The Dynamic World of Sterile Processing
For those of us who work in reprocessing of medical devices, we understand the role we play in patient care and the expectation of delivering medical devices of the highest quality to clinical care providers. We also know our role is critical as it drives the number of possible surgical operations and patient procedures in our healthcare facilities and thereby also their financial health. But does everyone understand the ‘bread and butter’ behind this highly technical operation? To give praise to our industry, we as professionals must understand the specifics of our daily lives in the field and the challenges to be overcome.
Let’s look at some of the eye-opening facts about this fast-paced and ever evolving field.
Medical device reprocessing is in high demand
Given the number of surgical procedures completed every year and the steady uptrend in quality requirements, it is not surprising that this unique skillset is in need, and with an ageing population it will only increase. People worldwide are living longer, with most people expected to live into their sixties and beyond. By 2050, the global population of people older than 60 is expected to jump to two billion. As a result, demand is expected to grow anywhere from 10% to 12% between 2020 and 2030, since a sizable percentage of the global population are senior citizens who rely on procedures and healthcare to support a healthy lifestyle. From this fundamental data we can conclude that reprocessing professionals will be a sought profession for the foreseeable future.
Reprocessing medical devices is highly labor-intensive work.
Despite the progress in automation, such as machine loading- and unloading automation or integrated Bowie Dick tests in steam sterilizers to increase efficiency and allow CSSD staff to focus on tasks that can only be done by humans, the work in CSSDs remains very labor-intensive. While most healthcare professions demand and require many hours of walking or standing, the CSSD field is one of the most labor demanding professions in hospitals. For example, a department may have 12 storage racks with 5 rows each totaling 60 shelves of inventory. This department supports 10 different patient care specialties, which each include anywhere from 25-150 trays. Of their total inventory, let’s say 500 different instrument sets that vary from 2 kg to 12 kg (5 lbs to 25 lbs), in one 40-hour working week a CSSD technician might lift, push, move, pull or carry up to 1,000 kg, or in other words one ton of weight!
Qualifications vary in geographic regions
High-quality education of current and future CSSD employees is extremely important, and we believe that education is the main driver of quality and patient safety. The European countries leading the way in making this profession stand out are Switzerland, Germany, the Netherlands and France. Switzerland’s approach is systemic and professional. The training to become a medical device technologist (Medizinproduktetechnologe in German or Technologue de dispoisifs medicaux in French) is part of vocational education (apprenticeship), which lasts three years. Belimed is also honored to be part of educating future professionals through the Belimed Academy, where apprentices spend a day in our training center in each study year learning more about the technical background of cleaning, disinfection and sterilization. In France, CSSD frontline workers do not yet require such an extensive educational background, instead the focus on education falls to the CSSD managers responsible. In order to take responsibility for a CSSD in France, the post holder needs to have a PhD in pharmacy with a 6-year specialization in hospital pharmacy, which is quite unique worldwide. Additionally, in South America, those running CSSD must hold a master’s degree in nursing or a similar level of higher education. In the U.S , there are currently five states that require certification to work in sterile processing, i.e. Connecticut, New Jersey, New York, Tennessee and Pennsylvania. There are four additional states that are actively pursuing legislation in a move towards a requirement for certification. To summarize: the global CSSD community is becoming increasingly aware that high education standards are needed to deliver quality and is working on improved education curricula and standards.
Understanding medical terminology can drive success
While medical terminology courses including anatomy and physiology are not mandatory parts in all sterile processing education, from our perspective, at least a basic level of terminology and its background is highly recommended. Most (higher) educational programs require these for career paths in operating rooms, such as surgical technologist and medical assistants, but in CSSD courses they are not always sufficiently present. Having a clear understanding of what parts of the body are exposed during surgery, as well as the application of instruments and their intended use, can help CSSD technicians find areas to evaluate the instrument functionality as well as locations of hard-to-find debris. This specific and unique language can help healthcare professionals find surgical cases more quickly, aide in clarity when reading preference cards and assist in fluently understanding surgical schedules. Medical terms help CSSD professionals be successful and help improve patient outcomes.
