SURG 101 - Sterile Processing

     This competency is in the Cognitive Learning Domain.

            Learning Objectives:

   1.  Examine the importance of the Sterile Processing Department.

   2.  Evaluate the sterile processing role in providing safe patient care delivery. 

   3.  Assess skills and knowledge required for effective sterile processing technique.

2.  Explore the function of surgical instruments, supplies and equipment.  

     This competency is in the Cognitive Learning Domain.

      Learning Objectives:

   1.  Identify the classification of surgical instruments, supplies and equipment.

   2.  Evaluate the proper function of surgical items prior to choosing a decontamination method.

   3.  Ascertain the composition of each surgical item for best processing method.

   4.  Review tray assembly safeguards and standards. 

3.  Justify rationale for environmental controls in each area of the Sterile Processing Department.  

     This competency is in the Cognitive Learning Domain.

      Learning Objectives:

   1.  Assess standards for environmental temperature and humidity.

   2.  Identify necessary documentation and recording for temperature and humidity parameters.

   3.  Determine chain of command and reporting for corrective environmental actions.

   4.  Determine appropriate air and pressures exchange for all department areas. 

   5.  Identify regulatory agencies that develop environmental controls.

   6.  Examine differences between regulations, voluntary policies and regulatory standards.

4.  Explain employee safety and risk management in the Sterile Processing Department.

     This competency is in the Cognitive Learning Domain. 

      Learning Objectives:

   1.  Investigate facility incident and sentinel event reporting policies.

   2.  Identify regulatory agencies that develop physical, biological and chemical prevention standards.

   3.  Identify prevention methods for all physical, biological and chemical hazards in the Sterile Processing Environment.

   4.  Complete blood borne pathogen training for the healthcare worker.

   5.  Complete HIPAA training for the healthcare worker.

   6.  Determine the appropriate course of action for physical, biological or chemical exposure.

   7.  Review the role of the sterile processing team for all hazard’s preparedness and emergency response. 

   8.  Review education and training record requirements (e.g. certification, competencies, continuing education, new equipment and processes). 

5.  Apply patient care safe practice to health facility items and equipment.   

     This competency is in the Cognitive Learning Domain.

      Learning Objectives:

   1.  Apply standards for patient care equipment operation and how to interpret the Manufacturer’s Instructions for Use (IFU) (e.g. operator’s manual).

   2.  Determine best cleaning and disinfecting criteria to all non-critical patient supplies and equipment.

   3.  Discuss required records or documentation of non-critical patient equipment. 

   4.  Determine corrective actions to follow if the process is broken.

6.  Inspect patient care equipment for cleanliness and functionality.  

     This competency is in the Cognitive Learning Domain.

      Learning Objectives:

   1.  Check for cleanliness of Patient Care Equipment.

   2.  Check for compliance with safety standards (e.g. frayed cords, preventative maintenance label, damage). 

   3.  Determine a corrective action plan for equipment out of compliance (e.g. missing/expired preventative maintenance label, whom to notify). 

   4.  Assess equipment requiring charging or battery replacement.

   5.  Assemble equipment for distribution (e.g. disposable components, Manufacturer’s IFU).

   6.  Test of equipment (e.g. per Manufacturer’s IFU). 

   7.  Assure proper care and handling of equipment.

   8.  Assess proper location and storage of equipment (e.g. dry, clean).

7.  Explore the different disinfection methods and when they are to be used.

     This competency is in the Cognitive Learning Domain.

      Learning Objectives: 

   1.  Define disinfection and how it differs from sterilization.

   2.  Explore disinfectant families used in the disinfection process (e.g. quats, halogens, aldehydes).

   3.  Identify three levels of Spaulding Classification (e.g. non-critical, semi-critical, critical).

   4.  Examine safety measures when using HLD (e.g. PPE, spill kit, ventilation).

   5.  Investigate dilution requirements of disinfecting products (e.g. concentration, expiration, end of use date, labeling).

   6.  Explain rinsing requirements (e.g. critical water). 

   7.  Explore proper documentation for verification of parameters (e.g. technician information, patient information, exposure time and solution temperature, lot control number). 

   8.  Apply handling, care and storage criteria for supplies and equipment (e.g. drying, expiration date).

   9.  Examine disposal methods of hazardous products and supplies (e.g. neutralizer).  

8.  Investigate sterilization methods and parameters. 

     This competency is in the Cognitive Learning Domain.

