we did during the pandemic brought more awareness to our purpose and worth in the healthcare family as we showed the world what we do matters,” she added.

Overcoming barriers

While many CS/SPD professionals and department leaders have taken the opportunity to advance their education and earn certification during these challenging times, their pursuit of professional advancement was not without barriers.

“Depending on their certifications, a certain number of continuing education (CE) credits are required for renewal. We found early that testing sites were not open, which led to delays in new SPD technicians obtaining their certifications,” said Crit Fisher, CST, FAST, Director, Onsite Service and Operation, KARL STORZ Endoscopy – America. “That said, many credentialling bodies allowed for some extensions due to the inability to recertify.”

Going virtual

Virtual education has been a key enabler to certification during the pandemic,” according to Susan Harley, Marketing Director (US), Belimed.

“Fortunately, use of virtual tools (Zoom, Microsoft Teams) has gained widespread acceptance, and much of this training has been/can be delivered virtually in the current environment,” Harley stated.

Adam Okada, CRCST, CIS, CHL, is Owner and Founder of Sterile Education, a mobile application dedicated to the education and technological integration of the Sterile Processing community, and President and Founder of the Central California Chapter of IAHCSMM.

In early 2020, Okada set up a classroom to conduct in-person training but had to quickly adapt his program to an online learning environment (Google Classroom) when the pandemic hit.

“Even though the online program was not what I originally intended it’s going strong,” said Okada. “Certification has become much more important in recent years. I’ve come across hospitals that won’t even interview a candidate who is uncertified.”

Linda Linton, Associate Product Manager, Central Sterile Products & Services, Aesculap, points to the success of the company’s program with Pfiedler Education as evidence of the surge in virtual CS/SPD education.

“In 2020, we recorded 33,405 program completions for our online programs with Pfiedler,” said Linton. “The vast majority of the participants (more than 32,800) earned two CE credit hours for completing each online program. In addition, we delivered 317 live CE-accredited educational seminars to more than 3,300 OR and CSD staff members.”

Kris Schlachter, Director of Marketing, ONE TRAY/IST, highlights her company’s virtual programs to assist CS/SPD technicians with certification requirements.

“We offer FREE online educational CEUs, which can be accessed via our website and also through our social media channels. The courses are easily accessible and IAHCSMM and Certification Board for Sterile Processing and Distribution (CBSPD) certified.” 

Getting hands-on

While some elements of certification training can be done remotely, Okada points out how IAHCSMM requires students to complete 400 hours of hands-on experience in the CS/SPD to earn certification, which can’t be done virtually.

“Getting students in for their hours has been a challenge. Hospitals are much more restrictive about letting students in and it is a lengthy process to gain permission. The school has to sign a contract with the hospital and only a certain number of students are allowed in at a time.”

Berg said he and his team at UCHealth in Northern Colorado created train-the-trainer positions in the CS/SPD where these individuals help their colleagues gain hands-on training to meet certification requirements. 

“We identified individuals within our department who were good mentors and subject matter experts,” explained Berg. “They research and perform walk-up skills labs where staff can practice techniques anytime during the day. Staying flexible with time and giving new options have been very successful.”

To help CS/SPD professionals continue their advancement during the pandemic, SpecialtyCare conducts Zoom classes for students to review course materials and attend lectures, then the company’s Educators provide hands-on training at contracted hospitals.

“The virtual learning environment was a big learning experience for me, since I normally would be in the classroom teaching in person,” said Marcy Konja CRCST, CSPDT, CIS, CER, CHL, CSPDM,Vice President, Sterile Processing Solutions, SpecialtyCare. “The interaction with the students was different but due to small class sizes and we were able to get to know each other well. Our hands-on instructor would then be with the students in the department.”

Setting aside time to learn

Balancing work, life and continuing education is no easy task. CS/SPD leaders that want to help their staff members earn certification should provide time during work hours to learn. Patty Taylor, CRCST, CIS, CHL, CFER, Central Sterile Clinical Supervisor at MHP Medical Center in Shelbyville, IN, describes how she makes time for her team. Taylor is Secretary-Treasurer of the Central Indiana Chapter of IAHCSMM and on the IAHCSMM Board of Directors.

“I give them time to take quizzes while they are at work and schedule webinars for more learning on the job. I think it’s important if you require them to be certified, you need to allow time to learn and keep up with what’s new. They enjoy getting the time and I reap the benefits of them loving what they do — and they enjoy working here. It’s a win-win.”

CS/SPD professionals who want to earn CEUs outside of work should have that opportunity as well, explains Sharon Ward-Fore, MT(ASCP), CIC, FAPIC, Infection Prevention Advisor, Metrex Infection Prevention, Envista Holdings Corporation.

“There are lots of online learning opportunities with webinars, podcasts and course work. Learning off hours, where you can learn at your own pace, provides many more opportunities to achieve and maintain certification,” she stated.

Career advancement resources

CS/SPD industry associations, schools, training programs and suppliers all offer ways for professionals to earn CEUs toward certification. Some are even free.