CSSDs can be dangerous places
CSSD workers may be exposed to various hazards in the workplace that could result in occupational disease. According to studies and surveys, the occupation of medical equipment preparer is one in healthcare that experiences a high rate of musculoskeletal disorders (MSD), known as ergonomic injuries due to repetitive movements, awkward posture and heavy lifting. In the USA, in the period from 2015-2109, 62% of the reported injury or illness cases were classified as MSDs. CSSD professionals also face a variety of other risks in their work, such as hazardous exposure to chemicals, disinfectants or sterilant, exposure to sharps and needles and to bloodborne pathogens and microorganisms. Each department needs to create safety practices, exposure control plans and use of work practice and engineering controls to protect all workers.
Quality first, quantity second
While CSSDs are industry-like production units continuously supplying products to their internal customers, it is always best to create a standard work practice that will help drive quality. A CSSD technician might work on over 160 instrument sets in one week, and each instrument must be inspected in detail for damage, cleanliness and functionality. Every step in the process is critical, and the need for secondary re-work should be avoided by creating quality practices and allowing each technician enough time to complete inspections. Work controls and data aides, such as visual cues, media images and worksheets, can help drive great production, as can creating a department design or layout that accommodates lean work practices.
CSSDs directly affect infection prevention and control
Without proper decontamination, preparation, packaging, inspecting, assembling, handling, transporting and storing of sterile surgical instrumentation and complex medical devices including equipment, patients could be at risk of contracting a healthcare acquired infection (HAI). According to a study published in The Lancet Infectious Diseases in 2020, the burden of HAI in the European Union (EU) is high, with an estimated 2.5 million cases of HAI occurring annually, resulting in approximately 91,000 yearly deaths. In the United States, the Centers for Disease Control and Prevention (CDC) estimate that approximately 1.7 million HAI occur annually, resulting in 99,000 deaths. Globally, the burden of HAI is high, particularly in low- and middle-income countries.
Randalyn Walters, Markus Auly
References and Resources:
Bureau of Labor Statistics (BLS) (2021, August 18). Survey of Occupational Injuries and Illnesses Data. U.S. Department of Labor. www.bls.gov
Bureau of Labor Statistics (BLS) (2022). Occupational Employment and Wage Statistics, May 2021. www.bls.gov
Centres of Disease Control and Prevention (CDC) (2021, November 10). Healthcare Associated Infections (HAIs). https://www.cdc.gov/hai/index.html
Magill SS, Edwards JR, Bamberg W, et al. (2014). Multistate Point-Prevalence Survey of Health Care–Associated Infections. New England Journal of Medicine (NEJM), 2014;370:1198-208.
Anderson, Deverick J., et al. (2008). Strategies to Prevent Surgical Site Infections in Acute Care Hospitals. Infection Control and Hospital Epidemiology, Vol.29, No.S1, 2008, pp.S51–61. JSTOR, https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/abs/strategies-to-prevent-surgical-site-infections-in-acute-care-hospitals/5A47518723D0E020A3F062C6ADB93E96
European Centre for Disease Prevention and Control (ECDC). (2023). Point prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities 2016–2017. ECDC. https://www.ecdc.europa.eu/en/publications-data/point-prevalence-survey-healthcare-associated-infections-and-antimicrobial-use-2016-2017
European Centre for Disease Prevention and Control (ECDC). (2023). Healthcare-associated infections in intensive care units - annual epidemiological report for 2018. https://www.ecdc.europa.eu/en/publications-data/healthcare-associated-infections-intensive-care-units-annual-report-2018
Fact Sheet Ageing and Health. (2018, February). World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
About the authors
Randalyn Walters, National Clinical Education Manager-US, is a highly experienced professional in the healthcare industry. With over 16 years experience in sterile processing and a diverse background in surgical operations, she brings a wealth of knowledge and expertise. Randalyn's extensive credentials and dedication to clinical education have positioned her as a valuable contributor to the industry, specializing in process improvement, compliance and competency.
Markus Auly, Head of Scientific Affairs at Belimed, brings expertise in medical device reprocessing, gained through diverse roles and extensive international engagement. With an MSc in Biotechnology and a Masters in Technology Management, Markus actively participates in congresses, visits CSSD facilities, and contributes to standard committees. He also enthusiastically shares his expertise as an author, lecturer and speaker.