When patient safety is prioritized, shortcuts aren’t an option
Most Central Service (CS) professionals are dedicated to doing what’s right to promote patient safety, deliver quality customer service and improve patient outcomes. At times, however, many may find themselves pressured by colleagues and customers to turn instruments around more quickly or otherwise rush a process to keep the schedule on track. They may also spot a fellow technician engaging in a practice that goes against the latest standards, policies and procedures, or manufacturer’s Instructions for Use (IFU) – or perhaps following a manager’s lead on a questionable practice because they don’t want to jeopardize their relationship with their boss or otherwise rock the proverbial boat.
Regardless of the scenario, CS professionals across all titles and tenures must stand firmly and do their part to ensure that patient safety and quality customer service are never jeopardized for the sake of time, convenience or relationships. Doing what’s right for every instrument and patient isn’t always easy, but the adage holds true: nothing worthwhile ever is.
Keeping quality and safety at the forefront requires that CS professionals know the reasons behind their processes and practices. An understanding of how their practices impact the department, its customers and, ultimately, the patient on the receiving end of the instrumentation, “is what empowers professionals to do the right thing and in the right way, every day and all day long,” explained Terri Goodman, PhD., RN, CNOR, Principal of Terri Goodman & Associates. Goodman is a perioperative nurse with clinical experience in both the OR and CS who specializes in continuing healthcare education.
Sticking to standards
Both CS and the OR professionals have been affected by technological advancements that made instrument reprocessing a far more laborious and difficult process. During Goodman’s early days as a perioperative nurse, she saw CS function as part of the OR, and most instruments in use were stainless steel and easy to use and sterilize.
“There was no real challenge with the instrument from point of use to decontamination and anywhere in-between,” she said. As time went on, however, sophisticated, high-tech procedures gave way to complex, sophisticated and, often, difficult-to-clean instruments. As a result, CS and OR professionals have found themselves increasingly challenged with how to manage these changes to consistently drive patient safety, satisfaction and other positive outcomes.
Regulations and standards impacting the profession have increased facility and employee accountability and provided CS professionals with critical references to promote effective, evidence-based practices within their departments. Unfortunately, some healthcare facilities fail to provide CS professionals with the most current standards, which places them, their customers and patients at a serious and potential dangerous disadvantage.
“Having the latest standards and evidence to back up the message is very important if your goal is to educate and initiate positive change,” Goodman explained, noting that this is essential because not all healthcare professionals have a solid understanding of the evidence or standards, or even the important role of CS in the delivery of safe patient care.
Even those that do have a solid understanding of regulations and have the latest copies of industry standards, such as ANSI/AAMI ST79, Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities, on file may still find some healthcare professionals who disregard them; this may happen unintentionally due to lack of knowledge or understanding, or purposefully to simplify a process for the sake of time, limited resources or external demands.
Regardless of the pressures faced, ethical behavior must govern and guide actions and decisions made by CS professionals and other healthcare workers. Each team member must respect patient rights, recognize the importance of the patient’s needs over other considerations, and consistently comply with regulatory guidelines and facility policies and procedures. They should also report any activity that may adversely affect the health, safety or welfare of patients, visitors or co-workers.
“If you see a mistake [or shortcut], speak up,” stressed Goodman. “If we know the potential of what can happen, then we need to go and fix the mistake or take the issue to the person who can.”
Lessons in leadership
Effective leadership is vital to a department’s success, and managers will lead by example. The best leaders serve as positive role models by exhibiting attitudes, words and actions that emphasize customer service quality and safety. They set realistic expectations and monitor performance as work evolves, and they solicit suggestions for corrective actions from the team to better attain pre-established goals.
Supervisors, managers and directors must have a solid understanding of the “Why’s” behind each reprocessing step, and they must fight for adequate resources to ensure their technicians have the tools, knowledge, staffing and equipment to tackle their jobs appropriately, safely and in accordance with standards and best practices — for every case.
A knowledgeable and quality-focused CS team will be able to more effectively communicate with the OR and other CS customers, and explain the steps involved in instrument reprocessing. Knowledge and supportive data will also help educate co-workers and interdisciplinary team members about why shortcuts and any other deviations from standards, recommended practices and instructions for use are unacceptable and could jeopardize patient safety. Promoting enduring quality and safety in CS involves a widespread commitment to teamwork, understanding and respect. It also requires every team member, regardless of their title and tenure, to recognize their role in the delivery of quality customer service and patient outcomes.
“We need to be respectful of our colleagues and understand one another. If that’s a world we would like to live in, it’s a world we should want to invest in,” said Goodman.