      Learning Objectives:

   1.  Explore high temperature methods (e.g. steam, dry heat).

   2.  Examine low temperature methods (e.g. gas plasma, vaporized, ethylene oxide, liquid chemical).

   3.  Evaluate different types of cycles (e.g. gravity, dynamic, standard, advanced, IUSS).

   4.  Explain how each method meets sterilization parameters.

   5.  Explain the necessary safety precautions needed for each method. 

   6.  Analyze physical, chemical and biological indicators that are necessary to the verification of parameters (e.g. selection, placement).

9.  Demonstrate storage and rotating inventory in Sterile Processing.

     This competency is in the Psychomotor Learning Domain.

      Learning Objectives:

   1.  Utilize proper ergonomics while handling supplies and equipment (e.g. workflow, proper body mechanics).

   2.  Demonstrate appropriate PPE while in different areas of the department.

   3.  Evaluate that all processed items have met sterilization parameters prior to storage destination.

   4.  Apply proper labeling criteria to each processed item prior to storage. 

   5.  Determine the location of supplies (e.g. shelf/cart location, sterile supplies).

   6.  Execute the process for rotating inventory (e.g. First in First Out (FIFO)).

   7.  Apply proper storage requirements (e.g. height, weight, distance from wall/floor, shelving).

   8.  Apply the shelf-life policy to identified supplies and equipment (e.g. expiration, event-related). 

10. Distribute sterile and non-sterile items.

      This competency is in the Psychomotor Learning Domain.

      Learning Objectives:

   1.  Apply distribution methods for medical supply and equipment transfer (e.g. just in time, exchange cart, case cart). 

   2.  Demonstrate proper handling of items (e.g. maintain sterility).

   3.  Adhere to facility transport guidelines (e.g. closed cart, bins, dust covers, off-site transport).

11. Demonstrate safe environmental practices and PPE requirements during decontamination, disinfection and sterilization.

      This competency is in the Psychomotor Learning Domain.

      Learning Objectives: 

   1.  Classify types of PPE used in each area of the Sterile Processing Department.

   2.  Demonstrate the process of donning and doffing of PPE.

   3.  Identify safety precautions for handling and disposal of surgical items and PPE.

   4.  Apply area specific safety standards to sterile processing tasks.  

   5.  Utilize quality measurement tests to ensure proper equipment operations. 

   6.  Transfer physical, biohazard and chemical prevention concepts to all processing tasks. 

   7.  Transport and receive soiled or contaminated items into decontamination or soiled utility rooms (e.g. inspecting for and reporting inadequate point of use cleaning).

   8.  Determine optimal traffic flow for prevention of disease transmission (e.g. cart placement). 

   9.  Access safety data sheets (SDS) for any chemicals and solutions in the department.

12. Prepare medical supplies and equipment for the decontamination process.  

      This competency is in the Psychomotor Learning Domain.

      Learning Objectives: 

   1.  Utilize the correct cleaning agent or chemicals for each medical item or equipment.

   2.  Evaluate the proper function of surgical items prior to choosing a decontamination method.

   3.  Ascertain the composition of each surgical item for best processing method.

   4.  Determine needed supplies for decontamination and reprocessing of used items (e.g. brush, towels, location of restock).

   5.  Verify necessary equipment for disinfection or sterilization method of each type of supply or equipment (e.g. washer disinfector, ultrasonic, cart washer, leak tester).

   6.  Utilize chemicals following the Manufacturer’s IFU (e.g. dilution, equipment).  

   7.  Manage and replenish chemicals used in various processing methods. 

   8.  Determine the correct solutions for maintenance and use of each piece of equipment. 

   9.  Test the functionality of light and magnification devices.

 10.  Demonstrate how to clean a sink strainer/drains including frequency.

13. Separate reusable vs. disposable items in the healthcare setting.

      This competency is in the Psychomotor Learning Domain.

      Learning Objectives:

   1. Demonstrate sorting of reusable and disposable items (e.g. laparoscopic tips, linens, drapes, third-party recycling vendors, sustainability). 

   2.  Demonstrate safe disposal of ineligible reprocessing items.

   3.  Separate expendable supplies properly.

14. Prepare medical instrumentation for decontamination.

      This competency is in the Psychomotor Learning Domain.

      Learning Objectives: 

   1.  Explain the importance of point of use and the instrument cycle.

   2.  Identify manual and/or mechanical cleaning according to the Manufacturer’s IFU.

   3.  Evaluate proper opening and positioning of instruments.

   4.  Demonstrate how to disassemble instruments.

   5.  Verify the soak process (e.g. water temperature, dilution).

   6.  Demonstrate how to use high-pressure water and air gun/hose (e.g. critical water).

   7.  Visual inspection of bioburden removal (e.g. magnifying devices). 

   8.  Demonstrate loading items into the pre-sterilization equipment.

   9.  Determine the appropriate wash cycle. 

 10.  Practice methods for reducing the risk of Toxic Anterior Segment Syndrome (TASS).

15. Evaluate pre- and post-sterilization package integrity.

      This Competency is in the Psychomotor Learning Domain.

