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Sterile Processing Technician–Donna Reich

Hi my name is Donna. I’m a sterile processing technician here at Southwest Washington Medical Center. I began working here about 3 months ago. So I’m still technically in training. I really like it here. There’s something different every day. Sterile processing is the main part of the hospital. Without sterile processing, the hospital would cease to exist. This is a very important part of the overall picture. There are so many different aspects to sterile processing. I might be putting up instrument pans one day, the next day I might be sterilizing, I might be working in decontamination. Each day is different. So it doesn’t get boring. This is my fashion statement. I have blue boots. This is called PPE – personal protective equipment. This is to prevent any fluids from passing through – any bio-hazard splashes. This is in decontamination.

Where the instruments come down from surgery. My job is to wash, rinse and clean everything, to make sure there’s no hidden debris in the instruments that can harm the patient. And they go through the washer. This is actually the most important step, because if there’s any material that’s left on the instruments, sterilizing is really not as effective. There are items with blood. So if anyone is squeamish, this is another consideration for anyone thinking going into this. You’re dealing a lot with bodily fluid, blood, bone, tissue, any bio-hazard material. This is the disinfectant for some of the items that can’t go through the washer. I’m putting these up so they’ll go through the washer this way. When they go through the washer, the water will wash…. This looks pretty clean, but we still have to check everything. This is with one particular case. The doctor might have 15 pans of instruments.

When they come through here and through the washer, they may get separated. So we try to keep all of the cases together. So I’m putting these numbers in each basket, so the person on the other side will know if they’re missing a particular instrument, it might be in one of these other pans. There’s nothing worse than searching for and instrument and have it missing. This case cart is empty. I’m checking everything to make sure there are no instruments left. This is ready to go into the cart washer. This is where the instruments come out of the washer from the dirty side. They come through the washer and they’re clean. I’m waiting for these instruments to cool off before bringing them over there. It’s hot.

Today I’m scheduled to put up instruments. These are the instruments that come out of the washer. The technician upstairs, assisting will do his instrument count. And put everything back into the tray. Once it comes through the washer, I’ll bring it over here and reassemble the instruments to go back into the tray. And then into the pans to be sterilized. This is the count sheet for the particular pan. And what I’m doing is matching the count sheet and putting the instruments into the particular pan. And when I’m finished I’ll click my count sheet off in the computer – print a sheet.

And then these we’ll put up in the pan to be sterilized to go upstairs to surgery. Some may only have a little as two instruments. Some may have as many as 50 or 60 instruments. The people who have been have been here for a long time, can put this set-up just from memory and click off everything. I’m not quite there yet. This is used for stapling. I’m going to make sure there are no small staples left in here. So I check each instrument before putting it into the container. Sometimes there might be some tissue left in there and it has to go back to “decontam” to get clean again. If I don’t have a particular instrument to put in my pan and I need something that’s missing, I’ll look over on this wall. It’s nice for me being new, everything is labeled.

That helps a lot, if not familiar with a particular instrument, I can look up here. There are also instruments in the drawers. That was the most challenging thing here -getting to know the instruments. And I’m still learning. OK, I’ve finished my pan. I’m going to print a sheet. These go in here. Again I’m taking the chemical indicator, so they can tell this was sterilized. If I forgot you put this in here, they would have to take the whole pan apart and send it back down here.

It would not be eligible for surgery. Now my search – I’m going to look for a mini lab pin 5 over here and match this with the genesis pan. I’m happy, it’s right on top. These are filters. This is steam heat and these filters are in place because of the steam and the moisture. We wouldn’t want any micro-organisms to wick in, so it’s just another way of keeping bad germs out.

Every step along the way, I’m logged into this particular computer, so they know who put the pan up. If there’s an error, they know where to come. I’m also putting my initials on here. They know the pan has been put up by me. This is an arrow to lock it. Again, if there isn’t an arrow on here, they can’t use it in surgery. OK, I’ll check my arrow, check my name-tag on this side – check everything over here. This particular paperwork goes with the pan. Now I’m taking this over to the sterilizer. Now I’m going to peal-pack a single item. There are two ways of processing instruments.

There are the instrument trays and then the peal-pack. This is real slick. So let’s see, I’ll do a knife handle. This is actually and extra instrument. One particular doctor may want extra instrument. So you never know what you’re going to get when the sets come down. They want it pretty. Actually it’s so they can grasp the outside. Put on my knife handle label. Again sign my initials. Everything that we do here has to be signed, so they know who did this.

And that’s ready. I was putting the instruments together, yesterday, inside the Genesis pans to be sterilized. The instruments were ready to go. They were clean, but they were not sterile. Now we’re at the next step. This is one of my favorite stations. These are the sterilizers that the instruments go into. Sterilizing is technically the absence of all forms of any microbial organisms – any spores and viruses. In order for the instruments to be sterilized, the instruments must have steam under pressure for a certain time at a particular temperature. And when the parameters are met, the steam is removed, the items removed, cooled completely before handling. Documentation is the most important part of sterilizing, because records can be subpoenaed in court.

Every single item that goes into the sterilizer has a particular number on it, so it can be traced if it needs to be recalled. It has the date as well as the particular load – the sterilizer that it’s going into. These are wrapped items. These are the genesis pans. The wrapped items and any lighter items need to be on the top shelf, because the heavier items have more moisture. So the genesis pans cannot be over the wrapped items. So it’s very important to load it properly. So they can be sterilized properly. It’s important that the items aren’t touching, because the steam has to… inside the sterilizer has to saturate everything. And it can’t get to all of the surfaces, if it’s touching.

Next I’ll do the peal-pack items. I call this my Taco Bell holder. These are some of the items that are put up in the peal-pack. These have to go on top. I’m going to sign my initials on each pan to make sure that I can certify that it’s locked – that is has it’s locker on it. The person who put this pan up has signed their initials. Otherwise, it wouldn’t be suitable for surgery. This particular pan has implantable items in it. That means the items are going to go actually inside the patient. So I need a biological indicator package. That has a little vial in it with the live spores. So it has to be going into the sterilizer.

And when the spores are killed we know that the sterilizer has done its job properly and it’s met all of the parameters. This is a biological indicator that just went through the sterilizer. It’s a little vial. It contains live spores – it did contain live spores. Hopefully the sterilizer killed them. I documented that I put it into the incubator. it takes 3 hours for it to be incubated – to know if the spores have all died.

I’m going to take my scanner and I’m going to scan this load into the second sterilizer. This way the computer knows where all the instruments are in this hospital. These particular instruments are going to go into the sterilizer. Then when they come out I’ll scan them into the storage. And from storage, they will be scanned upstairs when they go into surgery. The other part of my job is putting away the instruments that have cooled. Once they’ve cooled off I can touch them. If I try to handle them when they’re too warm, moisture wicks in. Another aspect of the job is you get a lot of exercise – walking. There’s variety every single day. There’s a lot of interaction too with the other employees.

Everyone tries to make the time go by fast. There’s a lot of joking around. And I have great co-workers. And actually, I like this hospital. I would consider it one of the highest standards. And at the end of the day I feel good. It’s a nice feeling to be able to be helping people. I enjoy being here and putting the instruments up to be used in surgery. And everyone has an important job all the way from the doctors all the way down to processing. And so I really feel good about what I do. .

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