Set Up for Success in Sterile Processing

Before our facility's rebuild, we had eight decontamination workstations. Now we have 12, but only nine of those are currently being used. The other three are ready to go for when we add on more cases and require more instrument reprocessing manpower. In terms of storage, the last thing you want to do is say, "Well, we can probably squeeze in extra capacity here." If anything, regardless of how well you plan, you're going to have to get creative with finding additional storage.

One way: Strategically placed sterilizers. For example, install a double-sided sterilizer right next to a storage area. That way the sterilizer can be loaded one end and, when the sterilization is complete, opened on the other end into the storage area for cool down. Also, use the design phase as an opportunity to see where you can pare down your instrumentation. With our increase in case volume, we anticipate reprocessing approximately 200,000 trays per year (up from a 144,000 before the rebuild). When I started working here, I did away with 288 trays that we simply weren't using to make room for more storage and more instrument racks.

While you're setting up or overhauling your SPD, keep worker safety front and center at all times. One critical focus should be on ergonomic — or adjustable height — decontamination workstations. At a minimum, you need workstations that can move up and down to accommodate the height of your staff. Tall members of your team who have to hunch over low sinks will wind up with repetitive strain injuries. You also want to pay close attention to sink depth and sink width when designing the SPD. A sink that's 30 inches long, 17 inches wide and 10 inches deep should fit any type of tray encountered in decontamination.

Of course, efficiency is also key, so you'll want to consider pieces of equipment that help staff reprocess more instruments more quickly. Some examples: Ultrasonic washers convert electric energy into high-intensity sound waves commonly traveling at frequencies between 20 kHz and 120 kHz. This technology is touted as an ideal way to remove blood and bioburden from complex, hinged instruments or lumened devices that are difficult, if not impossible, to manually clean.

While automation isn't new to SPD, there have been some key advancements in this area. The most significant involves single-chamber washers, which are designed for cleaning and intermediate-level disinfection of soiled reusable trays, and allow facilities to upgrade from a semi-manual (or even manual) decontamination system to an automated one.

If you want to be successful at building a new sterile processing department — or renovating an existing one — you need to have a point person who currently works in sterile processing involved in the process from start to finish. While it may sound obvious, you'd be surprised at how many facilities jump headfirst into building a SPD without getting critical input from the staff members who will be using that department day in and day out.

We paid attention to the needs of our frontline workers when deciding which staff-friendly features to add to our revamped SPD. When it comes to worker safety and satisfaction, it's often the small things that make the biggest difference.

• Easier access. If you have sliding doors leading into your decontamination area, make sure the door's track has a ramp-like device on it to make the entry as smooth as possible. That way when staff are wheeling heavy case carts in and out, they aren't pulling or tugging too hard, which can easily result in injury.
• Ergonomic aids. Automated instrument loaders remove the physical burden of placing heavy instrument trays into steam sterilizers. Additionally, adequate lighting at decontamination workstations reduces eye strain when cleaning and inspecting instruments. Finally, mobile storage shelves let reprocessing techs move the shelves so they can position themselves properly to avoid injury when placing and removing instrument trays onto or from the racks.
• High-tech monitoring. Instrument-tracking technology reduces the mental stress and time needed to locate specific trays within your facility. It can also help you monitor reprocessing cycles to identify areas of needed improvement and opportunities to streamline the process.

Staff perks. In addition to the third floor, window-filled view of New York City, we added a lounge area for the SPD staff, a place where they could get off their feet, escape the daily grind and recharge for a couple of minutes. We also sprung for a coffee machine, which is a first for us. And instead of having the giant bottles of filtered water that come every week or so and clutter our space with empty jugs, we had our water vendor hook up the filtration system to our actual tap, so staff don't have to hunt me down every time we're out of fresh water.

These were things our staff wanted. It was important to involve them in the process of the redesign — and implement their ideas whenever possible. When you add their suggestions, they own the changes, they're invested in making them work and they take better overall care of their SPD. Since the rebuild, I don't want to say our reprocessing team works harder, because they've always worked hard, but they seem happier and morale has gone up as a result.