CRITERION JANUARY 2008 The Official Newsletter of the CBSPD, Inc. VOLUME 13, ISSUE 1 A Message from the Executive Director By: Nancy Chobin, RN, AAS, ACSP, CSPDM Seasons Greeting to Everyone! The Board of Directors of the CBSPD hopes you enjoyed the holidays and will enjoy a Healthy and Happy New Year! As we look to 2008, the CBSPD is embarking on an exciting journey. After 1 ½ years of planning, the CBSPD will administer its inaugural exam for Certified Flexible Endoscope Reprocessor in February 2008. This is an exciting time and the CBSPD is proud of this additional certification program. The CBSPD also wishes to thank the endoscopy personnel who gave of their time to participate in the Flexible Endoscope Job Analysis Survey and subsequent item development. THE CERTIFICATION BOARD FOR STERILE PROCESSING & DISTRIBUTION, INC. (CBSPD) GRATEFULLY ACKNOWLEDGES OLYMPUS AMERICA INC. FOR THEIR SUPPORT, WHICH MADE THE FLEXIBLE ENDOSCOPE RE-PROCESSOR CERTIFICATION POSSIBLE. With this certification, the CBSPD will offer six (6) certification programs. In addition, the CBSPD, as the premier sterile processing certification program, is the only sterile processing certification accredited by the National Commission for Certifying Agencies, an accomplishment we are very proud of! During 2007, the CBSPD completed a full year of computer-based testing. We are proud of how smoothly this process was implemented and accepted by the candidates! The feedback was overwhelming positive and supportive! New cut scores for the technician, supervisor and manager exams were performed and implemented with the August 2007 exams. The cut scores revealed a dramatic increase in the knowledge required for these exams. In early 2008 the CBSPD Surgical Instrument Processor Job Analysis will be updated. The CBSPD is required to update the Job Analyses for its exams approximately every give years. The CBSPD exhibited at AORN (as it has for the past 15 years) and the ASHCSP meeting in St. Louis in September. That was when the ASHCSP announced its intention to merge with IAHCSMM. Both are membership organization and their merger does not impact on the CBSPD in anyway. Letters were mailed out to all CBSPD certified personnel confirming this information. In September I had the privilege of representing the CBSPD at the Colombia Central Service Association Annual Meeting in Cartegena, Colombia, South America. Over 800 Sterile Processing personnel attended. This was amazing to see; their enthusiasm and willingness to learn was inspiring! In August I traveled to Mexico City to facilitate the organization of a program to train the supervisors for the CBSPD Supervisor exam. To date, the CBSPD has provided international certification exams in over 14 countries world-wide. As the new year progresses, lets be thankful for our health, our jobs and profession. Continue to keep yourself educated on changes in the profession and continue to exhibit the professionalism that comes with the job of providing safe and sterile devices to patients. 3M/SPS Medical Scholarships The Board of Directors of the CBSPD want to congratulate everyone that was awarded scholarships in August and November from both 3M and SPS Medical. A list of all winners is posted on our website on the CS Scholarships page. As of this time, the 3M scholarships for the year 2008 are pending. Check out our downloads page on our website or call our office for updates in early 2008. SPS Medical will continue to offer their scholarships for all of the CBSPD exams. An SPS application can be obtained on our website or by calling SPS at 1-800-722-1529. ITEM REVIEW 2007 By: Sue McManus, RN, CEH, CSPDM Karen Swanson, LPN, CSPDM The Item Review Committee is a very important committee whose members are responsible for writing and approving all questions to be used on future exams. Currently, the committee co-chaired by Sue McManus and Karen Swanson, has nine members who represent each of the five certifications. Each committee member is required to submit 40 50 questions per year which are reviewed, revised and referenced at the annual committee meeting. The Committee met in July in Philadelphia, PA. A total of 190 new questions were added to the item banks during this meeting. These questions reflect the most current information of our profession. Nancy Chobin, Sue McManus and Karen Swanson have also been