Mandatory registered/licensed/certified CS techs

[Tim Brooks]

I applaud the efforts, yet I would caution the belief that licensed certification will solve pay issues, address staffing shortages, improve employee turnover, reduce errors, and address the lack of respect that the department receives. Adding additional requirements and cost let alone re-licensing will also limit the number of applicants if pay does not increase.

This truly is the cart before the horse. We currently do not have a national or state governing board that forces us all to do exactly the same processes regardless of which state we are in. Pick any ten hospitals across this great nation and you will find ten different ways of doing the same job; not to mention we have two different programs to accomplish certification.

Certifying CS staff that may move to another hospital that does not do the same process sends a message that we are not serious about the industry. We have inconsistent job titles, duties, policies, reporting structures, procedures, and no national benchmarking to support our services. Contracted CSSDP services are starting to become the norm due to the lack of qualified managers.

Nursing has the Magnet program which gives them the stamp of approval and a rating that attracts quality personnel. Magnet like The Joint Commission focus is nursing, documentation, physician compliance, and patient out-comes. They do not address quality out-comes in the hospital service industry for which we are part of.

We have IAHCSMM, ASHCSP, and AHRMM with all kinds of qualified people that could come together to form a single entity that would review hospitals CSSPD departments along side The Joint Commission. Let’s first either establish ISO certification or an independent contractor (IAHCSMM) to work directly with “The Joint Commission” to fix the problem before mandating CS certification and licensing.

I completely agree that training and education is foremost when it comes to operating a successful CS department that supports surgical services. It is amazing to believe that the one department that directly supports the largest revenue generating division of any hospital should have such little standardization or respect.

Most if not all the education and CSSDP training is on-the-job, which can be integrated into the operating room educational program. Included in this could be the National Certification, not as a separate test but combined with an in-house program.

For example, a hospital warehouse worker is certified to operate a fork-lift in Arizona. The certification for forklift operator is hands-on training; they must demonstrate the ability to operate the machine. This is completed at the hospital not some other organization or on-line program.

Now we need to ask why it is that a CSSPD professional is not required to be certified to operate any one of the five different sterilizers utilized in today’s hospitals but it is required that a warehouse worker must be certified to operate a fork-lift.

I believe that before mandatory CS certification is enforced, hospitals CSSPD departments must be licensed to prove that they meet national recommendations (AAMI-ANSI-ISO).

Hospitals receive a license to operate and under that they can sterilize surgical instruments in what ever manner they want. We all know it but just seem to ignore the facts regarding the many inconsistencies from hospital to hospital.

Build a program around an in-house hands-on program and you will have my complete support.

Tim Brooks - tbrooks@yumaregional.org. 1928-336-7003

[CAROL]

Hi Tim I agree with you there is little respect for the field and it is not recognized with pay increases so no one wants to be certified.
As you stated this has been an issue since day one. what about the Director or managers pay scale.. I have 3 departments in one and I am not getting paid for it. You cannot get an answer as to what the pay should be I know some directors who are making $75-80,000

you are also right on when you say everyone does everything different.
I have worked in other hospitals covering for them and they did not keep much of a monitoring process on their sterilizers..
what do you do as far as monitoring.?

[Tim Brooks]

Carol
Thank you for you thoughts and my apologies for not responding to you earlier.

Pay tends to increase when you are an RN in this position from what I have noticed and with no consistent reporting structure it is difficult to pay accurately form place-to-place. At my hospital I am over both Sterile Processing and Supply Processing along with data entry/billing and OR materials management. At some hospitals the manager may only be over Sterile Processing. Until we get a national job description and it is reported to the Human Resources data bases this will most likely never change.

As for the record keeping for sterilizers, I have designed one for each type and you can download them from my web-site www.csspdmanager.com for free. They are full-page designed to fit in a 3-ring binder and color coded to the type of sterilization.

Good luck and keep in touch

[Harvey Johnson]

Hi Tim,
Great to see you participating on this board.
My O.R. Manager and I together viewed your web presentation the other day...good information for those interested in improving communication and upgrading respect between departments.
I have also frequented your web site. For those who haven't, I would encourage them to take a look. Lots of good information and views about the world of sterile processing.
As usual, you bring up many good points about what is holding our profession back.
Mandatory Certification is a start, not a cure all. It will take passionate people such as yourself to chip away at the long held disrespect and work at gaining the respect our profession deserves.
I believe education is the key, especially supervisor and above, those positions directly affecting how we are viewed and who have the ability to initiate change.
I believe we are on the right track as the merging of ASHCSP and IAHCSMM has already shown results in the NW region.
Professionals who were in the past divided because of long held loyalties to one organization or the other, not agreeing on which organization to follow to form a chapter nor willing to take a look over the fence are now uniting.
Our chapter, formed last fall after the news of the merger, already has 48 paid members (including also 15 vendor member associates) and for our first seminar to be held this Saturday, 134 people have registered.
People who are willing to give up their Saturday to improve their understanding of our profession.
This indicates to me a hunger for education and professionalism that we need to feed as leadership people and work toward the common goal of bringing a progressive change upward of our standing in the healthcare industry.

[Tim Brooks]

Thank you for taking the time to watch the web-cast and for the positive thoughts on my web-site.