      Learning Objectives:

   1.  Evaluate each package for compromises of integrity (e.g. moisture, holes, filters, broken locks and seals). 

   2.  Validate filter placement, locks, seals and external indicators.

   3.  Demonstrate safe removal of sterilized items from equipment.  

16. Perform loading and unloading of a sterilizer.

      This Competency is in the Psychomotor Learning Domain.

       Learning Objectives: 

   1.  Determine the loading configuration (e.g. metal, wrapped, rigid container, peel pouch).

   2.  Verify the sterilization method (e.g. high vs low temperature).

   3.  Identify appropriate use of external indicators (e.g. sterilization method, placement). 

   4.  Assess what compromises sterility (e.g. cooling time, temperature, handling, equipment failure).

17. Evaluate potential sterilization process failures. 

      This competency is in the Psychomotor Learning Domain.

       Learning Objectives: 

   1.  Interpret the printout to validate the quality of the process (e.g. temperature, time and pressure exposure, cycle type).

   2.  Verification procedures to ensure accountability.

   3.  Identify a process failure (e.g. wet packs, color change, failure to meet sterilization parameters).

   4.  Practice the procedure for follow-up after process failure (e.g. recall, documentation, contact). 

   5.  Create documentation of process failures.

   6.  Determine corrective actions to be followed for process failures. 

   7.  Evaluate proper handling and incubation of the biological tests/process challenge devices.

   8.  Explain the process to quarantine (e.g. implants, early release).

   9.  Interpret and document test results. 

18. Document Load Contents in the medical setting and sterilization.  

      This Competency is in the Psychomotor Learning Domain.

      Learning Objectives 

   1.  Document lot number requirements.

   2.  Required information for a load control (lot) number. 

   3.  Evaluate how and what to record (e.g. computer or manual load log sheet). 

   4.  Produce rationale for documentation (e.g. recall, traceability).

   5.  Illustrate automated vs. manual tracking systems. 

 19. Manage the transfer of instrumentation to the preparation area for packaging. 

       This competency is in the Psychomotor Learning Domain.

       Learning Objectives:

   1.  Maintain appropriate airflow (e.g. negative pressure, positive pressure).

   2.  Apply concepts of microbiology to prevent cross-contamination (e.g. point of use cleaning and decontamination prior to IUSS). 

   3.  Perform visual checks for cleanliness and removal of gross debris.

   4.  Discuss safety guidelines for transporting and handling soiled items. 

   5.  Demonstrate proper item handling (e.g. stacking, rough handling (sliding), package integrity).

   6.  Prioritize rapid turn-around items.

   7.  Track items (e.g. manual, computer). 

20.  Assemble packing materials and procedure specific surgical instruments for packaging. 

       This competency is in the Psychomotor Learning Domain.

       Learning Objectives:  

    1.  Utilize surgical count sheets for each set. 

    2.  Identify items (e.g. catalogs, product number, computers, tape, etching, cross-referencing). 

    3.  Determine instrument protection devices (e.g. tip protectors, foam, mats, tray liners).

    4.  Verify proper instrument placement (e.g. facilitate sterilization, protect instruments).

    5.  Utilize instrument organizers (e.g. stringers, racks).

    6.  Classify/type and use appropriate chemical indicators/integrators (e.g. proper placement, intended cycle). 

    7.  Utilize weight limits and weight distribution. 

21. Utilize standard surgical instrument packaging and labeling methods.

      This Competency is in the Psychomotor Learning Domain.

      Learning Objectives: 

   1.  Review types of packaging methods (e.g. flat wrap, peel pack, rigid container, size, packaging weight). 

   2.  Review sterilization methods/cycles to be used.

   3.  Inspect packaging (e.g. wrap, rigid containers). 

   4.  Demonstrate closure methods (e.g. tape, locks, heat seal, self-seal).

   5. Utilize proper wrapping techniques (e.g. square fold, envelope). 

   6.  Verify the approved writing utensil. 

   7.  Determine the placement of labeling and writing.

   8.  Construct proper label information (e.g. missing items, tray information, technician identification, storage destination). 

   9.  Validate special information identifiers (e.g. implant, loaners, sterilization methods/cycle).

 10.  Evaluate the date of sterilization/date of expiration (e.g. event-related vs. time).