busy preparing the item bank of questions to be used on the first Certified Flexible Endoscope Processor exam which be given in February of 2008. We are grateful to all of the volunteers from the Endoscopy profession who are assisting us with the item writing. Also, throughout the year the co-chairs and volunteers from the Board of Directors have spent many hours reviewing and revising questions that already exist in the banks to assure the information remains accurate and up to date with the latest standards. Do you need CEU s? Anyone who is certified may write questions. (See the CBSPD CEU Protocols). It is not necessary to be a member of the committee. For every 10 (ten) test questions submitted and accepted by the Item Review Committee 2 contact hours will be awarded for a maximum of 15 points per re-certification period. Each question submitted must be Continued on Page 2 What s Inside Item Review 2007: Front Cover Continuing Education Report: Pg. 2 Technician Board Vote: Pg. 3 Pre-Approved In-service: Pg. 4 2008 Exam Dates: Back Page August/November 2007 Exam Stats: Back Page
Item Review Continued relative to the exam content outline, must specify which test it was written for, have current references and four possible answers with the correct answer identified. A certificate from the Item Review Committee will be sent once the questions are accepted. If you are interested, please contact Sue McManus or Karen Swanson for more information. 2008 CBSPD Board of Directors Executive Commissioners (Non-Voting) Nancy Chobin, R.N., CSPDT, CSIP, CSPDS, CSPDM, CASSPT Executive Director Teckla Ann Maresca, L.P.N., CSPDT, CSIP, CSPDS, CSPDM, CASSPT; Co-Chairperson, CEU Review Committee Nora Wikander, R.N., CSPDT, CSIP, CSPDS, CSPDM, CASSPT; Co-Chairperson, CEU Review Committee Bobby Osburn, CSPDM, Veteran s Affairs Representative Martha Young, CSPDT, International Liaison Representative M. Eleanor Reilly, R.N., CSPDM, Board Member Emeritus Margaret Ryan, R.N., CSPDM, Board Member Emeritus Sue McManus, R.N., CEH, CSPDT, CSIP, CSPDS, CSPDM, CASSPT; Test Development Committee Chairperson Liaison Karen Swanson, L.P.N., CSPDM; Test Development Committee Co-Chairperson Liaison CBSPD Voting Board Representatives Nyla "Skee" Japp, R.N., PhD, CSPDM, Manager Angela Joyner, CSPDS, Supervisor Vacant, Technician Jeanette Bakker, CSPDT, CSIP, Surgical Instrument Processor Jeanette Walch, CSPDT, CASSPT, Ambulatory Surgery Tech. Barbara Aldeman, CSPDT, Veteran s Affairs Technician Nancy Schlossberg, BSN, RN, CGRN, Interim GI Flexible Endoscope Re-processor Paul Letersky, B.A., J.D., Public Member Continuing Education (CEU) Column By: Teckla Maresca, L.P.N., CSPDM Nora Wikander, R.N., CSPDM We hope that the recent Holidays were Happy and Healthy and that the New Year brings many good things into each and everyone s life. 2008 is bringing some changes to our Continuing Education Protocols as recommended by the Board of Directors at the November Board meeting as well as suggested wording corrections by some of your colleagues. The first change is a clarification of which college courses are acceptable. The revised section on page 2 now reads: College Courses - will be awarded one (1) point per credit hour with completion of the course with a grade of 70 or better, to a maximum of 10 points per re-certification period. Proof of attendance and grade will be necessary at the time of recertification. Examples of approved courses are: Biology, Chemistry, Safety, Anatomy/Physiology, Microbiology, and Computers. Other courses should be submitted to the CBSPD for consideration. The course must be taken during the certificant s 5-year recertification period. Next there is additional wording regarding Employment which we hope will clear up some misinterpretation: Employment during a re-certification period For all levels the employment credits are awarded only if employed during the certification period. The Board also approved a request that Corporate inservices/programs be approved for a two (2) year period instead of requiring them to get re-approvals each year. As a reminder, please send in your request for approvals within six weeks of the in-service or program. The response will be sent to the address provided within six weeks of our receipt of the request. Some Continuing Education Facts approvals are provided in increments of 15 minutes, so