Beyond the Back Room: Why Certified Sterile Processing Technicians Deserve Recognition, Reclassification, and Better Pay

In the high-stakes world of healthcare, success is often measured by what patients see— doctors, nurses, spotless rooms, and advanced surgical suites. But behind every successful procedure lies a group of highly skilled, often unseen professionals: sterile processing technicians (SPTs). These technicians are the first and last line of defense in patient safety, responsible for ensuring every surgical instrument and device is clean, sterile, functional, and safe for use.

Despite the complexity and critical nature of their work, sterile processing technicians are frequently grouped under the outdated category of “Central Services,” a classification that undervalues their technical knowledge and expertise. As a result, these professionals are often underpaid, underrecognized, and excluded from the compensation and professional pathways afforded to similarly skilled healthcare roles.

This article explores why certification in sterile processing is essential, how misclassification under "Central Services" contributes to unfair pay, and why it's time to reclassify, rebrand, and properly compensate this essential healthcare workforce. It also highlights how professional bodies like the Healthcare Sterile Processing Association (HSPA) are working to drive legislative change that acknowledges sterile processing for what it truly is: a vital clinical discipline.

Sterile Processing: The silent cornerstone of patient safety

Every surgical procedure, from a simple biopsy to a complex open-heart operation, depends on clean, sterilized, and properly functioning instruments. Sterile processing departments (SPDs) are responsible for ensuring this. Their work involves more than just “cleaning tools”— they manage the full reprocessing cycle: decontamination, inspection, functional testing, assembly, sterilization, storage, and distribution. Key responsibilities of SPTs include:

• Decontamination: Using enzymatic cleaners, washers, and ultrasonics to remove organic and inorganic material.
• Inspection and assembly: Carefully inspecting each instrument for cleanliness, damage, or wear, and assembling sets to precise specifications. Often, device instructions for use (IFUs) are vague or misleading which requires critical thinking skills.
• Packaging and sterilization: Using steam sterilization, hydrogen peroxide, gas plasma, or ethylene oxide systems to eliminate microorganisms.
• Documentation and quality control: Recording sterilization data, monitoring biological/chemical indicators, and ensuring regulatory compliance.

Modern sterile processing requires proficiency in microbiology, anatomy, medical terminology, chemistry, infection control, engineering, and a deep understanding of hundreds of types of surgical instruments.

Yet many healthcare administrators still view SPD through a decades-old lens—grouping it with laundry, dietary, and environmental services under “Central Services.” This misclassification has devastating consequences for compensation, recruitment, retention, and, ultimately, patient safety.

Why certification matters

Certification is not a formality. It is a standardized, evidence-based method to validate a sterile processing technician's competency.

Leading organizations such as the HSPA and the Certification Board for Sterile Processing and Distribution (CBSPD) offer nationally recognized certification programs that assess knowledge in:

• Infection prevention and microbiology.
• Instrument identification and surgical procedure relevance.
• Manufacturer IFUs.
• Disinfection and sterilization principles.
• Quality assurance and risk management.
• Regulatory compliance (AAMI, CDC, OSHA, etc.).

Certification should be mandatory because it:

• Reduces variability in practice across hospitals and facilities.
• Raises the bar for accountability and professionalism.
• Aligns sterile processing with other certified healthcare roles, such as surgical technologists or respiratory therapists.
• Demonstrates commitment to patient safety and regulatory compliance.
• Creates a benchmark for fair pay and job advancement.

Yet, despite the technical knowledge required to pass certification exams, many hospitals still hire non-certified technicians, offer no financial incentive to become certified, and fail to require ongoing professional development.

How HSPA is leading the push for state-level certification laws

Recognizing the link between certification and patient safety, HSPA has been instrumental in advancing legislative efforts across the U.S. to mandate certification for sterile processing professionals. Their advocacy has already made a measurable impact. States where certification is now required or supported by law include:

• New Jersey: A trailblazer in this space, New Jersey mandates that all SPD staff be certified.
• New York: Requires SPD professionals to be certified and to maintain ongoing competency.
• Connecticut: Certification must be achieved within a defined time after hire.
• Tennessee: Recently passed a law requiring certification within two years of employment.
• Pennsylvania: Active HSPA-supported advocacy efforts are ongoing.

HSPA provides testimony, legislative consultation, and data-driven rationale to lawmakers, arguing that standardizing training and certification across states protects patients, improves outcomes, and reduces costs associated with surgical infections and OR delays. By promoting legislation that validates sterile processing as a clinical profession, HSPA is leading the charge to remove the outdated "Central Services" label and elevate sterile processing to its rightful place in the healthcare hierarchy.

