Infection Control Today

FEB 2016

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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www.infectioncontroltoday.com 8 ICT | February 2016 perspectives By I. Francis Kyle III, DMin, ThM, MDiv, BA, CRCST, CIS, CHL At the two hospitals where I work, the sterile processing departments (SPDs) are located in the basement and near the morgue. To think that people are literally dying to be closer to the SPD is a unique feature that not just any hospital department can claim! The only people who frequent the basement are the deceased, undertakers, medical examiners and coroners, visitors who are lost, electricians, plumbers, exterminators, Joint Commission staff and hospital employees like me who must labor for a living below ground if we want to see our thin wallets and purses become thicker come payday. The emergency room, operating rooms (ORs), ICU, PACU, human resources department, more palatable dining options, ATM machines, parking garage and other places of seemingly greater signifcance are all literally situated above. Being among the non-zombie living who work 40 hours a week at the subterranean level surrounded by concrete walls and artifcial lighting, my SPD co-workers and I—and other basement staff who have no windows to distract us from our work—look forward to going "up, up and away" and onto seemingly more signifcant places and activities when our shift ends. In a similar way, every sterile processing technician I have worked with or know would also like to go "up, up and away" regarding his or her hourly wage. However, I do not see this happening in the industry as a whole until the occupation becomes more professionalized and no longer one of the last hospital jobs that is entry level. The traditional way, of course, to ascend from any fnancial basement is to work hard, put in your time and ascend the career ladder. With promotions come higher pay. Because of bills that need to be paid and, for some, a family that needs to be fed, seeking to climb the SPD career ladder as a supervisor and then manager is understandable and noble. Plus, and in addition to a higher wage, if you work as a SPD supervisor or manager you most likely will not have to work weekends or do such oft-viewed unpleasant technician tasks as donning personal protective equipment (PPE) in the bioburden-saturated decontamination area. With the numerous perks that come with SPD leadership, why would a SPD technician ever want to remain "just" a tech? Why would he or she intentionally stay in the metaphorical career basement and not seek to ascend? Money aside—and as hard as that might be to imagine—I believe there are many benefts to being, and remaining, a career SPD technician. While not downplaying the important role that leaders have on the SPD team, I nevertheless contend that there is a measure of greatness that the frontline, in-the-trenches SPD technician has over his or her bosses. The following refection is based on my own work context as a two-year sterile processing technician—9 a.m. to 5 p.m., then third shift and now frst shift—at Louisville's 462-bed Jewish Hospital (est. 1905) and, more recently, the nearly adjacent 404-bed, Level I trauma University of Louisville Hospital (U of L, est. 1817). Both historic downtown hospitals are owned (2012–present) by the non-proft KentuckyOne Health, a subsidiary of the Colorado-based Catholic Health Initiatives. As featured in the front cover story in IAHCSMM's Communiqué (September/October 2015, "Triple Crown Certifcation: How One CS Department is Winning the Race for Quality, Safety and Professionalism"), Jewish Hospital's SPD is ranked third in the world for employing IAHCSMM triple-certifed technicians (CRCST, CIS, CHL). Greater job necessity. Even with advanced technology, sterile processing will always have a hands-on human component. No hospital in the civilized world can perform surgeries while signifcantly reducing the risk of patient infection if not for in-the-trenches sterile processing technicians. A hospital SPD with just supervisors and a manager but no technicians is like a military army full of ranked offcers but with no ground-level combat soldiers. "We are the heart of the hospital," says Shirley L. Raque, CRCST, CIS, CHL, a veteran Jewish Hospital sterile processing and quality assurance technician who is still going strong at age sixty-eight. I agree. Greater practical knowledge of surgical instrumentation. Since it is SPD technicians who literally handle surgical instruments in the decontamination area and during the prep-and-pack processing stage prior to sterilization, storage and eventual OR delivery, it is they whom supervisors and managers— and even the full-time instrument specialist at the hospitals where I work—frequently rely on for practical knowledge. In addition to physicians and OR scrub technicians, frontline SPD technicians are an indispensable human resource to SPD leaders, instrument manufacturers and others. Greater liberty from dreaded administrative duties. Employee schedules, taking inventory and ordering merchandise, written reports and budgets to the hospital's C-suite, constantly checking and responding to emails and a plethora of other administrative job duties—the SPD technician is free from all, if not most, of them. Greater team comradery and tighter bond. Though part of the same SPD team and with the same goal of ultimately serving the patient, there is a hierarchy and resultant social separation between SPD leaders and followers/technicians. Because of this justifable separation, the raw fact is that technicians spend more time "in the trenches" together and get to know each other more as we work side-by-side and converse in the non-V.I.P. cramped employee locker room and tiny break room. It has been fascinating for this technician to be part of the SPD "United Nations" at Jewish Hospital and U of L Hospital where more than 40 technicians—from ages 20 to 68 and with varying religious backgrounds, life experiences and interests—hail from such places as Bosnia, Canada, Cuba, Haiti, Panama, Philippines, South Africa, Turkey and even the Republic of Texas. Greater freedom away from work. When a crisis occurs on third shift at 3 a.m., it is a supervisor or the manager who is called at home. It is the SPD technician, therefore, who has a greater chance of still "having a life" outside of work. Greater usefulness in breaking the Chain of Infection. Infection control experts and clinical educators agree that frontline SPD technicians play a primary role in breaking Just a Tech? The Benefts and Greatness of Being—and Remaining—a Sterile Processing Technician

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