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Module 11 STERILE STORAGE AND TRANSPORT

Index :
1. Learning Outcomes
2. Introduction
3. Pre - Module Quiz
4. Product Release
5. Product Rejection
6. Product Recall
7. Sterile Storage Room
8. Event Related Expiration
9. Sterile Supply Expiration
10. Quality Assurance Checks
11. Time Versus Event Related Sterility
12. Consumable Inventory Management
13. Sterile Transportation
14. EVENT- RELATED STERILITY
15. CONCLUSION
16. Exercises and Checklists
Learning Outcomes
By the end of this module you will be able to:
> Clearly understand product release practices for processed goods
> Describe environmental requirements for storage areas
> Understand the need to segregate items produced in -house from
commercially produced items
> Understand health and safety requirements for manual handling and
movement
> Describe the tracking and traceability requirements for medical devices
> Demonstrate understanding of potential damage to sterile items when
being transported
> Outline procedures for product recalls

Introduction
This module will give you an understanding of Time related and Event
related sterility practices and the elements that can impact these
practices . We focus specifically on the importance of appropriate storage
locations and conditions , maintenance of sto ck levels and technician
handling.
Pre-Module Quiz
Keep these questions in mind as you go through the content and don't
worry if you don't know the answers yet -that's what you're here to learn.
Q: What does time related expiration mean?
Q: What does event related expiration mean?
Q: With your understanding of CSSD design, what do you think are the
key environmental aspects that would need to be monitored for sterile
storage?
Q: Where do risks occur when transporting sterile sets?
Q: What would you do if you dropped a sterile set on the ground or found
one on the floor? Q: What PPE precautions need to be taken when
transporting sterile items?
Q: With your understanding of the sterilization process and its monitoring,
what conditions must be met to release sterile products for use?
Q: What are some important features of a transport cart?

Product Release
Before we explore the storage, handling and transportation of processed
items we must ensure we have met the requirements for safe product
release. As we explored in module 7, there are key aspects that must be
assured after the sterilization process befor e we can release for storage or
patient use, such as:
Biological Monitoring
Monitoring must be carried out according to your local policy, but
generally you monitor with the first full load of the day and with all
implant loads. Biological indicators require anywhere from 1 -48 hours of
incubation before release so it is important to know your IFU
Did the biological monitor pass and was this documented?
Chemical Monitoring
Have chemical indicators been placed inside all packages and external
indicators used on packages that can't be viewed, like containers and
wraps? Was an additional process challenge device (PCD) run with the
cycle for assurance? Did the PCD chemical indic ator pass and was this
documented? Do the users in your facility check the indicator before using
on a patient?
Cooling
Was an adequate amount of time given for the items to cool after
sterilization before moving to storage? For most items a marked set of 30
minutes is allowed for cooling but longer times are required for larger and
heavier sets.
Physical Inspections
Was a physical inspection made of all packs to ensure the following:
· Items were correctly placed on sterilization racks and shelves with small
and lighter items on top and heavier on bottom?
· Correct packaging and sterilization methods were used, for low
temperature steam?
· Identification labels are correctly attached?
· No residual moisture on outside of package?
· Tapes and identification labels are attached?
Product Rejection
During the product release checks above, all must be fully met or the
item(s) will not be released for use. For all release check failures, the
item must go through the full reprocessing starting from
decontamination - no short cuts can be made.

Product Recall
There is always a possibility that items have been released but later
recognized as items that should have been rejected. Some reasons for
this include:
· Biological or chemical indicator wasn't used or didn't pass
· Documentation wasn't correctly completed
· Manufacturer recalled a defective item
When any of these things occur, it is critical to use your process
documentation to identify all items that are affected by the error and
carry out an immediate recall. Your facility should have a procedure for
recall that includes at minimum, notifying all users impacted and
documenting all actions in an adverse occurrence report.
Sterile Storage Room
CSSD requires multiple storage locations , one for storing sterile products
and another for storing clean ( unsterile ) supplies that are used in
production . For this module we will focus on the sterile storage room
where the items we released from the sterilizer room will be kept until
required or staged for later delivery.

