Can We Fight Dirty... While Dirty? Lifestyles of the Clean & Sterile

Stop what you're doing right now (if you're in a Sterile Processing department) and do me a favor.

Look up.

Now look down.

What do you see?

Stains on the ceiling tiles?

Holes or cracks in the ceiling tiles?

Dust, dirt, and debris on the floor?

Discoloration and cracks in the floor?

What about behind that trash can?

How about underneath or on top of your "sterile" storage rack?

When is the last time you've lifted up that key board or swabbed that touchscreen?

And let's not even get started about what's growing back in our decontamination areas. I think you get the point I'm trying to draw out here: our workspaces in Sterile Processing, by and large, are by all accounts...dirty.

So what? And What Not.

Imagine, for a moment, that we weren't reprocessing critical surgical instruments in our areas. Take out all of our equipment and let's pretend that it was a patient waiting room, or just a normal patient recovery room. How long would we let that weird stain hang out on the tiles by the front door? How large would we let the army of dust bunnies grow beneath our chairs? Do these things matter more or less when we consider our goal of sterility assurance of critical surgical devices?

I'm going to assume for the sake of argument that we all agree these things matter, and that we all see the value and have the desire to keep our Sterile Processing workplaces as clean as possible (whatever that objective, measurable threshold may be). Why is it not already so?

One reason SPD areas tend to fall short of this "environment of clean" (as I'll call it), is that we are not, by training, skill, or competency environmental cleaners ourselves. SPD does not equal EVS, and EVS does not equal SPD. We have two unique missions, two unique sets of skills. Although there is much overlap on the basics of breaking the chain of infection, standard precautions, and the like -- the similarities become smaller and small from there.

The More Clinical, the Less Comfortable

Add into this dynamic my perceptions that many EVS service professionals tend to become less and less comfortable with thier cleaning competencies the more clinical the space becomes. The more machines, the more complexity, the more risk associated with moving the wrong equipment or accidentally bumping the wrong button, the less comfortable EVS techncians are with leveraging the full capabilities they might have to get and keep these workspaces consistently clean.

This is not a knock on EVS. But what seems to happen time and again when Sterile Processing areas are cleaned is that a sub-par baseline clean is completed, and then there is an unspoken or unwritten assumption that SPD personnel will bridge the rest of the gap to get it up to the level of clean it should be. As mentioned above, this more often than not leads to SPD techs taking on the duties of EVS that they were neither trained nor have the competency to effectively accomplish.

Is Clinically Clean Possible?

So we're left with an obvious question -- is a clinically clean workspace in Sterile Processing even possible? If so, is it realistic? And how do we get there?

By "clinically clean" I do not intend to invoke industry jargon or categories from device manufacturers or cleanrooms, necessarily, although that is certain an option we can pursue. I just mean, a workspace that is daily terminally cleaned, free from visible areas of compromised infrastructure such as floor, wall, and ceiling, that includes areas that SPD technicians interact with such as worktables, touchscreens, shelving, transport carts, etc. You know, all the places BUGS live.

To get to this level of clean, at the very least we need to:

• Know whose responsibility it is (and if it is a shared responsibility, we need a clear scope)
• Have specific competencies for all responsible parties
• Have objective means to measure success
• Be willing to publicize the outcomes and standards

If, instead, we are ashamed at the state of our workspaces, not only will we be ineffective in our mission to "fight dirty, every instrument, every time", our clinical consciences won't be clean either.

I hope you agree that our patients and our people in Sterile Processing both deserve better.

What say you?

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Hank Balch is the Founder & President of Beyond Clean. He began his career in instrument reprocessing as a frontline technician in 2009, and has served as an Instrument Database Specialist, Department Manager, and System Director for various SPD departments across the country. Hank is an award winning Sterile Processing leader (2016 Healthcare Purchasing News "CS/SPD Department of the Year", 2023 Super Star in Sterile Packaging, 2024 GiG Award, 2024 MHHS Visionary Award), twice nominated for IAHCSMM President (now HSPA), founder of two state-wide IAHCSMM chapters, conference speaker, and well-known industry writer, blogger, and social media connoisseur. He has written over 200 Sterile Processing articles, with his work being published in Becker's Hospital Review, Infection Control Today, Healthcare Purchasing News, Communique, Outpatient Surgery Magazine, AAMI BI&T Journal, SteriWorld, NewSplash and other publications across the globe. His passion is seeing frontline Sterile Processing professionals equipped to #FightDirty, every instrument, every time.