At first glance it might seem common sensical for Infection Prevention (IP) and Sterile Processing and Distribution (SPD) to collaborate or at least work together more closely. After all, their missions and visions seem to align even if their experience, knowledge and understanding of the microbial world may diverge at different angles.
Still, each can and should teach the other something about what it does and why it matters, according to experts who also acknowledge that any partnership may have to navigate a rocky road at least initially.
“Infection Preventionists have a deep knowledge of how infections are transmitted and prevented. The Sterile Processing department has a deep knowledge of the specific processes required to sterilize critical surgical instruments and medical equipment. They need to learn from each other to ensure the best outcomes.”
Linda Homan, Ecolab Healthcare
“In some hospitals, Infection Prevention is so busy with ensuring quality care is provided to the patients related to surgical site infections (SSI), antibiotic stewardship, catheter associated urinary tract infections (CAUTI), and central line associated blood stream infections (CLABSI), that they don’t have time to spend with the Sterile Processing department. If there is a good working relationship with Infection Prevention and SPD, Infection Prevention can observe and learn the processes of SPD. To have an effective partnership, it is vital for Infection Prevention to learn how the SPD operates and the stringent steps that must be followed to produce high-level disinfection or sterile instrumentation.
“The Sterile Processing departments are also very busy with following guidelines and pre-cleaning/processing instruments, and they don’t have an opportunity to work with Infection Prevention. It would be helpful for SPDs to spend time with the IPs in order to understand the background on why certain standards/guidelines are written and the importance of following those guidelines.”
Janet Pate, The Ruhof Corp.
“If SPD staff are not already familiar with it, the quality review process is an essential [Infection Prevention] skillset that easily extrapolates to SPD. Data collection, trending and tracking process and outcome measures are similarly shared subjects where the more experienced team member can share their knowledge. In truth, SPD and IP share a lot of common fundamentals and a mentoring relationship can be supported throughout the partnership. SPD is inherently familiar with high-volume precision activity, and IP appreciates the critical role of human factors engineering in ensuring worker safety and avoiding mistakes/missteps.”
Marc-Oliver Wright, PDI
“IP has a good understanding of the overall infection prevention issues and efforts within the hospital as well as detailed knowledge of how infections are transmitted and can be prevented. SPD is well-versed in methods for disinfection and ensuring that medical devices and instruments are clean and sterile. These areas of expertise are complementary, and by sharing their respective best practices, patient outcomes and safety can be improved.”
Alice Brewer, PDI Healthcare’s Tru-D division
“Infection Prevention and Control (IPC) and Sterile Processing and Distribution (SPD) can learn from each other as each profession offers expertise in their respective areas of specialty. SPD professionals have extensive knowledge of how to reprocess instruments and devices to make the equipment patient-ready. Their scope of practice includes awareness of how this equipment is used in patient procedures and the necessary steps in cleaning, disinfection or sterilization (CDS) to reprocess these tools safely and efficiently to be patient-ready for the next procedure.”
“Acknowledgement of SPD expertise is often recognized through various credentialing bodies, such as International Association of Healthcare Central Service Materiel Management (IAHCSMM) or the Certification Board for Sterile Processing and Distribution (CBSPD). Certification recognizes the proficiency of SPD professionals. At present, five states require SPD staff to be certified. Advocacy for certification is based on the understanding that this credentialing leads to improved patient outcomes.”
“IPC professionals are experts in preventing infections. Their knowledge stems from study of microbiological organisms and pathogenicity, replication, best practice in minimizing risk for infection, increased surveillance and management oversight. Certification can be obtained from the Association for Professionals in Infection Control and Epidemiology (APIC).”
“IPC and SPD each has a goal of minimizing patient harm from infection. Each specialty utilizes evidence-based practice to support patient care. SPD may be the ‘behind the scenes’ team, but without their knowledge of device and instrument safety, patients would be at increased risk during procedures. IPC is the ‘face’ of infection prevention, but without collaboration with SPD, their ability to ensure high-quality, safe patient care would be greatly compromised.”
Lynn Burbank, Olympus Corporation of the Americas
“Although one of the core functions of sterile processing is to break the chain of infection through effective reprocessing of medical devices, there is often a knowledge gap in ‘the why’ behind some of the less intuitive reprocessing practices. The IP team can leverage their understanding of infection prevention best practices and how they relate to surgical site infections (SSIs) and healthcare-associated infections (HAIs) to help communicate the significance of seemingly insignificant steps in reprocessing. On the other hand, sterile processing can help the infection prevention team better understand some of the pain points of medical device reprocessing that aren’t apparent unless you’re doing the job every day. Helping the infection prevention team understand the challenges the ‘front-line technicians face, can promote collaboration and continuous improvement efforts for both the infection prevention and sterile processing teams.”
Brandon VanHee, Key Surgical
“What SPD will learn is that there is a lot more reprocessing going on within the health system than they might have imagined. SPD should be a partner with Infection Prevention to ensure that these practices are being performed according to the [device instructions for use], current standards and best practices consistently.
“Anywhere high-level disinfection or sterilization is occurring should be overseen with help from SPD as they are the true experts in reprocessing. We have the expertise, the tools, resources, experience and knowledge on how to safely reprocess devices.
“Infection Prevention will learn that they have a department of experts who can be a resource for many areas within the health system. They will learn they have a department with the expertise, the tools, resources, experience and knowledge on how to safely reprocess devices.”