Event Related Expiration


Event related sterility is defined as “items are considered sterile unless
the integrity of the packaging is compromised or damaged, regardless of
the sterilization date".
Events are the interactions that can cause a negative impact on sterile
products and occur from both storage and handling.
We identified the requirements for a safe sterile storage room above .
some additional considerations include:
reduced on hands to minimize contamination. Hand wash facilities should
be available but segregated to prevent splashing on sterile sets.
Correct handling - do not drag or push items against surfaces causing
friction or abrasion . This damages the packaging and compromises
sterility.
Correct Shelving - shelving should be of correct size and design to
hold items safely and ideally the top and bottoms shelves should be solid
or covered to reduce or prevent dust accumulation.
Walls - packs must be at least 5cm from walls and windows to reduce
condensation risks.
Floors - packs should be kept at least 25 -30cm above the floor to
prevent contamination from floor cleaning products , spills and
inadvertent touching.
Ceilings - there should be at least 45cm between the highest package
and the ceiling or fire sprinkler heads.
Removing items from a shelf - lift the front of the package underneath
with one hand , place the other hand midway under the package and lift
the whole item free from the shelf.
Minimal handling - this is a critical element as each time a package is
handled it is considered an event.
Food or drinks - never consume , store or transport food or drinks
through a sterile supply room.
Corrugated boxes - harbor moisture , mold , mildews , insects and
potentially contaminating micro - organisms . Do not use cardboard
boxes.
Don't force or stack on shelves - items when forced , stacked bent or
compressed can force contaminated air inside or cause ruptures to
closures and seams that me by difficult to detect.
Dropped items - jarring and compression from landing , forces dust and
airborne microorganisms into the package . Dirt from the floor can also be
carried onto the shelf and contaminate the next pack placed in that
position . Dropped items must be considered contaminated and removed
even if no damage is apparent.
Sunlight - items should not be exposed to direct sunlight and ideally not
located near windows.
Moisture - packages must not be stored near or under sinks , pipes ,
sewage lines drains or other items that could expose sets to moisture.
Ball pens - only validated markers should be used for writing on
packages as ink from pens may seep into packages and also physically
damage the surface.
Rubber bands - force or compress packages so should never be used for
sterile items.

Sterile Supply Expiration


Time Related Expiration
When referring to medical devices, time related sterility is defined as " a
package remains sterile until a specific expiration date is reached".

Time date
This method is particularly important for perishable items like food that
can spoil or grow dangerous levels of bacteria and relies on the ‘first in -
first out’ principle where items with the shortest expiration date are
always used first.
Quality Assurance Checks
We explored the events that can negatively impact sterile items but since
we can't watch items 24/7 we must carry out quality assurance
monitoring of our environment and safety checks each time we interact
with the sets.
Environmental Monitoring
Monitoring the environment ensures the conditions have been maintained
consistently and no events have occurred that could reduce package
integrity.
· Are you measuring temperature, humidity and room pressure regularly
and documenting the results?
· Is there a regular schedule of environmental cleaning and is this
documented?
· Are heating ventilation and air conditioning (HVAC) units serviced
regularly and documented ?
Safety Checks when Handling
Like the environment, we can never assume our colleagues have always
handled items correctly so we should always look for signs of events that
may impact sterility:
· Tears or abrasions?
· Tracks, or fuzzy or worn areas from dragging?
· Dents or punctures?
· Dirt?
· Moisture or evidence of moisture -like spotting?
· Sterilization label with date?
· Chemical indicator inside set or view pack?

Time Versus Event Related Sterility


In most parts of the world , both time and event related sterility are used
together to ensure safe items for patient use . In some countries there is
a shift to using only event related expiration with the idea that as long as
handing is minimal and environmental conditions are stable , then items
should never expire . If you are considering using only event related
sterility can you answer yes to the following questions?
1.Is your storage appropriate ?
2. Are you handling sets correctly ?
3. Are quality assurance checks carried out each time items are handled?
Case Cart System
In many hospitals, a Case Cart system is used for the preparation of
surgical procedures. This system uses a Pick List that lists all the specific
CSSD sets, consumables and equipment needed for an individual surgical
procedure. In most facilities that use this system, it is CSSD that "pick"
the case cart so this requires additional storage considerations for
consumables.

Consumable Inventory Management


For reusable items processed in CSSD we have a fixed number of items
and rely on a ' first in - first out' out method to ensure items are used on
a rotational basis Consumables are used and disposed of and require
replenishment systems to ensure they are a vailable when needed A lack
of consumables can pose a risk to patients . Consumables are also an
additional cost to a facility so it is important to maintain correct levels so
there isn't an overstock or risk of waste if items expire before use For this
mo dule we will focus on the top three management systems : periodic
automated replenishment ( PAR ) , exchange cart and requisition.
Periodic Automated Replenishment ( PAR ) or 2 bin - uses a
defined minimum and maximum level of supplies frequently with 2 bins so
that an order is placed when one bin is empty.
Exchange cart - a cart with determined levels is exchanged at a regular
interval with a new fully stocked cart This system is commonly used for
laundry or areas with high usage as it allows a cart to be filled in a central
location and simply exchanged with the deplete d cart.

Sterile Transportation
In module 4 we discussed how transport carts play a key role in
protecting us and the environment from contaminated items during
transportation . For sterile ite transport carts play an equally important
role but instea they protect the sterile items from us and the environment
as we move them through the hospital . The same principles for carts
apply:

Closed Cart
Ideally closed or at minimum covered , to protect sterile items from
contamination risk when travelling through public areas Closed carts also
reduce the chance of items falling out of the cart.
Correct Size and Weight
The cart should be an appropriate size with adequate shelves to hold the
items being collected without stacking , stuffing , or overfilling as this
counts as an event that can negatively impact sterility . The size must
also be appropriate so users have sa fe visibility when moving them
through corridors and be of an appropriate weight that allows them to be
moved in a controlled manner . Larger and heavier carts may need two
people to move safely.
Washable
This cart is used for sterile items but will be travelling outside sterile
areas so needs to be cleaned effectively before returning to use in CSSD .
The cart should ideally be compatible with a cart washer if available , or
be designed to facilitate effective manual cleaning and disinfection
between uses.
Servicing
The carts should be constructed from robust materials to withstand the
rigors of daily use . Doors , shelves and wheels must be maintained to
ensure safety and ease of use to the users transporting items in the
facility.
Handling
We discussed the key requirements for minimal handling to meet event
related sterility but for transportation we must also consider:
·Select the most appropriately sized cart for the collection process and
ensure it is functioning correctly.
· Bring any required documentation necessary to log items being
delivered .
· Perform hand hygiene before loading or unloading carts.
· Before transferring items , move the transport cart as close as possible
to the destination to reduce the distance you carry items and minimize
the risk of dropping them.
· Place heavier items on the middle or lower shelves and never on high
shelves to reduce the risk of dropping.

