VHA National Center for Patient Safety

Cassandra Williams, MSN, RN is currently the chief of sterile processing service. Members of the CAVHCS SPS team from left to right. Front row: Hui Osborn, lead technician and Cheryl Owens, MSN, RN, RME coordinator/educator. Second row: Eldon Prince, technician, Betty Boswell, technician, Cassandra Williams, MSN, RN, chief and Charles Curry, technician. Staff not available for picture: Christopher McDaniel and Gary Smith, sterile processing technicians.

The Sterile Processing Service (SPS) at the Central Alabama Veter­ans Healthcare System (CAVHCS) is a dedicated team of professionals in the trenches of the patient safety im­provement effort throughout the Vet­erans Health Administration (VHA).

The SPS team collaborates with departments and clinics throughout the facility in supporting the usage of Reusable Medical Equipment (RME). SPS not only supports West Campus (Montgomery) and East Campus (Tuskegee); they also serve communi­ty-based outpatient clinics through­out Alabama and several specialty services such as dental, podiatry, optometry, women’s health, sleep lab, the operating room and urology. 

Staff commitment and the utiliza­tion of best practices play a key role in this effort. Although certification is optional, 70 percent of CAVHCS SPS employees maintain professional certification. SPS technicians are also intentional in keeping up with the expeditious pace of technological advances in health care, the dynamic equipment they use, as well as in­creased demands of their customers.

Due in part to the increasing complexity of device designs and components,1 the Food and Drug Administration (FDA) requires cleaning validation studies of each device from the device’s manufac­turer, to ensure adequate repro­cessing of complex device designs and components.

The RME Coordinator provides education about the RME regu­lations and its process, while the SPS staff ensures the departments have adequate numbers and types of equipment and supplies neces­sary to perform direct patient care activities. Oversight is provided by the VHA National Program Office for Sterile Processing2 and Veterans Integrated Service Network 7, which includes unannounced site visits at random intervals and internal quality monitoring in all areas where RME items (instruments and equipment) are cleaned.

During the surgical instrumen­tation cleaning process, SPS staff con­ducts 100 percent occult blood tests on all colonoscopies. This test checks for blood (hemoglobin) residue inside a flexible endoscope, prior to the sterilization/disinfection process, and is one way in which the SPS team contributes to the larger patient safe­ty effort throughout VHA. 

Another safety priority SPS ad­heres to is upholding the goal of “0” percent use of Immediate Use Steam Sterilization (IUSS). IUSS describes steam sterilization cycles in which unwrapped medical instruments are subjected to an abbreviated steam exposure time and then used promptly after cycle completion. The ability to maintain adequate par lev­els of all sterile processing supplies help facilitate the decreased need for IUSS sterilization.

The SPS department also utilizes the Censitrac instrument tracking system, which is a web-based soft­ware solution focused on maximizing SPS efficiency through the manage­ment and tracking of instruments processed through SPS. The best practices mentioned help create pos­itive patient outcomes for Veterans receiving care at CAVHCS by ensuring that our customers receive the right instruments, at the right time, in the right condition.

References

1. George Sheffield. “Responsibilities for Effective Medical Device Reprocessing Procedures and Instructions.” Biomedical Instrumentation & Technology 46, no. 12 (2012): pp. 76-79.
2. Department of Veterans Affairs. “Sterile Processing Services”, (2016) VHA Directive 1116(1).