David Jagrosse, oneSource
“Work together and learn from one another. CSPD leaders cannot know everything, so trust in your IP and know they are looking out for you and want to know that everything you do will ultimately have a positive effect on patient outcomes.
David Taylor, Resolute Advisory Group LLC
Rough riding and weaving?
The benefits of IP and SPD working together may be recognizable, acknowledged and desired, but the pathway to arriving at that destination can be bumpy. What might the roadmap look like?
“Frequent, open communication is probably the biggest pitfall in the relationship between Infection Prevention and SPD – or any two inter-related departments in the hospital for that matter. Taking the time out of busy schedules for a regular cadence of conversations, either in person or virtually, helps develop strong working relationships. Frequent communication also means fewer surprises or last-minute requests for information or input.”
Linda Homan, Ecolab Healthcare
“SPD and the Infection Prevention departments both have a vital role in quality patient care that includes the prevention of healthcare-associated infections (HAIs). Both departments may become so busy and involved in their own issues and resolutions that they may not take the time to involve the other department. This may ultimately result in decreased communication, or silos may develop. Communication is vital between the two departments, and in many large organizations, the leadership of the two departments may not even know each other. Effective communication between the departments could easily result in the ability to share and meet common goals and issue resolutions.
“If both departments have a clearer understanding of the roles of the other department, it will enhance problem solving and make it easier to develop processes. This will not only provide increased quality for the patients, but it will enhance the working relationship for the departments. The prevention of silos enhances the productivity and effectiveness of the organization.”
Janet Pate, The Ruhof Corp.
“The largest pitfall to an SPD-IP relationship is a lack of understanding, by each department, that their goals and responsibilities are so closely intertwined. Many of The Joint Commission (TJC) standards that the Infection Prevention department audit their facilities to relate directly to SPD activities. This is most apparent in TJC’s standards section on Infection Prevention. For example, standard IC.02.02.01 calls for, ‘reducing the risk of infections associated with medical equipment, devices, and supplies.’ Additionally, a key ‘element of performance’ in this standard is EP2, ‘performing intermediate, high-level disinfection and sterilization of medical equipment, devices, and supplies.’ With these activities being such a large part of a Sterile Processing department’s duties, good communication and understanding of each department quality goals will solve this shortcoming.”
Seth Hendee, Healthmark Industries Co.
“Probably the biggest potential mistake is in making assumptions. [Infection Preventionists] who are not already familiar with the intricacies of SPD need to ‘walk a mile’ in their colleagues’ shoes. They can shadow staff for a period of time to gain an appreciation for the pressure and high demands of many SPDs. Leaders in both departments can realize that their joint efforts can elevate both. SPD often may have a closer relationship with the perioperative environment than IP and may therefore be aware of changes in the OR workflows before IP.”
Marc-Oliver Wright, PDI
“It is important that IP and SPD both realize the important roles they play in patient outcomes. One is not necessarily more important than the other, and the two should work toward a shared, common goal of patient safety and facility cleanliness. Consistent communication between the departments can help ensure that everyone is aligned.”
Alice Brewer, PDI Healthcare’s Tru-D division
“Pitfalls in the collaborative relationship between Infection Prevention and Control (IPC) and Sterile Processing and Distribution (SPD) can occur when acknowledgement of the importance of each team is not recognized. Each specialty provides expertise on how to minimize risk for infection, yet their ability to implement high-quality care can be compromised when resources may not be available to bridge the gap in communication between the two teams.
“Vendor support for SPD or IPC is essential, offering informational and reprocessing resources that can strengthen their relationship. The Olympus Endoscopy Support Specialists (ESS) offer a means of assistance to strengthen communication between the services. Providing educational and training resources, audit tools, onsite support, and device expertise is of value to both SPD and IPC. Each of these services is of benefit to the reprocessing technicians, as well as infection preventionists seeking the root cause of a problem.
“A pitfall in the relationship between SPD and IPC can be communication. Facilitating interaction and education with outside support, such as an ESS team, is a means to building a reprocessing community utilizing the strengths of all the team members.”
Lynn Burbank, Olympus Corporation of the Americas
“The relationship between SPD and IP is defined by the nature of their most common interactions. Often, IP only visits the Sterile Processing department to perform audits or investigate failures in medical device reprocessing, which can create an adversarial dynamic between the departments. When this is the case, Sterile Processing professionals may avoid contact with IP altogether to stay out of trouble or avoid being hassled. Luckily, this is easily addressed by SPD and IP collaborating on projects and including each other in their daily activities. A great way for IP to stay involved with SPD is participating in daily rounds and spending time in the department shadowing the instrument reprocessing cycle.”
Brandon VanHee, Key Surgical
“One pitfall is the IP professional not knowing what CS does or having a background in CS or the OR for that matter. The IP arrives to tour the department(s) and starts telling the CS leader all the things that are wrong and instructs them to create an action plan and begin fixing the deficiencies.”
David Taylor, Resolute Advisory Group LLC
“It has to be balanced and leveraged so the existing structural chains of command are not strained to the point where there are tensions. Some pitfalls can be that SPDs’ expectations and needs are so great that even a powerful department like Infection Prevention cannot overcome them in a manner that is fast enough for the SPD. Infection Prevention may want to utilize SPD more within the health system, but the department is typically already strained, understaffed and over-budget.”
David Jagrosse, oneSource