Adams and his team at Sinai Hospital leverages IAHCSMM’s 8th Edition course materials for certification training, with the hospital covering the expense for textbooks, fee for the first time a technician takes the certification exam, and any work/overtime hours spent by its Educator to host this program. In exchange for these benefits, technicians must commit 12-months to working in the department.

“As a result, over 50% of our staff members have two or more certifications, and the rest are working on it,” commented Adams. “For our staff that reprocess flexible endoscopes, we require that they obtain their certification as a CER as well.”

Ward-Fore refers to IAHCSMM and CBSPD as two resources that every CS/SPD department should utilize.

“They both have a lot of resources that are beneficial to anyone in the CSS/SPD field,” she said. “Having both IAHCSMM and CBSPD certifications demonstrates you are serious about your career, and you understand the important role you play in patient care.”

While SpecialtyCare has its own training programs for CS/SPD professionals through their team of Sterile Processing Educators, Konja says the company also relies on vendor programs.

“Most vendors provide training on their products and can schedule an in-service for the staff,” she stated. When purchasing products, the Sterile Processing Manager or Materials Manager should always request training.”

“We provide this support as we understand that ongoing education, training and mentoring are critical to the success of any health system, especially a system challenged by the recent pandemic,” said Noreen Costelloe, Director of Marketing, Ruhof, Corp.

Lane says utilizing suppliers and/or equipment manufacturers is a huge part of staff education and yearly competency sign-off.

“While equipment manufacturers and product suppliers vary from hospital to hospital, 3M, Beyond Clean, Healthmark, Getinge, ASP and STERIS have always been willing to provide as much education as needed for staff in the hospital or off-site at education seminars in some instances,” she said.

CEU program supporters

Here are some of the other supplier CEU programs available:

Aesculap currently sponsors 21 CE-accredited programs through Pfiedler Education ranging from Maintaining Quality Surgical Instruments to Containerizing Pre-configured Instrument Trays: What You Need to Know. These programs not only offer CE credit hours, they also provide current, practical solutions for the issues and challenges facing the OR and CSD in today’s surgical facilities.

Belimed offers continuing education programs on various topics related to 1) the role of, and how to use, various types of Sterile Processing equipment, 2) the impact of water quality on cleaning performance, 3) protocols related to proper instrument transport from the OR. The company has also delivered webinars on how to improve efficiencies in Sterile Processing and better ergonomic practices in instrument sorting and packaging. It provides scholarships to SPD professionals to attend and obtain the education provided at the annual IAHCSMM meeting.

Ecolab launched a new continuing education program titled, “Patient Care is in Your Hands,” which provides two hours of continuing education credits for Sterile Processing professionals, nurses and surgical technicians. This course covers topics such as the evidence linking hand hygiene to infection prevention, when and how to perform proper hand hygiene, how to maintain skin health and an overview of hand hygiene compliance monitoring methods. Ecolab’s sales and service team provide an overview of the content and then direct the technician to a website to complete the course for two continuing education credits.

KARL STORZ Academy of Clinical Education (ACE) is designed to educate technicians of all experience levels on topics such as device care and handling, reprocessing, emerging technologies and service solutions. KARL STORZ works with clinical educators to enable OR and SPD staff to earn CEUs through societies such as Association of periOperative Registered Nurses (AORN), IAHCSMM and Association of Surgical Technologists (AST).

OneSource offers free continuing education (CE) credit webinars accessible on its website. Current offerings include Safety Data Sheets: You have a library but have you read any of your books? and Understanding, Adapting and Planning for unknown and ever changing practices in SPD (When do you need a Risk Assessment?).

ONE TRAY/IST offers free, comprehensive online CE programs that are IAHCSMM and CBSPD certified through its website and social media channels. Current offerings include, Passing Your Accreditation Survey, Terminology for Steam Sterilization and The Wonderful World of Water Quality. 

Ruhof Corp. supports its customers with multiple continuing education programs at the various trade shows it attends, along with those it hosts on its website. The company presently offers three continuing education courses on its site: Superbugs: Updated Guidance for Infection Prevention During GI Endoscopy (2 contact hours), A Care, Handling, Inspection & Prevention Program (CHIP) for GI Professionals (1 contact hour) and Biomarker Technologies & Bioburden Detection: Elements to Consider in the Surgical Processing Dept (1 contact hour).

SpecialtyCare provides certification courses for Sterile Processing Technicians and Endoscope Reprocessors. Both courses involve detailed lectures and course work along with hands-on training in actual sterile processing departments with the company’s Preceptors and Educators.

STERIS offers numerous programs to serve the ongoing Sterile Processing education needs of its customers. The company’s web-based certification readiness programs are broadcast each quarter in advance of the CBSPD and IAHCSMM exams. More than 9,800 SPD professionals have participated in the course during the last nine years, and 90% have passed the exam. Onsite, STERIS offers comprehensive solutions to include standardized technician training for existing or new hires, a train-the-trainer program and annual competency validations.

Original photo courtesy Bayhealth SPD, HPN's 2021 SPD of the Year, with affects added by generative AI.
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