Diverse competencies are required for central service success

Healthcare Purchasing News, Feb, 2004

What exactly do Central Service personnel do as they go about their work? The short answer is "a lot of things." Their work is absolutely critical to protect patients of the healthcare facility. The level of skill and knowledge these personnel bring to their jobs also affects the efforts of their peers in other departments. In this lesson, we will explore the work done by Central Service professionals, and you will learn about the broad range of competencies required for them to be successful in their jobs.

Objective 1:

Explain that the Central Service technician is a professional who is part of a profession.

A professional is a person working in an occupation that requires extensive knowledge and skills. A profession involves membership that is limited to individuals with formal education in a specialized body of knowledge. Membership in a profession is usually controlled by licensing, registration, and/or certification and is governed by a universal code of ethics.

Occupations including medicine, nursing, law, and engineering satisfy this definition of a profession. The practice of Central Service technology requires professionalism and includes the essential elements of a profession. The Central Service discipline will be fully classified as a profession when requirements for formal education, certification, and a universal code of behavior are fulfilled and become requirements for employment. (1)

Objective 2:

Define the term, "competencies," and explain how they are addressed in professional certification programs.

The term "competencies" refers to what a person must know (knowledge) and be able to do (skills) to be successful in a job. Certification programs developed and implemented by professional associations such as the International Association of Healthcare Central Service Materiel Management (IAHCSMM) identify the competencies (knowledge and skills) required for success in the positions which they represent. Competencies, in turn, drive the certification efforts that are an integral part of the requirements for a profession, as discussed in Objective 1.

Objective 3:

List basic activities and related tasks requiring specialized knowledge and skills that Central Service technicians practice in the sterile processing aspects of their profession.

A significant part of a Central Service technician's work involves the sterile processing of surgical materials including medical supplies, surgical instruments, equipment, utensils, and manufactured supplies and equipment. This requires the ability to perform numerous tasks involved in four specific activities: decontamination, assembly, sterilization, and storage. (See Figure 1, Sterile Processing Tasks and Knowledge.)

Figure 1. Sterile Processing Tusks and Knowledge Applied by CRCSTs (2)

A. Decontamination Activities
   Task 1: Separate and discard disposable material.
   Task 2: Sort reusable material based on method of decontamination
           (i.e., heat sensitive vs. non-heat sensitive, immersible vs.
           non-immersible, mechanical vs. hand wash).
   Task 3: Determine sequence of decontamination activities based on
           factors including need, processing time, and time management.
   Task 4: Perform decontamination activities.
   Task 5: Inspect material.

B. Assembly Activities
   Task 1: Determine sequence of assembly based on factors including
           processing time and time management.
   Task 2: Perform and document assembly activities (for example,
           assembly, inspection, and inventory).
   Task 3: Verify and document functionality and cleanliness of
           material.
   Task 4: Package and label material based on item properties and
           sterilization process.

C. Sterilization Activities
   Task 1: Determine the sequence of sterilization based on factors
           including need, sterilization cycle times, and time
           management.
   Task 2: Load sterilizer.
   Task 3: Document load contents, date, sterilizer number, operator,
           and other information.
   Task 4: Monitor sterilization processes with use of mechanical,
           chemical, and biological indicators.
   Task 5: Unload sterilizer.
   Task 6: Transport sterilized material to designated locations.

D. Storage (Clean/Sterile) Activities
   Task 1: Place cleaned/sterilized material in designated storage
           areas.
   Task 2: Rotate material (first in/first out).
   Task 3: Monitor and document storage environment (address factors
           including temperature, humidity, cleanliness, shelving, fire
           codes, and traffic control).
   Task 4: Monitor inventory (consider factors including par levels,
           minimum/maximum, re-order points, and re-order quantities).

Note that sterile processing responsibilities typically begin in the Central Service area. (Other activities should be done at point of use, according to policies developed by the facility's Infection Control Committee and procedures implemented by Central Service, Operating Room, and other personnel.)