Error Reduction in Sterile Processing Through Standardization of Operations and Training

Abstract

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. 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. 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. 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. 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.