When I was growing up, my mother used to tell me that I was incredibly good with my book knowledge (probably the reason why I was respected when surveying for 25 years) but common sense was not my strong point. Common sense is something that I developed as I matured, and I have concluded that it is the best asset to have in your arsenal. So, now, I am disappointed when I see health care professionals making uninformed decisions based only on what someone else has told them rather than using their own common sense to find information on their own to support their decisions. Where am I going with this discussion?

If you do not have a Sterile Processing area that works to protect our patients every minute of their day, the operating room is in trouble. For too long, there have been disrespectful and discourteous exchanges between the Operating Room and Sterile Processing. Unfortunately, staff who do not have a sterile processing background should not be making decisions for this area; this would include inspectors, surveyors, and consultants who are asked to inspect/survey/consult on this area.

Look at your budget sheet and see how much you are paying for your consultant firms and accreditation organization. Granted, we are all imperfect humans, but do you get what you paid for? In my opinion, as I travel throughout the country, the answer must be no when it comes to sterile processing. Organizations have the responsibility to hire capable and knowledgeable staff that manage this area so, where did using common sense go? The sterile processing area is the one location above all others where inspectors, surveyors, and consultants that have no experience or knowledge are permitted to express their “opinions”; the sterile processing staff is often told by the administration not to push back; administrators ignore the in-house experienced staff that they count on every day except when a consultant, surveyor or inspector is on site.

Are organizations so afraid of a survey or inspection that they are willing to make changes that provide unsafe patient care? If so, there is no common sense being used here. Unfortunately, too often, sterile processing directors and managers are told to go to their office and close the door during onsite visits. Many times, these sterile processing leaders are not even invited to the summation meetings.
Here are some thoughts for consideration:

  1. Seek and interview applicants for sterile processing positions, ask probing questions that will show their knowledge base on sterile processing topic areas; include some common-sense situational examples.
  2. Hire the best that you can to direct or manage your sterile processing area(s).
  3. Hire the best support staff that will assist with a standardized and consistent approach in your sterile processing activities.
  4. Orient and train the staff on the needs of not only their area but also the O.R. Rotate the Sterile Processing staff to the OR to experience what happens on the other end of their work. Provide ample time, not just a few hours, possibly even a week for them to rotate through various services.
  5. At the conclusion of their orientation and then in an ongoing manner, document in writing the competency of the new hire.
  6. Train your SP leader and staff on the proper way to speak to a visitor (consultant, inspector, surveyor) while making their point(s).
  7. Permit your staff to actively engage with any visitor. Keep the tone polite and professional.
  8. Listen! Listen! Listen! If the staff tells you that the visitor(s) is/are incorrect, have them prove their case. Don’t ignore them or worse than that belittle them by telling them that you will not permit professional conversation.
  9. Request the visitor to provide written documentation (too often it is an opinion that comes off as fact). Be willing to discuss the pros and cons of the disagreement with your in-house experts participating in the discussion.
  10. If a disagreement still exists, stand your ground, and then wait for your report. Sometimes when a visitor returns to their home base, the comment/citation goes away. Be ready to provide a written response if there is a citation or deficiency.
  11. The next step will be determined by the veracity of the accreditation organization. In many instances, the failure is if your visitor decides it is a game and he/she will prevail. The purpose of these visits is to make the organization better than when it was visited. This action should help with patient care. If it does not, the overall message has been lost; it does not take years of education but just a wee bit of common sense.

I do not know of individuals who want to interfere with safe patient care but much too frequently that is exactly what I see when onsite. I understand the pressure on administrators not to “rock the boat” but when it comes to patient care, be prepared for the swells and an angry body of water now and then. Do not place blame on your staff when you have a disappointing visit unless it has been earned, instead provide constructive criticism so that all can grow together. Use your common sense, we all make mistakes.

Barbara Ann Harmer, MHA, BSN, RN
ASORN Past President

To view the full article that was posted in the June ASORN eNewsletter click here:


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