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Certification vs. Competency in Sterile Processing

Updated: Mar 10, 2022

In 1990 New Jersey required C.S.S.D. managers to be certified as a C.R.C.S.T. (Certified Registered Central Service Technician) from the International Association of Healthcare Central Service Materials Management (I.A.H.C.S.M.M.), later including the C.S.P.D.T. certification (Certified Sterile Processing and Distribution Technician) from The Certified Board for Sterile Processing and Distribution (1991 N.I.C.H.S.P.D.P. – now C.B.S.P.D.). What most people believe is that mandatory certification in the United States began in 2004 when N.J. required certification for sterile processing technicians. At that time, they also increased the requirements for managers to include the C.H.L. (Certified Healthcare Leader) certification from I.A.H.C.S.M.M. or the C.S.P.M. (Certified in Sterile Processing Management) from C.B.S.P.D. At this time, only four states require certifications in the sterile processing field (N.J., NY, CT, TN).

Hospitals are starting to expand job description ladders in Sterile Processing. Positions descriptions for technicians may include tech 1, tech 2, lead tech, supervisor, etc. Areas of opportunity within the technical field are expanding, but only with the expansion of knowledge. Most job description changes are accompanied by a requirement for more sterile processing certifications. Most certifications are designed to tap into best practice recommendations, and best practice is derived from a number of sources in the U.S. We have ample opportunity to review numerous opinions S.G.N.A., A.O.R.N., A.S.T., A.A.M.I., to state a few. The Association for the Advancement of Medical Instrumentation (A.A.M.I.) is the gold standard in N.J. for Sterile Processing and is required by State regulation (N.J. Chapter 43G Title 8). One of the most significant issues is that opinions vary, and adoption is not always at the same pace. Varying opinions can lead to confusion in the workplace.

As leaders in the sterile processing field, it is our job to help expand the knowledge of our technicians. The certification process allows technicians to increase their awareness and build a baseline for continued education. In the U.K., if you work in the H.S.D.U. (The Hospital Sterilisation and Decontamination Unit) in the Royal Devon & Exeter N.H.S. Foundation Trust Hospital’s main site at Wonford technicians are required to undertake an internal 12-month training program, with continual assessment, in order to ensure compliance with ISO 9001:2008, 13485:2003 & EN ISO 13485:2012 as well as Medical Devices Directive 93/42/EEC. Staff are trained in the new Qualifications and Credit Framework (Q.C.F.) level three diploma award, (Formerly NVQ Level Three) in Healthcare Support Services.

Competency is tied to job tasks and the knowledge of how to complete these tasks. Generally, the manufacturer’s instructions for use are referenced to develop each step within a competency review. Competency reviews are usually an annual event vs. certification which may only be required once. Departmental competencies should be completed at the time of hire while also completing a comprehensive orientation plan. Secondarily, a risk assessment for the department, should be completed on an annual basis so that an education plan coupled with a competency plan. Competency plans typically look at low utilized processes that have a high risk to our patients if not completed correctly. I recently read a document, and it listed C.P.D. as a “competent person (decontamination).” This is the end goal, competent staff.

Certification in Sterile processing is a great place to start. Continual education, as in every medical field, needs to be developed and maintained. Staff need to be evaluated for their ability to demonstrate learned practices. At some point, if not sooner than later, we may need to consider combining the knowledge in each certification type into a degree format to bring the sterile processing field to the next level of recognition within the medical field. I believe there still is a lack of understanding of what C.S. professionals do, and the risk associated with our patient population if it is not completed correctly. I still hear the phrase “sterile debris.” With over 53k workers in the sterile processing field (Bureau of Labor Statistics 2018), there is ample concern for contracting a nosocomial infection. That is born out with the C.D.C. reporting over 1.7 million HAI’s (Hospital Acquired Infections) each year.

At Evolved Sterile Processing, our consultants have a greater focus on sterile processing. With our decades of experience, we will help you develop better processes and educational resources for your staff.

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