Close enough isn’t good enough when it comes to sterilizing surgical instruments. That's why SPECT's program involves context specific classes on sterile processing that consider local conditions and resources. The week of classes include lectures, skill demonstrations, group activities and peer teaching.
Prior to SPECT's training program, an environmental survey of the sterile processing areas in local healthcare facilities are completed by SPECT personnel. Recommendations based on findings are provided to leadership and staff of the facility.
Following SPECT's training program, participants are supported in their work settings by visits from SPECT personnel. These visits include meetings with facility leadership to discuss and elicit support for planned changes and address potential barriers to implementation.
Barriers to performing effective sterile processing include a lack of knowledge related to products and equipment needed to clean and sterilize instruments. SPECT explores options for acquiring these resources in country and provides this information to local facilities. Supplies donated to SPECT are given to trainers for use in their training of others.
Fostering partnerships is key to the success of SPECT's work, as we endeavour to ensure all patients, regardless of where they live, have access to safe surgery. This is a global fight, and we make a bigger impact when we work together.
We’ve seen the less-than-ideal conditions that many resource-constrained healthcare facilities face. The participants motivation to improve conditions has inspired us to increase awareness of sterile processing challenges by conducting research and publishing findings on the impact of our training programs.
A mixed-methods research study was initiated in the Lake Zone areas of Northwestern Tanzania in the summer of 2018. The goal was to identify the impact of education and training on sterile processing practices at ten hospitals. Data on sterile processing practices prior to, during and after training and mentorship showed that improvement in test scores was directly related to sterile processing training. The greatest sterile processing practice changes identified through hospital assessments involved how instruments were cleaned, both at point of use and during the cleaning process, with rusted and discoloured instruments appearing as new again. Themes identified in participant interviews included: changes in practice, challenges in implementing practice changes, resource constraints, personal and professional growth, and increased motivation, confidence and responsibility.
Large gaps exist between instrument reprocessing practices in LMICs and recommended policies/procedures. Identified areas for improvement include instrument cleaning and decontamination, sterilization aspects of instrument reprocessing, and verification of sterilization. Education and training of staff responsible for reprocessing instruments and realistic, defined policies and procedures are critical, and lend themselves to improvement interventions.