When travelling through the facility make sure you :


· Take care to follow correct hand hygiene to reduce the chance of
contaminating items in the cart .
· Do not leave sterile transport carts unattended particularly if they
cannot be locked as other staff or patients could open them and
compromise sterility of the items .
· When deliveries are complete , bring your cart back to CSSD for
decontamination .
· Empty carts should be processed through a cart washer if available or
manually cleaned and disinfected if not , as per local policy .

EVENT - RELATED STERILITY


Shelf life is related to events that may compromise the pack sterility.
Event-related sterility is the concept that sterile products remain sterile
until an event occurs to make them unsterile. The following list describes
events that may render a package unsterile. This list is not inclusive, as
there are many events that can compromise sterility.
Product Life
Some products and packaging material will degrade over time. Using
these items once they have expired is unsafe. As items begin to degrade
an event has occurred that can affect the items sterility.
Type of Packaging Material Utilized
Many packaging materials have a defined useful life. CS technicians must
be sure to follow the manufacturer's recommendations for shelf life before
and after sterilization as the products ability to perform appropriately is
diminished after the stated expi ration date. One of the events that could
occur after the expiration date is loss of microbial barrier protection of the
packaging. When this happens, items will not remain sterile.
Condition of Package
Package integrity is very important. Rough handling, poor storage
practices, moisture, dust and poor transportation procedures are some of
the events that can occur to damage a package. Once a package is
damaged, the items inside must be considered unsteri le.
Storage/Transportation Conditions
Clean, dry shelving in the storage area or in the transportation carts is
required to keep items sterile. Whether the shelving or carts are opened
or closed can affect item sterility. Open shelving allows for greater chance
of contamination from the enviro nment or personnel working in the area.
Temperature and humidity must be monitored, and ensuring the absence
of dust and insects helps maintain package integrity.

Handling
Lack of proper handling can cause items to become unsterile. Handling
items while they are still warm, over handling items and the hygiene of
the personnel handling the items are all considered events. All sterile
items should be monitored for events that may render them unsterile. If
any event occurs to jeopardize an item, the item in question must be
removed and processed or disposed of according to the facility's policy.
Whenever there is doubt regarding the sterility of a package, the item
should be con sidered unsterile.

CONCLUSION
Maintaining product sterility during storage and transport is one of the
most important Central Service job tasks. If unsterile instruments or
supplies are used, patients could acquire an infection. Carefully following
written storage and transport procedures, and keeping the area clean and
maintained will help keep patients safe.

Exercises and Checklists


Exercise 1 Explore your sterile storage room.
Check your log book for instructions and documentation.
Exercise 2 Complete the competency checklist.
Check your log book for instructions and documentation.

Module 12 SAFETY AND RISK MANAGEMENT

INDEX:
1. INTRODUCTION
2. RISK MANAGEMENT
3. COMMON WORKPLACE SAFETY HAZARDS
4. GENERAL PHYSICAL HAZARDS
5. AREA - SPECIFIC SAFETY CONCERNS
6. DISASTER PREPAREDNESS
7. EMPLOYEE ACCIDENTS AND INJURIES
8. PATIENT ACCIDENTS AND INJURIES
9. EMPLOYEE INFORMATION AND TRAINING
10. EMPLOYEE PREPAREDNESS
11. CONCLUSION
INTRODUCTION
It has been said that "safety is no accident," and that statement couldn't
be more true, especially for healthcare professionals who are responsible
for keeping patients, employees and visitors free from injury. Safety
requires ongoing education, safeguards, proper planning and the
combined implementation of safety systems to reduce risks, prevent
injury and save lives. The Central Service (CS) decontamination area is a
perfect example of how safety systems and due dilig ence is essential for
ensuring safety. Employees are educated in biohazard safety and must
follow specific regulations, such as those established by the Occupational
Safety and Health Administration (OSHA), to reduce the risk of injury.
This chapter will identify common risks found in the CS work areas and
discuss ways to minimize the risk of injury.
RISK MANAGEMENT
Risk management is a method used to assess the risks of a specific
activity and develop programs to reduce that risk. It also involves injury
prevention and claims management (the settlement, defense and
prevention of lawsuits). Healthcare facilities must effectively manage
injury prevention for patients and employees as part of a risk
management program. Various authorities, including The Joint
Commission (TJC), require that healthcare facilities develop and
implement procedures to ensure that they meet mi nimum safety
standards - prevent accidents and/or injuries, and ensure accurate
reporting and follow up to help prevent similar incidents. After a situation
is examined and hazards or unsafe practices have been discovered, risk
management personnel ensure t hat corrective actions are taken to
improve systems, behaviors and/or physical conditions to help prevent
employee and patient accidents and injuries. as well as the
manufacturer's Instructions for Use (IFU), standards and regulations, and
CS technicians support patient safety.
COMMON WORKPLACE SAFETY HAZARDS
All jobs involve some risks. The key to working safely in any work
environment is to understand those risks and take appropriate steps to
minimize them. CS technicians must understand potential hazards and
pay close attention in work areas within and somet imes outside of their
department. The belief that "an accident or injury will never happen to
me" creates a false sense of security that results in many injuries each
year. Following safety protocols and incorporating them into all work
practices is necessary for preventing injuries and accidents.
Central Service Occupational Hazards
In CS, there are three different types of occupational hazards: physical,
biological and chemical hazards. Some of those occupational hazards can
be present in all areas of the department. Other hazards may be confined
to a specific work area.
Physical safety hazards may be caused by the environment and the tasks
performed within that environment, Due to the nature of the tasks
performed, there are many potential physical hazards in the CS
department. Physical hazards may include: wet floors, cl uttered
walkways, heavy carts and sharp instruments. Fire is also a physical
safety concern. Biological safety hazards (infectious waste and blood
borne pathogens) can potentially be found in any area of the department.
Obviously, the decontamination area is the main area of concern for
biological hazards.
Chemical safety hazards may be found throughout the work area. For
example, solutions used in the decontamination area, sterilants used in
the sterilization area and some patient care products may pose chemical
hazards within the department. The following sections examine general
safety hazards and then outline specific safety hazards by work area. The
risk of injury from all of these hazards can be minimized by following
safety protocols.

