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Background
Surgical instrument processing is critical to safe surgical care. Hospitals have massive
instrument inventories that are organized into thousands of instrument sets. Millions
of instrument sets are reprocessed annually due to multiple use. Errors in processing
may impact operations, post-surgical infection rates, and/or mortality. Upon review
of error data within sterile processing, an analysis was performed that identified
a need for process standardization and education.
Methods
A quality monitoring approach was developed to help identify and reduce errors in
sterile processing. An education plan was implemented that included weekly in-services,
individual training, process standardization, and modification of orientation program.
Standard Operating Procedures (SOP) were created to help avoid missteps in daily operations.
Visual, auditory, and kinesthetic learning methods were utilized. Competency was evaluated
through observation. A solid orientation program helps instill confidence and demonstrates
a commitment to success. An orientation packet was developed that included an employee
and preceptor learning packet. Competency is evaluated throughout the orientation
period at routine intervals. At the end of the 90-day training, competencies are reviewed
to ensure fundamentals were retained and to gather overall feedback on the training
program.
Results
Since beginning this initiative in 2018, quality errors have decreased from an average
of 17 per month to three, which is an 80% sustained decrease. Immediate use steam
sterilization (IUSS) rates decreased from 6% to less than 1%. This decrease contributes
to increased patient safety through reduction of events that could potentially lead
to mortality or infection, as well as reduces delays in surgical operations.
Conclusions
Surgical instrument processing errors are a barrier to the highest quality and safety
in surgical care. However, these are modifiable through educational initiatives, standardization,
and targeted resources. Implementation of SOPs and standardized training programs
have shown success in reducing errors, leading to better quality outcomes, and improving
patient safety.
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Copyright
© 2022 Published by Elsevier Inc.
