The Source | June 11, 2019

Advice from the Field

I tell all new employees at our facility, regardless of experience, to treat every instrument you process as if it will be used on you or a loved one. SPD techs may not have live patient interaction but we reach patients through the work we put in preparing them for use in the OR.

Rhaiz, NY

Supervisor, Sterile Processing

Setting Standards

Author: C. Jason Rawlings, CRCST | Director of Clinical Services

If you visited a hospital 100 years ago, you wouldn’t find an SPD anywhere. In the history of modern medicine, the SPD is a relatively new concept—one that sprouted from the work of medical groups and individuals concerned about patient safety in healthcare facilities. They set out to improve the status quo and, building on knowledge about sanitation and contamination, developed many of the processes and early iterations of systems used today.

Germ Theory

In 1857, Louis Pasteur’s germ theory kicked off a new era of knowledge about sickness and infection. When the first steam sterilizer enabling temperature measurement was developed in 1933 by the American Sterilizer Company, it effectively added steam to the engine of modern sterilization science. Over the next decade, scientists W.B. Underwood and J.J. Perkins identified the need and advocated for central processing units where all of the services needed for clean and sterile supplies and equipment could be provided and carried out.

“Up until the 1940s, medical/surgical supplies were mainly decontaminated (or ‘reprocessed’) and maintained in the surgery or patient care area in which they were to be used,” Gerald McDonnell and Denise Sheard wrote in A Practical Guide to Decontamination in Healthcare. “Under this system, there was duplication of both time and equipment at various locations within larger healthcare facilities, and it was difficult to maintain consistently high standards. As the number and variety of surgical procedures grew and the types of medical/surgical devices, equipment and supplies increased, it became apparent that centralized reprocessing areas were needed for efficiency, economy and patient safety.”

Seek to Understand

If you know the right thing to do, don’t sit around waiting for someone to make you do it.

That piece of advice can apply to all of life—and it’s essentially what led to the existence of today’s SPDs. The medical community saw infections happening within their facilities and decided to, first, seek to understand why those infections were happening and, then, engineer ways to prevent infection.

The internal motivation that drove those pioneering developments in healthcare is still needed in SPDs. “The appearance of antibiotic-resistant bacteria, like methicillin-resistant Staphylococcus aureus and carbapenem-resistant Enterobacteriaceae, means that hospital-acquired infections can be more dangerous and harder to treat,” Donna Swenson writes in Basic Concepts in Sterilization Processes: Verification, Validation, and Qualification, a publication of the Association for the Advancement of Medical Instrumentation (AAMI). “The increased complexity of new medical instruments … and the incorporation of delicate materials and sensitive electronics into devices, are making the work of reprocessing personnel similarly more complicated and demanding.”

Swenson suggests that this increased risk and complexity means device manufacturers and SPD personnel need a “deeper knowledge of the science and practices that underlie reprocessing,” so that they understand why the various reprocessing steps exist.

Every step has a particular purpose, but if personnel don’t understand the reasons for each step, not only may they fail to comply with manufacturer IFUs (and, thus, federal regulations), but they also won’t notice when an IFU’s reprocessing directions are incomplete due to a printing error or are poorly designed due to manufacturer oversight. Failing to recognize these issues can lead to dire consequences for patients who are at their most vulnerable in healthcare facilities.

SPDs need to be compliant with government regulations, but in order to maintain the highest standards of safety, they need to look beyond what’s legally required. Current knowledge—regardless of industry—is almost always ahead of government regulation. Because of this, SPDs must take it upon themselves to keep up with the current scientific knowledge and best practices for reprocessing and sanitation.

You Can Set Higher Standards

To keep abreast of developments in the SPD space, keep tabs on these organizations and agencies:

  • International Association of Healthcare Central Service Materiel Management (IAHCSMM): Ever since the 1950s, IAHCSMM has existed to share information within the sterile processing profession. The organization offers certifications (an ideal way to educate your personnel on the “why” behind reprocessing) and advocates for public policy changes so that regulatory bodies can at least attempt to keep up with the field.
  • Food and Drug Administration (FDA): The FDA regulates all medical devices, as well as sterilizers, sterilization monitoring devices, and the reprocessing of single-use medical devices. The FDA is also the reason device manufacturers must provide IFUs with their products. The FDA maintains a webpage of resources related to the reprocessing of medical devices.
  • Joint Commission (JC): JC certifies and accredits healthcare organizations and publishes standards relating to a variety of areas of healthcare. JC’s Disinfection and Sterilization page is a launchpad to other resources.
  • Centers for Disease Control and Prevention (CDC): The CDC offers recommendations specifically for disinfection and sterilization in healthcare facilities. The overall recommendations were published in 2008, but have been updated since in response to the Ebola outbreak in 2014 and other developments.
  • AAMI: AAMI publishes sterilization method guides, and its standards are developed by more than 100 technical committees and groups so that they represent a national consensus. Their standards publications are available for purchase online.
  • AORN: Specifically focused on the work of perioperative nurses, AORN provides education and clinical practice resources, including education/resources around reprocessing. Recent issues of its monthly journal for members covered sterilization and single-use device reprocessing.