GENERAL PHYSICAL HAZARDS


Ergonomic concerns
General physical hazards include those related to ergonomics, slips, falls,
electrical, safety and sharps. Ergonomics is the process of changing work
or working conditions to reduce physical stress. CS technicians are
exposed to many ergonomic stress facto rs, such as repetitive motion,
lifting and pushing. Ergonomic stressors that employees may encounter
include:
· Force -Heavy lifting or manipulating equipment or instrument sets.
· Repetition - Using the same motion, or series of motions, continually or
frequently.
· Awkward positions - Assuming positions that place stress on the body,
such as reaching or twisting while lifting.
· Vibration - Rapid oscillation of the body or a body part.
· Contact stress Continuous pressure between the body and a sharp
edge.
Exposure to these stressors can cause numerous problems, including
ligament sprains, joint and tendon inflammation, pinched nerves,
herniated spinal discs and other injuries.
Training can help employees to:
· Recognize the signs and symptoms of injuries, so they can respond to
them.
· Report potential problems.
· Recognize jobs/tasks that have ergonomic stressor.
Simple changes, such as stretching before work, shifting position,
learning and practicing good body mechanics and breaking up repetitive
activities can help employees reduce the risks of ergonomic injuries.
Proper lifting and pushing movements can also prevent injuries. When
loading and unloading carts from dumbwaiters or elevators, or receiving a
cart into the department, it is essential to check the weight on the cart
before attempting to move it.
Ensuring that the wheels are straight, and that they will roll over door
spaces or uneven edges is also important, as is unloading some items to
lighten the cart if it is too heavy to move easily.
Slip and Fall Concerns
Slips and falls are always a concern in the CS department. Mobile
equipment and ever -present wet floors increase fall risks. To reduce these
risks, mobile equipment should be parked away from common traffic
areas. Areas that often have wet floors, such as in the decontamination
area, around the cart wash exits, and washer unload areas, must be kept
as dry as possible, and spills should be wiped immediately. Non -slip
footwear should be worn and attention should be given to slippery floors.
Signage, such as the wet floor alerts people to the potential hazard.
Electrical Safety Concerns
Burns and shocks from electric equipment can result if safe handling
precautions are not observed. Carefully check all electrical cords to
ensure they are intact, with no breaks in the insulation. Electrical cords on
mobile equipment run a greater risk of being kinked or run over by rolling
carts which can make the equipment unsafe. All plugs on electrical
equipment must be three -pronged and grounded, and all electrical outlets
must accommodate these plugs. Inspecting electrical cords for breaks and
plugs for bent prongs is a responsibility of CS technicians. Identifying and
reporting a potential hazard during cleaning or delivery can prevent
injuries to patients and staff.
Sharps Concerns
Cuts and puncture injuries from sharps can happen in any area of the CS
department. Sharp instruments can break the skin's surface and produce
puncture wounds, lacerations and abrasions. If the injury occurs in the
decontamination area, these injuries can result in exposure to disease.
Some general precautions to prevent sharps injuries include:
· Handling all sharps with care.
· Not grasping several objects at the same time.
· Ensuring that sharp ends point away from any part of one's body during
transport.
· Placing all disposable sharps, such as needles and blades, in the
appropriate sharps container.

