A Nationwide Survey of Sterile Supply, Processing and Distribution (SPD) Services within Department of Veterans Affairs (VA) Medical Facilities

Abstract

BACKGROUND/OBJECTIVES: Location and function of the area known as Central Supply, Central Service, Sterile Supply or Supply, Processing and Distribution (SPD) has impact on infection control. VA provides care to over 5 million patients from over 1300 sites nationwide. Within VA medical facilities across the nation SPD may be run by various departments. METHODS: A survey was sent to all VA medical centers nationwide asking questions about SPD functioning, practices and needs. Several infection control topics were included (but not limited to): sterilization, biological monitoring, temperature and humidity, and decontamination. Quantitative and qualitative questions were asked. RESULTS: Response rate to the survey was ∼87%. There is variability of services provided, depending on facility size and clinical services offered; of 126 responses to that questions, only 49.2% of SPDs report doing all decontamination and sterilization of reusable medical/surgical devices at their respective medical facilities. With regard to environmental conditions in SPD, table provides basic information from the survey: ∗ AC in prep area AC in decontam area AC in 1° storage area Temp in 1° storage area Humidity in 1° storage area # of responses 92 89 83 96 81 Mean 10.8 9.6 9.4 70.3°F 39.4% SD 3.6 5.0 3.8 3.7°F 15.6% Mode 10.0 6.0 10.0 70.0°F 35.0% 75%ile 12.2 11.3 10.0 72.1°F 45.0% 50%ile 10.0 10.0 10.0 70.0°F 36.0% 25%ile 10.0 6.0 9.0 69.0°F 30.0% ∗ AC=air changes per hour; SD=standard deviation. With regard to biological indicators, 100% of facilities (n = 110 responses) report performing monitors at least daily, while 89.9% of facilities (n = 98 responses) report performing monitors with each gas sterilization load, and 93% of facilities (n = 100 responses) report performing monitors with each implantable device sterilized. Bowie-Dick testing for pre-vac sterilizers is reported being performed at 99.1%, 99.1% and 97.2% of facilities (n = 109, 108 and 107 responses, respectively), at least daily, after repairs and after shutdowns, respectively. A qualitative question asking Top Five areas of importance/concern has revealed a significant number of the facilities focused on education and training for SPD employees, pay structure, staffing needs, turnover in SPD area and inadequate space. CONCLUSIONS: SPD is an area of infection control vulnerability in medical facilities. Decentralization of services, environment in SPD facilities, training, salary, personnel retention, qualifications, and space are issues noted in this nationwide survey.