90 Days of Sterile Processing Glory: Taking Dominion of SPD Onboarding

"How long does it take to train an SPD instrument technician?"

I always have to hold back a laugh when hospital administrators ask that question. It's like asking how long it takes to train a Hollywood stunt man -- honestly, the longer the better, for all parties involved. Stunt work is dangerous. It may look like they're just jumping off a platform onto an air mattress, but it's the skill that makes it look easy, not the job itself. The more practice they get, the smarter, safer, and more skillful they become.

And the same is true for training skilled CS/SPD technicians in your department. Unfortunately, when your administrator asks how long it takes to train one of these CS stuntmen, you can't be honest and say "forever." With limited time and resources, most hospitals just can't afford an extended orientation process for frontline instrument technicians. So what are you to do? How do you take the raw material of an earnest, critical thinking new hire and turn them into the next Sterile Processing Leonidas, to stand against the invading forces of bioburden (and win)? Here are a few onboarding-weapons to help equip your preceptors and newbies for the coming microbial war:

1) Preceptors as Culture-Warriors

Before your new hire ever walks through the door, you must ensure your preceptors understand the real scope of what they are being asked to do. Almost anyone can communicate technical facts to someone else. "Touch this button to turn it on." "Tape it there and place the label here." But that's not the extent of what you need from a trainer preparing your new technician to become the next weapon of mass microbial destruction. Almost as important as communicating the technical information (times, temperatures, volumes, testing instructions, etc) is the cultural training that must take place. Going back to the Leonidas example, what made the Spartans such a fearsome opponent wasn't just what they knew about battle, it was their culture of supreme bravery and unmitigated brotherhood. Make it clear to your preceptors and your new hire that you expect to see cultural adoption to "our SPD way" of doing, talking, leading, and growing. We're not in the business of creating know-it-all lone rangers. We need competent, dependable, team-minded CS soldiers.

2) CS/SPD Boot Camp: Teaching Warrior-Learners

So, with culture laying the foundation of your training program, let's get to some technical details on how to actually do it. As mentioned in the intro, true CS/SPD training never ends. We are to be life-long learners at our trade. However, to have a life -long learner, you first have to develop a love and respect of learning in general. Keeping with our theme, this means your first 90 days of onboarding glory should be spent teaching your new hires to become warrior-learners. You need to introduce and drill them in every area of the department they will be responsible for and exposed to - from decontamination to sterile storage, from viewing surgical cases to spending time on the instrument repair van. There will never be a better time to mold their perception of the value you place on your department's role as the heart of the hospital than their early days on the team.

Here's an example of one of our 90 day training guides:

Obviously this layout will look different for every department, depending upon the particular scope of your team. One important column to note on this "training matrix" (as we call it) is the blue section on the right-hand side labeled "CRCST Chapter Completion." These are the chapter assignments in the IAHCSMM CRCST textbook for uncertified new hires to complete at weekly intervals throughout their first 90 days of orientation. This technical reading is then bolstered by hands on explanation, training, and yes, culture creation. By the end of their training period, they should be ready to sit for the exam and earn their industry credentials. And you should have a new technician well on their way to becoming a warrior-learner.

3) The Battle of Thermophiles: 300 Department Need-To-Knows

One final idea that may be of use in your microbial battle-planning is coming up with a CS-battlefield checklist of sorts, or what we call our "Spartan 300 Checklist." This is separate and in addition to our department competencies and standard operating procedures (SOPs). You may have noticed the light red column in the training matrix pictured above had due dates for portions of the Spartan 300. Here's a few examples of what made the list:

This kind of document is an opportunity for you and your team to list the 300 things your new warriors need to know before they head off to battle -- things like where to find the SDS documentation, how to refill the indicators at your prep/pack station, where the emergency numbers are for department leadership, and on and on. Some of these will overlap your competencies and SOPs, but many will just be little things like when the break room refrigerator needs to be cleaned out and the code for the scrub machine. The point of this document is to assist your preceptors in presenting a standardized training experience to every new hire. With so much to cover during an onboarding period, it can be easy to forget the 150 little things you told the last guy but can't remember if you told this one. Along with the training matrix, competencies, and SOPs, a "Spartan 300"-style document can help fill in the gaps of your metaphorical department shield wall.

Few things are more important to the life and strength of your CS department than getting onboarding/training right. If poor training practices become your Achille's heel, your team and surgical quality could suffer for generations, with the same bad habits, bad culture, and bad information being passed on from one technician to another. Our mission of safe patient care is too important to compromise with just having a "warm body" to fill a staffing need, or settling for a technician who is "good enough" to get by. We need to be producing cultural CS-warriors and warrior-learners who know every square inch of our departments and are willing to stand their ground against the massive microbial army constantly seeking to do our patients harm.

We are SPD! And we #FightDirty!

What say you?

Hank Balch

Beyond Clean  Ⓒ February 2020

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