General Chemical Hazards


Although most chemicals used in CS are found in the decontamination
area, chemical hazards may be found in other areas of the department,
as well. Splashing chemicals is a common cause of eye injuries, so the
use of eye protection is required. Eye wash sta tions are also required in
areas where chemical injuries are a concern.
Hazardous Substance Concerns
Each state categorizes certain chemicals and substances as hazardous.
Each CS department should have an easily accessible, understandable,
and current list of all hazardous substances with which employees could
come in contact. Most facilities today have a comprehensive computerized
hazardous chemical list. If employees are required to perform known
hazardous tasks, it is important that they understand the safety
procedures developed for that task. Prior to performing such tasks,
employees must be given inf ormation about the hazards to which they
may be exposed. This information should include identification of specific
hazards, use of PPE, recommended safety measures and emergency
response procedures. Employers should take measures to minimize
hazards to em ployees. These could include increased area ventilation,
respirators, presence of other employees to assist, and the rehearsal of
emergency procedures.
Safety Data Sheets
An SDS (formerly called material safety data sheet - MSDS) contains
important information about product materials and properties that
employees must know to work safely with any given product. SDS are
developed and provided by the manufacturer of the product, and they are
specific for each product. SDS contain at least the following information:
· Product identification Product name, manufacturer's name, address and
telephone number, product item number (manufacturer's identification)
and synonym names.
· List of hazardous ingredients.
· Physical data - Vapor pressure, evaporation rate, solubility in water,
freezing and boiling points, specific gravity, acidity (pH), vapor density,
appearance and odor.
· Fire and explosion information - Flash point, flammable units,
extinguishing media, special firefighting procedures; and unusual fire and
explosion hazards.
· Reactivity data - Stability, incompatibility, hazardous decomposition
products and conditions contributing to hazardous polymerization.
· Health hazard data Effects of overexposure.
· Storage recommendations - Incompatible materials and storage
temperatures.
· Emergency and first -aid procedures.
· Spill or leak procedures, spill management and waste disposal methods.
· Protection information and control measures.
· Special precautions.
Employee Monitoring
To prevent potential health hazards to workers, OSHA has established
permissible exposure limits (PELS) for many chemicals used in sterilant
and disinfectant formulations. These include ethylene oxide (EtO),
hydrogen peroxide (H,O,), ozone (0,) and others. Glutaraldehyde is a
chemical commonly used in CS as a high -level disinfectant. The National
Institute for Occupational Safety and Health (NIOSH) recommends that
exposure to glutaraldehyde be under 0.2 parts per million (ppm) time
weighted average over an eight -hour work shift. The American
Conference of Governmental Industrial Hygienists (ACGIH) recommends a
ceiling value of 0.05 ppm, which should not be exceeded at any time.
Healthcare facilities are required by OSHA to:
· Provide adequate ventilation systems.
· Establish safe work operating procedures.
· Provide PPE.
· Implement other methods to ensure that occupational exposure limits
are not exceeded in the workplace.
Fire and Explosions
The presence of large volumes of combustible materials and flammable
substances poses unique risks. The large combustible loading created by
single -use items and their wrappings in storage and as trash is especially
dangerous. When these materials burn, la rge quantities of highly toxic
smoke are produced. Even with hospital compartmentalization features
that limit the spread of smoke and fire, a high -risk situation occurs,
therefore, healthcare fire safety programs must include:
· Minimization of the combustible load.
· Fire response plans.
· Early detection.
· Containment of the fire and combustible products.
· Extinguishment.
· Evacuation plans.
Fire Response Plan Every healthcare facility requires a comprehensive fire
response plan and each staff member in every department must know
his/her specific role in these plans. The fire safety emphasis should begin
at the time of new employee orientation and should continue with ongoing
training. Every healthcare facility is required to have and maintain
sprinkler systems, smoke detectors, fire extinguishers and audible alarms
to warn and protect staff and patients.
Workplace Violence
According to OSHA, approximately two million people are the victims of
workplace violence Each year. All employees should pay attention to
possible warning signs, and they should:
· Immediately report any direct threats of violence or retaliation to
management.
· Note behavior, statements or attitudes that are unusual, threatening or
disconcerting.

AREA - SPECIFIC SAFETY CONCERNS


There are safety concerns that are common in specific work areas within
the CS department. Must personnel notifying about the need for PPE in
the decontamination area.

