In each of the countries we have worked in, medical staff responsible for decontamination and sterilization of surgical instruments have had no formal training in sterile processing of medical devices. Other than in a couple of the largest hospitals, staff performing these duties are primarily nurses who do this "on the side". These nurses are trained by predecessors and they in turn become the trainers for new staff.
SPECT provides training by internationally certified sterile processing technicians who conduct customized training sessions running anywhere from 20 to 40 hours of classroom instruction followed by individualized hands-on mentoring and further training at the workplaces of the trainees.
Classroom training sessions include the following topics: Introduction to Sterile Services, Microbiology, Infection Prevention and Control, Cleaning and Decontamination, Disinfection, Surgical Instrumentation, Sterile Packaging and Storage, and Sterilization.
Innovative Sterilization Method
In developed countries, medical devices are commonly sterilized with the use of autoclaves or steam sterilizers. These autoclaves are generally large, expensive, require consistent and adequate electricity, plumbing connections, distilled water, access to parts and knowledgeable staff to operate and repair them. Since one or more of these factors are not available where we work, many hospitals and clinics resort to sterilizing with the use of dry heat sterilizers (if they can afford them) or to boiling instruments in a pot of water. Dry heat sterilizers require much higher temperatures and longer sterilization times as compared to autoclaves and are also reliant on electricity.
Thanks to a grant from Grand Challenges Canada, SPECT has developed a low cost, low resource method of sterilizing that is efficient, low tech and not reliant on electricity. With the use of a pressure cooker, a specialized instrument basket and a variety of heating sources, hospitals and clinics can now sterilize their medical devices even during power failures or in rural clinics lacking electricity.
Sterilization Equipment Testing
In developed countries sterilizers are continuously tested to confirm that they are meeting required standards of sterilization. Observations and enquires at most hospitals and clinics we work with has revealed that calibration and equipment testing do not exist and that equipment is often old with dials, gauges and timers that no longer function. Subsequently staff have no way of verifying whether the equipment they are using is actually reaching sterilization temperatures or pressures.
With the use of chemical and biological indicators, we can conduct simple tests that will verify whether the conditions in each sterilizer reach the temperatures and times needed to sterilize. Based on the results, if failure occurs, we can provide recommendations and re-test the equipment.