SURG 110 - Sterile Processing Clinical 1

This Competency is in the Cognitive Learning Domain.

Learning Objectives: 

a.Evaluate record-keeping policies and procedures.

b.Discuss the importance of employee training.

c.Identify how to receive and maintain CRCST credentials.

d.Investigate the affiliated accreditation bodies associated with sterile processing standards.

2.Define quality assurance related to the Sterile Processing area.

This Competency is in the Cognitive Learning Domain.

Learning Objectives: 

a.Examine quality in the context of Central Service Operations.

b.Describe the components of Sterile Processing quality control process.

c.Explain the basics of failure mode, effects analysis, and root cause analysis.

d.Evaluate common quality process programs i.e. Six Sigma, Lean, CQI.

 3.Examine healthcare regulations and standards related to Sterile Processing.

 This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Examine differences between regulations, voluntary standards and regulatory standards.

b.Verify basic information about the U.S. Food and Drug administration and other government and regulatory agencies.

c.Access roles and responsibilities of regulatory agencies that impact Sterile Processing Departments (AAMI, ANSI, HSPA).

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

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Practice prevention of cross-contamination (e.g. point of use cleaning & decontamination prior to IUSS).

b.Perform visual checks for cleanliness of each item.

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

d.Utilize proper item handling (e.g. stacking, rough handling (sliding), package integrity).

e.Prioritize rapid turn-around items.

f.Use a tracking system for all items (e.g. manual, computer).

5. Apply safety standards in the preparation and packaging of surgical instruments.

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Uphold area-specific environmental safety awareness (e.g. hot carts, wet floors, hot trays).

b.Demonstrate sharps safety and prevention techniques (e.g. skin hooks, K-wire, towel clips).

c.Monitor equipment operation (e.g. heat sealers, insulation testers, scope inspectors).

d.Advise where to find Safety Data Sheets (SDS).

e.Review chemical safety and handling (e.g. interpreting the Manufacturer’s Instructions for use (IFU) & SDS, disposal).

6.Prepare a work area for packaging of surgical instruments. 

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Explain the instrument reprocessing cycle starting at point of use.

b.Identify supplies needed for each type of item (e.g. indicators, tip protectors, tray liners, tape).

c.Identify work area requirements (e.g. cleaning requirements, lighting, magnification, flat clean surfaces).

7.Assemble surgical instruments for preparation including inspection for cleanliness and functionality.

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Unload equipment/instruments/supplies (e.g. instrument, cart washers).

b.Determine how to accept manually cleaned items (e.g. pass-through window).

c.Identify and sort items (e.g. service, facility, loaner).

d.Demonstrate checking for cleanliness and functionality of each item.

e.Utilize testing tools and the process for checking functionality of items (e.g. sharpness testing).

f.Evaluate the process of handling broken and/or damaged instrumentation (e.g. dull, misaligned, documentation).

g.Apply lubrication to indicated items (e.g. according to the Manufacturer’s IFU, when and how to lubricate).

h.Assemble, test and disassemble items according to the Manufacturer’s IFU.

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

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Utilize count sheets, peel pack lists and tray lists.

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

c.Determine size and measurements of items.

d.Determine Instrument protection devices (e.g. tip protectors, foam, mats, tray liners).

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

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

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

h.Utilize weight limits and weight distribution.

9. Utilize standard surgical instrument packaging and labeling methods.

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

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

b.Review sterilization methods/cycles to be used.

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

d.Closure methods (e.g. tape, locks, heat seal, self-seal).

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

f.Verify an approved writing instrument.

g.Determine placement of labeling and writing.

h.Proper label information (e.g. missing items, tray information, technician identification, storage destination).

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

j.Date of sterilization/date of expiration (e.g. event-related vs. time).

10.Determine sterilization methods and cycles.

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Evaluate high temperature methods (e.g. steam, dry heat).

b.Discuss low temperature (e.g. gas plasma, vaporized, ethylene oxide, liquid chemical).

c.Determine sterilization parameters of the high and low temperature sterilizers.

d.Validate different types of cycles (e.g. gravity, dynamic, standard, advanced, IUSS).

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

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Evaluate compromises in integrity of packaging (e.g. moisture, holes, filters, broken locks and seals).

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

c.Explore packaging for quality concerns.

12. Perform loading and unloading of a sterilizer.

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

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

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

c.Perform biological tests/process challenge devices (e.g. selection, placement).

d.Identify appropriate use of internal and external indicators (e.g. sterilization method, placement).

e.Assess what may compromise sterility (e.g. cooling time, temperature, handling, equipment failure).

f.Determine appropriate department traffic flow (e.g. cart placement).

g.Verify and document required information for a load control (lot) number.

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

i.Explore rationale for documentation (e.g. recall, traceability).

j.Evaluate automated vs. manual tracking systems.

13. Demonstrate operating and monitoring of sterilization equipment including sterilizer tests. 

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Perform sterilizer component checks (e.g. according to Manufacturer’s IFU, door gaskets, drains, carts, incubator temperature verification).

b.Execute a change cycle for high and low temperature sterilizers (e.g. exposure, dry, temperature).

c.Demonstrate replacement and disposal of empty cartridges/tanks/cassettes.

d.Evaluate testing methods for leaks.

e.Verify Bowie Dick test results.

f.Validate biological tests (e.g. high and low temperature, cycle changes).

g.Evaluate equipment test performance guidelines (e.g. repair, construction, malfunction, routine).

14. Evaluate potential sterilization process failures and troubleshooting. 

This Competency is in the Psychomotor Learning Domain.

Learning Objectives: 

a.Interpret the Manufacturer’s IFU (e.g. operator’s manual, locate).

b.Identify, respond and report malfunctions and/or alarms.

c.Demonstrate how to clean equipment strainers/drains.

d.Identification of outlets (e.g. on/off, regular, emergency).

e.Functionality of a chemical feed line (e.g. identifying detergent dosage).

f.Identify how to clean and test spray arms.

g.Identify how to check washer manifolds and baskets.

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

i.Verify procedures to ensure process accountability.

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

k.Examine the follow-up procedure and documentation required for process failures (e.g. recall, documentation, contact).

m.Determine future corrective actions to be followed for process failures.

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

o.Explore supply or equipment quarantine timelines (e.g. implants, early release).

p.Interpret and document varying types of test results