Soiled Receiving and Decontamination Areas


Safety tips when working in soiled receiving and decontamination areas
include:
· Never reach into a basin or container holding contaminated objects,
unless the objects in the basin are clearly visible. Use a sponge forceps to
grasp the object or pour out any solution that prohibits visual
examination, and then remove objects from bas ins or containers one at a
time. Never use foaming detergents when handling contaminated
instruments in the decontamination sink, as the foam can prevent
visualization of sharp objects.
· Never reach into trash containers or sharps containers.
· Use extreme caution when disarming scalpel blades. Do not attempt to
do so without training. Never disarm by hand. Always use a needle holder
or tool specifically designed to remove blades .
· When processing reusable sharps, separate them from other
instruments and position them in a manner that protects anyone who
may handle them.
· Follow the manufacturer's recommendations for safe use of chemicals.
Always wear recommended PPE to protect all skin surfaces. and mucous
membranes from chemical burns.
· Follow the manufacturer's recommendations for safe operation of
cleaning and testing equipment.
· Use caution when walking, and inspect the floor for slippery surfaces.
Utilize mats and non -skid footwear.
· Sinks and other working surfaces should be at levels to afford easy
access, and to reduce back and arm strain.
Preparation and Sterilization Areas
Safety tips when working in preparation and sterilization areas include:
· Move sterilizer carts to low/no traffic or other designated areas, so co -
workers will be less likely to come in contact with hot carts.
· Use thermal insulated gloves when handling steam sterilizer carts,
washer baskets and other objects subjected to high temperatures.
· Keep sterilizer doors closed when not loading or unloading the chamber
to protect co - workers from coming in contact with the hot inner door.
· Use caution when using heat sealers. Keep away from heated
components. Be sure to follow the manufacturer's instructions.
· Be cautious when using a cutting edge to prepare paper/plastic packs.
· Be cautious when testing instruments for sharpness.
· When lifting instrument sets, use the larger muscles in legs and arms.
Hold the item as close to the body as possible without actually touching
the body.
· Follow procedures for using and disposing of biological indicators.
· Ensure that proper signs and labels are posted to warn of hot surfaces
or other hazard.

Supply Receiving, Breakout and Storage Areas


To ensure a safe and efficient supply receiving area, adequate storage
space and traffic access must be available. Supply storage and shelving
units must be secure and steady. Shelves should be arranged to facilitate
maximum space efficiency and allow empl oyees easy access to supplies.
Heavy materials and items used most frequently should be placed on
middle shelves to enable them to be easily and safely accessed by
employees. Lighter, infrequently - used items should be placed on higher
shelves.
Employees should use appropriate equipment (e.g., steps, stands and
ladders) to safely reach upper shelves. Climbing on shelves is not
acceptable. Procedures for the safe operation of dollies, hand trucks or
carts to handle bulk materials must be available , and employees must be
trained to consistently comply with them.
Closed trash containers should be available to properly dispose of
unwanted materials. Containers for the appropriate storage of hazardous
or flammable materials must be readily available to avoid exposure to
hazardous substances. Employees working in this area must also follow
proper procedures when disposing of and removing hazardous materials.
SDS must be available for reference where these substances are used.
DISASTER PREPAREDNESS
Disaster preparedness is an important component of the CS safety
system. Each facility has developed a comprehensive response plan for
internal and external disasters. An internal disaster is any situation with
the potential to cause harm or injury to the healthcare facility employees
or where the loss of utilities may drastically impact departmental
operations. Examples of internal disasters include a hazardous chemical
spill or leak, loss of power or failure of a utility, such as water, electricity
or ste am. An external disaster is a situation in which activities outside the
facility impact departmental or facility operations. Examples that may
necessitate activation of the external disaster plan include earthquakes,
floods, hurricanes or other events that result in large numbers of
seriously injured patients being sent to the facility. When an external
disaster occurs, theentire facility is placed on alert and personnel from
each department are expected to perform tasks, based on the situations
present.
Disaster Plans
Elements of a CS disaster plan typically include:
· An emergency call list outlining the lines of authority, and the key
individuals to be notified in specific types of disasters. Note: These may
differ for each type of disaster.
· Protocols for inventory replenishment and delivery of emergency
supplies. Usually, supply distribution department personnel are
responsible for the maintenance of supplies and, in times of disaster, will
deliver to an area for emergency patient care.
· Posted evacuation plans and practice drills for employees to ensure that
they know alternative ways to leave the department if their safety is at
risk.
Biological Disasters
Many healthcare facilities have added biological incidents to their disaster
plans. As with other types of disasters, CS technicians should know their
role. Close communication with the Infection Prevention department is
critical in this type of disaster.
CS departments should utilize appropriate resources, such as the Centers
for Disease Control and Prevention (CDC; www.cdc.gov) for up -to - date
information regarding emerging biological threats. Other resources, such
as the World Health Organization (WHO; w ww.who.org) can also provide
guidance. In all instances, coordination between Infection Prevention and
all areas impacted by the disaster is very important.