Here is the link for those of you who did not see it.
http://event.on24.com/eventRegistration/EventLobbyServlet?target=previewLobby.jsp&eventid=102022&sessionid=1&key=793F4D322C7C4357A948E84458A33756

The merger is a very positive start but now we need to get into the minds of the OR managers and directors, build a structure that supports instrument management, amend the AIA construction guidelines, and start showing up more at AORN and OR Manager. We also need to somehow mandate in the hospital licensing how CSSPD departments are to be built, how to expand with hospital growth, managed, and educated. We also need hospital based studies to support what we are doing. The manufacturers approach the FDA with their new products and their own studies that do not reflect what occurs in hospitals today.

I belong to the Arizona IAHCSMM chapter, unfortunately the meetings are 180 miles away (one way) and are on Saturdays. Living in a rural area adds additional cost and time, we need to develop phone based meetings for the out-lying areas.

We also need to be able to express our thoughts on new products without censure in the forum. I find it very disappointing that I cannot address a new product on this web-site because it would be considered advertising. The reason why I started my web-site was to share my progress and make changes which I cannot complete here.

[sunshine]

Thanks Tim!!

I haven't look real good yet but what I've skimmed over is wonderful!

[Sunny One]

Tim,
I applaud you and your colleagues' efforts to "raise the bar" in this profession. I can not help but reflect the parallels between this struggle and that of another I have encountered. As a Certified and Registered Surgical Technologist this is not unlike the initiative/battle currently being waged in that arena. I now am an SPD manager (with a BSHS) after several years as an ST instructor, so you know my commitment and advocacy to education, especially for the healthcare worker. It is imperative that standardization across the board (nation) becomes the norm. How can patient’s expect the best possible care when the variables are so diverse? Granted, they are unaware of this discrepancy, but we, as the professionals we are responsible for the care we provide.

When reflecting on the need for mandatory certification, I do think this is the direction of all healthcare. Based on the experiences of surgical technologists, let me say that it really is a hard fought idea, but will likely come into its own eventually. What is necessary is the complete support of those affected, the CS techs. If the grass roots are not committed, it will be difficult. The ST professional organization has had lobbyists in the state legislatures for years and only now is becoming successful in getting individual states to agree to pass laws that mandate certification for employment. I doubt the process would be unlike this for CS techs as well. It was with the eventual support of AORN that this has taken off. The importance of such organizational backing is what will help this cause.

Tim, you are so right. I commend your vision and commitment to the profession and patients we serve.

Dawn Arnold
Chicago

[Tim Brooks]

Dawn,
Thank you for your thoughts, there is a lot of work ahead but it can be accomplished if we start at the bottom first. Credibility comes with consistency and we all have to be on the same page.

[Ray Taurasi]

Your assistance is needed the Virginia Association of Central Service is seeking to have the Virginia Department of Health Professions require mandatory certification for all CS practitioners within the Commonwealth of VA. We have a very important meeting on 12/17/08 to present our case to the Board. It would be very helpful to be able to show support from the health care community across the country - Below is a form letter which you can print out or cut and paste - if you would like to support our cause please submit your letter to Dr. Elizabeth Carter, PhD Virginia Board of Health Professions
9960 Mayland Drive, Suite 300 Richmond, VA 23233 you may also fax or e mail her at; Elizabeth.Carter@dhp.virginia.gov fax---- 804-527-4466 Letters must be received by December 1, 2008 Thanks!!![/b][/b]Dr.

Elizabeth Carter, PhD
Virginia Board of Health Professions
9960 Mayland Drive, Suite 300
Richmond, VA 23233

Dear Dr. Carter,

As a health care professional I have personally witnessed the critical role that central service practitioners play in supporting quality patient care. They are responsible for the care, handling, inspection, decontamination, and sterilization of vital patient care medical devices, equipment and surgical instruments. The knowledge and skills required to appropriately care for critical care medical devices is very specialized and extensive. Central service technicians must also be knowledgeable of the ever changing technologies and regulations associated with reprocessing and sterilization. This knowledge includes competency in the precise operation of various highly technical reprocessing equipment, washers, sterilizers and related accessories items. Central Service Technicians must also be competent in the appropriate and safe use of chemicals, detergents, sterilants and disinfecting agents. The inappropriate application and use of such products could pose a hazardous risk and threat to the environment, patients and other health care workers. Work practices and protocols involved in reprocessing and sterilization require compliance and adherence to rigid standards and regulations set forth by professional entities and governing bodies such as; AAMI, AORN, IAHCSMM, SGNA, APIC, OSHA, EPA, FDA and DOT. Medical devices that are inappropriately handled, assembled, maintained, decontaminated and sterilized could result in serious harm, transmission of infection and death of a patient. It is without reservation that I urge the VA Board of Health Professions to take expedient actions to mandate the professional credentialing of all central processing practitioners working in health care facilities within the Commonwealth of Virginia.

Sincerely,

[libra]

I think it is important issue as well, done:)

[Sunny One]

Ray, I agree, and did write a letter like this and sent it. Best of luck. Dawn

[sheper1]

Thank you everyone for your support.
Erle Shepard
President Elect
Virginia Association of Central Service (VACS)