How Safe Is Your Sterile Processing Department?

Patient Safety

By: Jared Bilski

Published: 9/27/2019

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Protect your reprocessing team from these 5 injury risks.


Sterile processing techs are the unsung heroes of your facility, playing an invaluable role in patient safety by sending load after load of sterilized instruments back to the ORs. But are you doing enough to keep them safe? Between handling contaminated devices, working with strong chemicals, lifting heavy instrument sets, pushing heavy carts and the repetitive motion of work tasks, sterile processing techs are vulnerable to injury by the very nature of the job. But there’s another factor at work, as well.

“There’s the already high potential for injury coupled with the fact that there’s an almost constant pressure for quick turnaround,” says Natalie Lind, CRCST, CHL, FCS, the education director for the International Association of Healthcare Central Service Materiel Management (IAHCSMM) in Chicago, Ill. “And that pressure definitely adds to the risk for injury.”

In addition to creating a culture where sterile processing techs don’t feel the need to put turnaround times ahead of their own well-being, you should focus on the areas where injuries are most likely to occur and put stronger safety protocols in place.

1. Safe lifting
NOT OPTIONAL Make it clear to sterile processing staff members that proper PPE must be worn at all times.

In June 2017 at Memorial Sloan Kettering in New York City, according to a workplace injury report (osha.gov/severeinjury) from the Occupational Safety and Health Administration (OSHA), a worker was pushing a loaded instrument cart into an autoclave when the cart’s movable legs became unlocked, causing it to fall and strike the worker, who suffered a broken tibia. Automatic loaders now let staff load instruments easily and safely into sterilizers and washers, removing most of the risk from the process.

However, there’s no way to avoid all of the strenuous lifting sterile processing techs must do to pick case carts and move instrument trays. You must go beyond reminding techs to bend at the knees and avoid lifting heavy instruments and supplies with their backs. Avoiding lifting-related injuries demands setting your staff up for success, particularly when it comes to heavier items.

“We had one instrument box for ortho cases that weighed 41 pounds,” says Teresa Boynton, MS, OTR, CSPHP, a healthcare ergonomics expert and clinical consultant from the Denver, Colo., area. “Not only did this instrument set weigh a significant amount, it was an awkward item for staff to lift and carry.

“If you have a heavy or especially awkward instrument set, call up the vendor to see if you can get it in 2 boxes that are smaller and don’t weigh as much,” says Ms. Boynton. “Some-times it’s as simple as that.”

As an occupation therapist, Ms. Boynton has a unique take on safety in the sterile processing department. When it comes to lifting, she says, there are a number of things you can (and should) do to reduce the risk of injury. For example, keep the heaviest instrument sets in areas that are easy for staff to reach, and make sure they can access the instruments with proper lifting techniques. “You want to store heavier items on a shelf between waist high and thigh level,” says Ms. Boynton. “Staff members shouldn’t reach above shoulder height or bend down close to the ground. That’s how muscle strains occur.”

2. Avoid burns

When sterile processing techs remove hot instruments from washer-disinfectors, hand protection should always be used and care should be taken to avoid reaching directly into the machines, says Ms. Lind. This safety risk again centers on turnaround pressures. “Reprocessing techs are often tempted to inspect and assemble sterilized instruments while they’re still hot,” she adds.

Designate an area in the sterile processing department safely away from high-traffic areas and work zones where staff can place hot instruments sets to cool. Finally, your staff should remember that instruments cool at different rates. For example, says Ms. Lind, ring-handled instruments in a tray may be cool to the touch, but a weighted speculum in the same tray may still be very hot.

3. Prevent slips and falls

In August 2017, according to OSHA, an employee at Rock Surgery Center in Derby, Kan., was washing instruments in the decontamination room. When she turned to take the instruments to another sink, she slipped and fell, and fractured her humerus. That’s not necessarily surprising, because water often splashes to the floor in front of decontamination sinks.

The importance of proper footwear can’t be overstated when it comes to limiting slipping risks. “Look at the shoes your staff is wearing,” says Ms. Boynton. “Make sure all reprocessing techs have on slip-resistant shoes.”

Ms. Lind agrees that wearing proper footwear is important, but also supports the use of slip-resistant mats to prevent slip-and-fall incidents.

“Some facilities hesitate to add mats because they think dirt and bacteria collect underneath them,” says Ms. Lind. “But there are plenty of products currently on the market that you can run through your automated instrument washer. They might be just what you need to place in front of sinks or washers to prevent slips and falls.”

4. Stop sharps injuries
TOO HOT TO HANDLE Items removed from the sterilizer cool at different rates, so allow enough time after cycles before reassembling instrument sets.

There are proven ways to reduce the risks of sticks and cuts in the sterile processing department, including implementing sharps separation policies.

“In many facilities, sharps need to be separated from other used instruments and placed in their own basin,” says Ms. Lind. “That takes away the danger of reaching your hand into a basin full of instruments when you don’t know what you’re reaching for.”

But Ms. Lind sees room for improvement here, too. Facilities fall short with sharps separation policies because the policies aren’t broad enough.

“We tend to look at sharps solely as instruments like osteotomes and scissors,” says Ms. Lind. “Even though instruments like skin hooks and retractors might not fall into an obvious sharps instrument category, they can certainly puncture a glove.”

Help limit sharps injury risks in sterile processing by reminding your surgical team to neatly organize dirty instruments in trays and string sharps together before sending them for reprocessing. That will prevent techs from having to untangle a pile of potentially dangerous instruments.

5. Promote proper protection

Another incident report from OSHA: In July 2015 at HCA West Florida Hospitals in Hudson, Fla., an employee was loading a 35% peracetic acid concentrate canister into a sterilizer when the acid sprayed out of the canister, burning the employee’s eyes, neck, upper chest, arm, hand and face. As that frightening example demonstrates, sterile processing techs are constantly exposed to hazardous chemicals, so wearing proper personal protection equipment (PPE) is imperative; make sure reprocessing techs always don head coverings, face shields, gloves, gowns and shoe covers.

Techs have to understand that although PPE can be hot and uncomfortable, it must be worn at all times. You must lead by example. “Managers may talk the talk, but then they’ll run into the decontamination area without PPE on just to tell somebody their PTO request was approved,” says Ms. Lind. “That sends the wrong message about safety.” OSM

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