Patient safety is the sole purpose of every SPD. Government regulations are just a baseline. Use the leading scientific and industry knowledge around sanitation and reprocessing to set higher standards and achieve patient safety from now into the future.

CDA FDA Health Advisory: 3 Recommendations [eBook]

We created this eBook to share our recommendations to ensure your facility is:

  • Complying with all steps as directed by the device manufacturers
  • The appropriate policies and procedures are in place and consistent with current standards and guidelines

The Only Thing That Is Constant Is Change

By: Derek A. Murray | Director of Professional Services

Even in 500 B.C. people were aware of the guarantee that life would consistently change.  Today, Derek provides two leadership models that will help you navigate most organizational changes.

Meet the Family: Marlin Minnis

With over 35 years in the surgical management field, we're excited to spotlight Marlin D. Minnis Censis' Director of Strategic Initiatives.

Serving Around the World

My name is Marlin Minnis.  I started my career spending 13 years in the United States Army as a surgical technologist with assignments in Colorado, New York, and Augsburg Germany.  After departing the military, I spent the next 5 years in various SPD leadership roles at three hospitals in Maryland and graduated with a Bachelor of Science degree in Healthcare Management from the University of Maryland University College. 

Prior to joining Censis, I spent over 22 years in various management roles in the implementation, sales, and administration of asset management software solutions for two companies (Materials Management Microsystems & Integra LifeSciences.)

An All-Army Soccer Star Turned Surgical Tech

I get the most satisfaction from having worked directly with staff in over 85 health organizations and watching them grow and develop as SPD leaders through the many benefits that an asset solution brings to their department.  I look forward to continuing this mission alongside the Censis family.

I live outside of Richmond, VA with my lovely wife Tarra, an attorney; we will celebrate 30 years of marriage this year.  A fact unknown to my current colleagues is that I spent one year playing on the All-Army soccer team and touring the U.S. in that capacity.

CtUC 2019 Keynote Speaker: Dr. M. Joycelyn Elders 

We’re excited to share that former U.S. Surgeon General, and the first African American woman to hold that post, Dr. M. Joycelyn Elders will be this year’s keynote speaker!  Here’s a quick overview of her life and career before you see her at CtUC 2019.

A humble beginning

Dr. M. Joycelyn Elders is the eldest of eight children. Now a Distinguished Professor of Public Health at the University of Arkansas, she never saw a physician prior to her first year in college. At the age of fifteen, she received a scholarship from the United Methodist Church to attend Philander-Smith College in Little Rock, AR. Upon graduation at age 18, she entered the U.S. Army as a first lieutenant where she received training as a physical therapist. 

After graduation in 1960, from the University of Arkansas Medical School (UAMS) on the G.I. Billshe was an intern at the University of Minnesota Hospital in Minneapolis and did a pediatric residency and an endocrinology fellowship at the University of Arkansas Medical Center in Little Rock. She ascended the academic ladder to full professorship after her fellowship and board certification in 1976. She also holds a master of science degree in biochemistry. 

Joining the fold

Dr. Elders joined the faculty at UAMS as a professor of pediatrics and received board certification as a pediatric endocrinologist in 1978. Based on her studies of growth in children and the treatment of hormone related illnesses, she has written many articles for medical research publications. She was appointed Director of the Arkansas Department of Health in October, 1987. While serving as director, she was elected president of the Association of State and Territorial Health Officers. 

Nominated as Surgeon General of the U.S. Public Health Service by President Clinton in July of 1993, she was confirmed by the Senate on September 7, and sworn in on September 8. During the Senate hearings on her confirmation, Dr. Elders stated "I want to change the way we think about health by putting prevention first. I want to be the voice and vision of the poor and powerless. I want to change concern about social problems that affect health into commitment. And I would like to make every child born in America a wanted child".  

Outstanding accolades

Dr. Elders has been active in civic affairs as a member of the Little Rock Chamber of Commerce, Northside YMCA and Youth Homes. She was listed in "100 Outstanding Women in Arkansas", "Personalities of the South" and "Distinguished Women in America". 

She has won awards such as the Arkansas Democrat's Woman of the Year, the National Governor's Association Distinguished Service Award, the American Medical Association's Dr. Nathan Davis Award, and the National Coalition of 100 Black Women's Candace Award for Health Science.