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Defunding Sterile Processing

Updated: Jul 11

The lack of funding for sterile processing in the medical field is becoming an increasingly signification issue nationwide. The prevalent challenges include the lack of space, malfunctioning equipment, and low salaries. Employees are often forced to work with outdated equipment in obsolete environments. Salaries in sterile processing are becoming comparable to non-technical enterprises like fast food. It doesn't take but a few minutes on platforms like LinkedIn and Facebook to find comments like " Add to this the comparatively low pay scale (as compared to the value + complexity of SPD's work, as well as other clinical wages across surgical service roles) and you start to see why so many hospitals are losing this "Wage War" in SPD" and "I graduated from school and got my CRCST certification 2years ago but because of the low pay and high cost of living I haven't searched for a position".

In April 2024, hospitals had an average operating income margin of 3.9%. While departments that generate income receive the majority of the operating budget, the Sterile Processing (SPD) does not fall into this category. SPD is considered a support department that has a negative impact on the budget. However, unlike other support departments, SPD plays a crucial role in patient care by directly influencing infection control. Infection control failures are one of the leading costs that affect hospital budgets. According to the CDC, there were approximately 110,800 surgical site infections associated with inpatient surgeries in the U.S. in 2015, and in 2022 there was an approximate 4% increase.. The NIH estimates that the average cost of a hospital-acquired infection (HAI) ranges from $28.4 billion to $45 billion.

Unfortunately, numerous hospital administrations continue to view sterile processing as an entry-level position similar to washing dishes. This perception of SPD is not surprising, given the historical opposition from nursing and hospital associations to legislation mandating certification for sterile processing technicians. Currently, only six states acknowledge the significance of certification in sterile processing. Hospital associations are concerned with wage growth, while nursing associations have been concerned with the hierarchy of the political order within the medical field. In New York, the term "licensing" was a concern which caused the governor to veto the original legislation. Percention of the sterile processing department ads to the defunding process.

Out of order sign

The risk to patients is evident. Hospitals that persist in inadequately funding sterile processing are endangering both their staff and patients. Understaffed Sterile Processing departments are forced to work at a faster pace to meet demand, leading to an increased likelihood of errors reaching patients and staff injuries. Due to lack of time or resources, education often takes a back seat, unlike in areas like the Operating Room where there is typically dedicated support from one or two educators. Sterile processing staff remain undertrained. Sterile processing consultations are increasingly revealing deplorable conditions, from HVAC system failures to malfunctioning cleaning and sterilization equipment, which are becoming commonplace.

If the driving force behind funding the sterile processing department isn't patient care, what is? Creating an environment to support more operating room cases is certainly important. The OR is the breadbasket for hospital. However, not factoring in the negative impact resulting from understaffed and poorly operating sterile processing departments will likely negate some of those gains. The average cost of a surgical site infection is $25,546.

Where does this leave us if the Hippocratic Oath emphasizes the importance of "first, do no harm"?

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