Misclassification: The root of the pay problem

One of the most damaging issues sterile processing professionals face is being grouped under the broad umbrella of “Central Services” or “Support Services,” a designation that encompasses food service, transport, linen, and housekeeping. While these departments are essential to facility operations, sterile processing technicians perform clinical, technical, and regulated work. Some consequences of misclassification include:

• Wage suppression: SPTs are often paid on par with custodial workers or dietary staff, despite the complexity of their roles.
• Limited career advancement: HR systems typically do not offer a defined promotion pathway for SPD professionals.
• Lack of respect and recognition: Clinical departments may view SPD as non-clinical or subordinate.
• Minimal onboarding or training: Some facilities onboard SPD techs with little to no formal instruction or certification support.
• Burnout and turnover: Low pay and lack of respect drive away talent, creating unsafe staffing levels.

In contrast, certified sterile processing professionals in well-supported environments are often key players in infection prevention teams, operating room logistics, and surgical readiness programs.

What Canada gets right

Canada has taken a progressive step by removing the term "service" from the profession’s name altogether. The standard term across Canadian hospitals is now Medical Device Reprocessing (MDR), which more accurately reflects the scientific and technical nature of the job. This new term matters because it shifts public and institutional perception from support work to clinical reprocessing; encourages integration with perioperative teams and infection prevention; facilitates standardization of training and career pathways; and lays the groundwork for appropriate compensation.

While the naming convention may seem trivial to some, it carries deep professional implications, much like the difference between calling someone a "clerk" versus an "analyst." Language shapes how institutions treat and compensate their staff.

Why pay must reflect complexity and risk

The average wage for a certified sterile processing technician in the U.S. hovers between $18 to $26 per hour, depending on the region and healthcare system. However, these wages frequently fail to reflect:

• The level of certification and continuing education required.
• The legal liability and infection control responsibility.
• The surgical dependency on SPD output and turnaround times.
• The complexity of modern instrument design and reprocessing protocols.

Technicians in high-volume facilities may reprocess 10,000-plus instruments per week, with turnaround times measured in minutes, not hours. Instruments for robotics, endoscopy, neurosurgery, and orthopedics are intricate, delicate, and require exact specifications. Errors can, and do, lead to surgical delays, site infections, equipment damage, and patient harm. Yet, despite this pressure and precision, many SPD staff earn wages that barely compete with entry-level retail positions. This is a structural failure in healthcare policy that must be corrected.

A patient safety issue

The stakes are far higher than technician morale or payroll budget lines. Understaffed or undertrained sterile processing departments lead to:

• Retained surgical items.
• Improperly sterilized instruments.
• Case delays and cancellations.
• Surgical site infections.
• Hospital-acquired infections (HAIs).
• Regulatory citations or financial penalties.

Hospitals that fail to invest in certification, staffing, and professional development for SPD staff ultimately compromise patient outcomes and institutional reputation.

Five critical changes

1. Reclassify the department. Hospitals must move sterile processing out of “Central Services” and create a dedicated classification—Medical Device Reprocessing or Surgical Instrument Reprocessing. This allows for customized job descriptions, pay structures, and career ladders.
2. Mandate certification and reward it. Make certification a requirement within 12 to 24 months of hire. Provide financial incentives and continuing education opportunities. Certification should lead to higher pay and advancement potential.
3. Benchmark compensation fairly. Conduct local and national pay studies comparing sterile processing to roles with similar training and risk. Adjust pay accordingly to attract and retain talent.
4. Educate clinical and administrative leadership. Use internal education, case studies, and infection control data to educate OR directors, executives, and HR teams about the vital role of SPD.
5. Support legislative action. Engage with HSPA and local lawmakers to support certification laws in your state. Bring patient safety data to the table and help define standards that elevate the profession.

A vision for the future

Picture a hospital where sterile processing technicians are fully certified, fairly compensated, and respected as vital members of the surgical team. Where job titles reflect skill, not history. Where no instrument leaves the SPD without a trained expert inspecting it, and where patient safety is enhanced because those experts are empowered and valued. This is not a fantasy—it’s a future within reach. But it requires action.

A call to action

To hospital executives: Reclassify sterile processing. Invest in certification. Pay your technicians what they’re worth—not based on outdated labels, but on the complexity and impact of their work.

To human resources: Create new titles and pay bands that reflect real-world skills. Support career ladders and require certification for advancement.

To policymakers and regulators: Partner with HSPA. Adopt laws requiring certification to ensure safe, standardized reprocessing across facilities.

To sterile processing technicians: Get certified. Share your stories. Advocate for your profession. Join the movement to raise the standard—for your patients, your peers, and yourself.

It’s time for the hidden heroes of the hospital to step into the light, not as support staff but as clinical professionals safeguarding every surgical moment from the shadows.