High demand and limited resources seem to be a prevailing wind for many Sterile Processing departments (SPDs) across the country. Healthcare organizations’ push to do more with less may lead to Sterile Processing (SP) technicians to cut corners—skipping or rushing steps in order to meet high procedural volume and end users’ instrumentation demands.
When processes are considered redundant or inefficient by SP technicians, there may be opportunities to reevaluate and streamline existing practices when appropriate. Doing so can be part of process improvement initiatives as long as the changes remain rooted in standards and best practices and follow manufacturers’ instructions for use (IFU), and the frontline employees are solicited for their input. Eliminating or altering steps is never appropriate, however, when the goal is to hasten instrument processing to keep up with procedure scheduling and requests from end users or departmental leaders (including SP supervisors and managers) to turn instruments around more quickly than is safe.
Cutting corners or eliminating steps is typically indicative of more serious operational and budgetary issues, and even insufficient leadership support. Whatever the cause, taking shortcuts causes a ripple effect for the healthcare organization and, most importantly, patients. Rushing or skipping steps can cause bioburden, instrument damage or other potentially dangerous scenarios to be overlooked, increasing the likelihood of contaminated or malfunctioning devices making their way to patient procedural areas. If such devices are used, patients could become injured or infected. Even if an instrument problem is identified at the point of use, before being used on the patient, stopping to find a replacement device translates to costly and potentially risky procedural delays.
Speak up for safety
Individuals should always do the right thing and never cut corners, but their decisions may often be rooted in more complex circumstances. It is not uncommon for more procedures to be scheduled than what instrumentation inventories and SP equipment, staffing and other resources can safely or comfortably accommodate, for example. Even SP leaders feeling the pressure from user departments could prompt SP technicians to work faster than is safe or appropriate—a moral dilemma where the desire to do the right thing is countered by demands for more expedient instrument turnaround and the fear of not doing what one is told (this is especially problematic when a supervisor or manager makes the request).
Every healthcare employee must feel empowered to speak up whenever they know something is being requested or done that goes against standards, best practices, instructions for use (IFU) and policies and procedures. This is true regardless of whom makes the request. If a technician sees an SP teammate taking shortcuts or performing any step incorrectly, they should identify the problem/error at that moment, even if the technician incorrectly performing the task is experienced or in a higher position. If the employee does not feel comfortable correcting a co-worker or if the co-worker refuses to listen or correct the mistake, the SP leader should be made aware so they can address the issue.
A similar approach should be followed if a healthcare customer pushes the SPD to turn instruments or sets around too quickly or is engaging in practices that go against standards, IFU and policies and procedures. It is helpful to share standards and other guidance documents to support the correct practice and remind why processes must never be hastened or circumvented. Note: It is also important to remember that every SP professional has their own experiences and strengths that make them valued team contributors. This understanding can help SP supervisors and managers increase productivity and employee satisfaction and reduce burnout by ensuring tasks are well suited and fairly distributed to each individual. Increasing training for certain tasks and reassigning and rebalancing responsibilities throughout the shift can ensure the team gets the right work done at the right time.
When leaders won’t do what’s right
An individual’s integrity and commitment to doing what’s right is crucial to the success of the team, department and facility, but if practices are compromising one’s integrity, seeking new employment with an organization that shares the similar values could be prudent. This might especially be the case if SP leadership fails to support safe, effective, standards-based practices (or presses staff members to rush steps to stay on schedule and keep clinicians happy) and technicians feel they have nowhere else to turn. Note: When an SP leader refuses to support the team or promote proper practices, technicians could seek assistance and support from the Infection Preventionist, Risk Manager or other facility executive.
If an SP professional decides it’s time to seek new employment, they can set themselves up for success by advancing their knowledge and education and becoming more specialized in regard to skill sets. Becoming certified can also help create new job opportunities.
SP professionals sometimes face circumstances where they are pressured to go against what they know is right in order to expedite a process. In such difficult circumstances, they must take control by sharing their knowledge about standards and best practices and explain how skipping or rushing steps or otherwise pressuring the SP team to go against policy can impact patient safety. Further, they should escalate the situation to SP leadership (or Infection Preventionists and facility executives in the event that the SP leader fails to do the right thing). If none of these approaches is successful and the organization and its leadership fail to respond and support the SPD, seeking employment with a new facility could very well be the best solution.