My Reflections Working with SPECT

When I started working with SPECT as a research assistant in Tanzania, I was given the opportunity to challenge myself and expand my knowledge into many new areas. Professionally and personally my experience is with environmental issues, as I have my Bachelor of Environmental Studies, so it was interesting for me to learn more about the healthcare sector. Since my time with SPECT I have become increasingly interested in healthcare, particularly because I had such a wonderful learning experience. Over the course of the summer, my primary duties were to help with translating between English and Swahili and assist SPECT facilitators with training activities for both the Fundamentals of Sterile Processing course and the Training of Trainers course.

During our time in Tanzania, SPECT has made a significant impact on the ten hospitals that we worked with in the Mara and Kagera Regions. One nurse told me: “Staff members are happy with the visible results and changes that have been made since the training”.

As I was visiting the hospitals, prior to assisting with training sessions, I observed many sterile processing practices that I learnt were putting staff at risk of causing infections to patients and themselves. A few of the situations and stories I found most interesting, which I’d like to share with you are as follows:

• Often, staff would store food and sometimes take tea in the sterilization room. Most rooms were not well organized since sterilization staff did not have the training to know that poor organization increased the risk of infection. I also found sterilization staff did not realize how important their positions were in the hospital.
• Big brushes that would be used to clean floors, walls or clothes were used to clean instruments.
• Clothes used to wrap instruments had lint and holes in them. The lint would stick on the instruments during sterilization and the holes allowed microbes to contaminate the sterilized instruments before use. Gauze was also used to tie wrappers, increasing the potential of contaminating the instruments.

• Instruments looked clean on the outside but had rust on the box locks and serrations. There were also many instruments that were not functioning.  
• There was no one way flow of instruments, increasing risk of cross contamination and infection.
• The sterilizer chambers and the rooms (walls and floors) were seldom cleaned.

After assisting SPECT with their sterile processing training, I visited the hospitals again for follow up assessments. I was impressed by the changes that had been made by staff.  One nurse told me “Instruments appeared clean, shiny and attractive compared to the previous; even the doctors and other staff members are impressed”. Other changes that I’m pleased to share include:

• Some hospitals had stopped using Chlorine to wash instruments and were using just water and soap and had also trained other staff working in the operating theater.
• Sterilization staff were using smaller brushes (like toothbrushes) to wash instruments and big brushes were now used to wash clothes, walls and floors.
• Instrument packages were neatly tied for sterilization and storage.
• Sterilization staff were now following processes learned in SPECT training, cleaning decontaminating, sterilizing and storing instruments in an organized fashion.

During my time with SPECT, I was able to witness significant changes this training program had on hospital staff. Firstly, the training reminded staff that their jobs are important. The course emphasized the importance of sterile processing and this helped to communicate the importance of the staff’s role in this process. Secondly, it renewed their sense of fulfillment in their positions. I noticed staff worked hard to initiate these changes during our follow up assessments and were proud of what they accomplished. Lastly, I was able to recognize a shift in mindset focused on keeping patients and staff safe. It was apparent that hospital staff looked favorably on their training and were ready and willing to make changes to positively impact the safety of patients, themselves and other staff members.

Theresia Maduka
SPECT Research Assistant

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