EMPLOYEE ACCIDENTS AND INJURIES


Even significant efforts to emphasize safety and accident prevention
cannot eliminate all employee accidents, and CS technicians can still be
injured on the job. If an injury occurs, it must be documented and
reported to the appropriate administrative pers onnel, in compliance with
OSHA regulations for healthcare facilities.
PATIENT ACCIDENTS AND INJURIES
CS professionals have responsibilities to help prevent patient injuries,
accidents and infections. They do so as they perform the important tasks
of decontaminating, inspecting, testing, assembling. packaging,
sterilizing, aseptic handling of sterile items , and delivering items
according to established procedures. When their job is done correctly, risk
to the patient is greatly reduced. When a patient incident occurs, it must
be promptly investigated and documented. Any practices or physical
conditions within the facility that can cause a patient injury must also be
investigated and reported. All healthcare workers must report unsafe
practices or hazards promptly to minimize accidents and prevent their
recurrence.
EMPLOYEE INFORMATION AND TRAINING
No safety and risk management system can be successful without
employee involvement. Each employee must understand their role and
responsibilities in maintaining a safe environment. This requires education
for all staff at all levels of experience , All ne w CS employees should
attend a health and safety orientation provided by the facility to become
familiar with hazards and safety practices throughout the facility. They
should also attend a department - specific orientation that focuses on, at
least, the following :
· An overview of the requirements contained in the hazard
communication regulations, including employees' rights under the
regulations.
· Notification of employees about any operations in their work area where
hazardous substances are present.
· Location and availability of written hazard communication program
information.
· Physical and health effects of any hazardous substances they may
encounter.
· Methods and observation techniques used to determine the presence or
release of hazardous substances in the work area.
· Strategies to lessen or prevent exposure to these hazardous substances
through safe control and work practices, and use of PPE.
· Steps the department has taken to lessen or prevent exposure to these
substances.
· Instructions on how to read labels and review SDS to obtain appropriate
hazard information.
· Emergency spill procedures.
· Disaster and fire plans, and the role of the Cs department in their
development and implementation.
EMPLOYEE PREPAREDNESS
An important factor in safety and risk management is employee
awareness and preparedness. Every employee should approach each shift
and each task with two questions in mind: "What can I do to ensure my
safety and the safety of those in the facility?" and " What do I need to
know to respond if I am faced with an emergency?" Some strategies to
help ensure emergency preparedness include:
· Be familiar with safety policies. Ask questions if specific information is
not understood.
· Be familiar with the chemicals used. Know how to handle them safely
and what to do in the event of an emergency.
· Know how to work safely around equipment. Understand the hazards
and know where emergency shut -off buttons are located.
· Be familiar with evacuation routes, the location of fire extinguishers and
fire alarm boxes. · Leave each area safe. Wipe up spills, prevent trip
hazards and do not cross contaminate.
· Maintain a safe environment at all times. Pay attention to detail. Report
anything that threatens the safety and well -being of those in the facility.
The success of any safety system is dependent upon the individuals who
work within that system. Creating and maintaining a culture of safety
reduces the risk for everyone.
CONCLUSION
Central Service technicians play an important role in every healthcare
facility's safety program. It is important to know the expectations and be
able to perform efficiently and calmly during any type of situation that
may arise. For the safety of patients , visitors, other employees and
departmental staff, training and safety drills must be taken seriously, as
should the adoption of safe work habits that help ensure preparedness for
any unplanned emergency.

Module 13 PERSONAL AND PROFESSIONAL


DEVELPOMENT

Index :
1. Introduction
2. Personal development : what is it
and why is it important?
3. Professional development : what is it
and why in it important?
4. Central Service Career Paths
5. Planning Your Career Goals
6. The Importance Of Resources
7. Professional Development activities
8. Understanding the interview
process
9. Personal and professional
development timelines
10. Conclusion
Introduction
Learning is a lifelong endeavor , and change is inevitable . Never have
these statements been truer than when applied to the field of Central
Service ( CS ) . CS professionals must be prepared to encounter growth
regularly , and sometimes profoundly , in their positions . Whether cs
professionals wish to stay in their department or seek advancement or
promotion , personal and professional development will enable them to be
proactive and more easily prepare for change . This chapter will highlight
some of the resources and strategies available to help CS professionals
grow and advance in their career.
Personal development : what is it and why is it important ?
In some ways , personal development is the first step toward professional
development . Personal development may be defined as any activity that
identifies and develops talent and personal potential , and improves
employability and enhances quality of life . Personal development can
help individuals develop personally rewarding goals.
Personal development is usually an individual endeavor - something a
person does on their own time , however , more employers are
recognizing the importance of investing in personal development .
Employers may offer educational programs as part of employee benefit
programs to help staff learn more about time management stress
management , teamwork , healthy lifestyles , competency development
and career development . Ultimately , these programs are a win - win for
both employees and the healthcare facility because personal development
can create a workplace that is happier , healthier and more fulfilling . This
environment can lead to greater productivity and quality in a department
, which helps the healthcare facility meet its strategic goals.

Strategies for Personal Development


How does personal development work ? There are four steps :
Step 1 : Identify your goal . What do you want to achieve ?
Step 2 : Identify the requirements for your goal . What will you need to
achieve the goal ? Step 3 : Identify your strengths and areas that need
improvement . What can you build on ? What do you need to improve ?
Step 4 : Create an action plan with a time line for meeting that goal .
How do you plan to move forward?

Personal development Activities that identify and develop talent


and personal potential , improve your employability and enhance
quality of life.
Professional development Commitment to continuous learning and
improvement ; taking responsibility for your own development.

Professional development : what is it and why in it important?


Professional development specifically refers to the skills and knowledge
attained for both personal and career advancement . It provides the
information and experience needed to progress in a career , stay
competitive with other job seekers and , ultimatel y , become more
employable.

Two Types of Professional Development


professional development can be divided into two categories:
Professional development to keep current in an existing job Growth is
inevitable in the field of CS , and some professional development is
mandatory . For example , changes in procedures , policies ,
instrumentation , products , and sterilization technolog ies , as well as
changes in regulations and standards , must be adapted by every
employee . Job growth in an effort to stay current is required of all CS
professionals.
Professional development to advance in one's career : Some CS
professionals have goals to advance and promotion . They participate in
activities to through position advancement improve their professional
competency , enhance tot out of their comfort zone to take on new
responsibilities and learn new things.

Central Service Career Paths


While most CS professionals choose to remain employed in a CS
department and become experts at their assigned duties, some seek
different career paths. Common career opportunities for CS professionals
include lead technician positions in the CS department, CS management
positions, OR core technicians, OR liaisons, CS department educator,
faculty positions in local community and technical colleges, consultant,
and vendor positions, such as sales representatives and on -site product/
service facilitators. Each career path has specific requirements. It is
advisable to research the needed requirements, and develop personal and
professional goals to move forward on a specific career path.

Planning Your Career Goals


Those professionals looking to make their career more personally
meaningful and rewarding, should establish goals and periodically review
them. This will identify activities and steps that will help meet those
objectives. As with personal development, profession al development
requires working toward identifying areas in a present position in need of
improvement, and then moving forward with set goals. In many ways, the
steps to take for professional development are similar to those one would
take for personal dev elopment, with a specific emphasis on developing
one's position and career advancement.
Strategies for Planning Career Goals
Step 1: Determine the goal for improving professional employability or
skills.
Step 2: Identify the requirements for the goal. What will be needed to
achieve it?
Step 3: Identify personal strengths and areas that need improvement.
Step 4: Create an action plan with a timeline for meeting that goal.

The Importance Of Resources


One of the most important factors in attaining goals is finding the right
resources to help provide direction and support. There are many
resources that can aid in professional development Educational resources
include publications , printed resources , co urses , conferences , online
information and other types of information designed to enhance
knowledge about a specific process or topic.
Developing professional resources within the field of CS can provide a
network with which to share information on issues pertinent to the
department . CS peers may have already faced similar situations and may
be able to share insights and information.
Do not underestimate the importance of developing a network outside of
one's current specialty . OR professionals , infection preventionists ,
safety officers and Biomedical engineers are a few of the healthcare
specialists that can help CS professionals i ncrease their knowledge about
specific aspects of the field – and the healthcare, in general.
There are several ways to build a network of resources . Becoming active
in a local professional group is a great place to start . If there is no group
in the area , contact local CS departments and explore the possibility of
starting one . The first step can be as simple as gathering some
interested individuals at a local business establishment.

Professional Development activities


There are also ways to enhance existing skills and develop new ones to
increase professional knowledge , develop professional behaviors and
attain more expertise. The schedule explores some ideas for professional
development activities .

Professional Development Skills Building


Desired Skill Skill building activities
Public speaking - Start with smaller presentations , such as
*Teaching reports and small in services . Work up larger
*Presentation presentations for larger groups.
*Speaking in larger Join a speaking development group. -
groups - Take a public speaking class.
Technical expertise - Pursue additional knowledge through
courses , certifications , job shadowing , self -
study.
- Participate in committees through your
facility of local and national professional
organization.
- Take steps to keep up with changes in
regulations , standards and technologies.
Writing skills - Practice writing and ask someone to review
what you have written for accuracy , clarity ,
grammar , spelling and punctuation.
- Take a writing class.
Team building skills - Start by examining your relationships and
role with your current team. What can you
improve?
- Move outside your comfort zone and work
with different teams for short projects.
- Read articles on team building.

Understanding the interview process


There are four basic steps in any type of interview :
Step 1 : It must be planned . Be sure you know the exact purpose of the
interview and the mechanics of it ( time , location and estimated
duration).
Step 2 : The opening conversation is helpful . Hopefully , there will be an
initial discussion of mutual topics of interest to move the discussion away
from ongoing work considerations to the specific topic . Professional CS
technicians should have the confidenc e , pride , expertise and positive
attitude to reduce tension and allow them to be confident during the
interview.
Step 3 : Questions will be asked . This is where the interviewee's
anticipation of potential questions and ability to effectively speak and
listen will be most useful . It is also where application of the speaking and
listening tactics outlined previously will b e most helpful.
Step 4 : The interview discussion can be reviewed . Hopefully , the
interviewer will provide a summary The CS technician should provide
reactions to this review , so both parties can agree on what was decided
and which , if any , follow - up activities should be undertaken.
There are two types of questions that interviewers are ask ?
* Open - ended questions that permit the interviewee to respond in an
unstructured manner . Examples may include :
What do you think the role of a CS technician should be? " *
* Give an example of a time when you communicated successfully with
another person even when that individual may not have agreed with your
point of view . "
* Closed - ended questions call for a brief response . Examples may
include:
, do you like your job? "
, do you understand the correct way to do this task? "

Personal and professional development timelines


Some personal and professional development goals are easier to attain
than others . Promotions usually don't happen overnight , but neither
does preparing for them . Personal and professional development
timelines should be realistic and achievable . Goals for each require
planning , commitment and an understanding that things don't always go
as planned. When setbacks occur , and they sometimes do , it is
essential to regroup and continue more toward established goals.

Conclusion
The field of Central Service is dynamic and ever - evolving, and it requires
professional and dynamic individuals to help lead the way in education,
systems development, and departmental management. Through personal
and professional development, CS technici ans can not only enhance the
skills necessary to improve upon their current positions, but they can also
create new opportunities for career fulfillment and growth.

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