even those quick reviews of instrument function, inspection etc. can be submitted. times are based on a 60 minute hour of educational information. breaks and meals are not included in the CEU approvals vendor exhibits are not awarded contact hours only education that pertains to the exam content outlines as determined by the job analysis done for each level will be awarded contact hours journal in-services that state they are pre-approved by the CBSPD do not have to be sent to the CEU committee follow the instructions given in your re-cert packet when using those pre-approved in-services. The Criterion has one pre-approved in-service per publication as well as the following professional journals they are available on line as well. The professional journals that provide pre-approved printed inservices are: Healthcare Purchasing News (HPN) 7650 So. Tamiami Trail Suite 10 Sarasota, FL. 34231 941-927-9345 ext 203 www.hpnonline.com Managing Infection Control PO Box 25310 Scottsdale, AZ. 85255 480-585-0455 www.managing-infectioncontrol.com We also want to remind you that you can earn CEU s by submitting questions to our Item Review Committee, preparing and presenting CS/SPD educational programs to groups (other than departmental in-services), having a paper or article on CS/SPD topics published, and chairing or serving on committees or holding office in a local, state and/or national level of a CS/SPD related healthcare professional organization. For more information on each of these opportunities you can download a copy of the Continuing Education Protocols from our website www.sterileprocessing.org or request a copy be sent to you by contacting the office 908-454-9555. If you have any questions for the CEU Committee please submit them to the office and we will be happy to answer them, and if we feel the answers would be helpful to others will include them in our next column. Remember: Start out the New Year by completing at least 1 (one) hour in-service a month you will have more than enough credits for your re-certification and will be able to keep up with the new trends and changes in our profession. 2 www.sterileprocessing.org
www.sterileprocessing.org 3 CBSPD BOARD VOTE The CBSPD is holding one vote at this time to elect a new TECHNICIAN member to our Board. You will find the ballot below with the nominees and some information about them. Please note, you must only vote for a candidate that represents your job title (i.e. if you re a Technician, you can only vote for those nominees.) Everyone here is CBSPD certified in the category they are nominated in. Adrienne Bell Adrienne hails from Pennsylvania and has been a Shift Coordinator in SPD at Lehigh Valley Hospital for several years. She has a great passion for the sterile processing profession and is considered a motivational person. She has attended many local and national conferences geared towards sterile processing and found them interesting and worthwhile. At this writing she is pursuing a position as an SPD Educator at her present employer. Her goals for this job include motivating more staff to become certified and making a push for certification to be recognized in her health network. Moreover, it is Adrienne s hopes that state certification will come to fruition in her state. Christen Smith Christen is from Michigan and works at the Henry Ford Hospital as a Technician. She has been employed at the hospital since 2003. Her Manager, Kenneth Warnock describes her as having a positive attitude and demonstrates consistent interest and professional growth. She is very familiar with the proper methods of decontamination, disinfection and sterilization. Christen is currently attending Wayne County Community College to pursue an Associates Degree in Applied Science in Nursing. She has been a CSPDT since October 16, 2006 and feels she would be suitable for the Board position and happy to be part of the CBSPD Board team. Cindy Buell Cindy is from Oregon and has been employed at Providence St. Vincent Hospital for 19 years in SPD. She currently holds four of the CBSPD s certifications: CSIP, CASSPT, CSPDS and CSPDT. In addition, she has served on the CBSPD s Ambulatory Surgery Technician Cut Score Workshop and the Item Review Committee since 2005. Cindy graduated from Portland Community College with 3 dental assistant certifications: Certified Dental Assistant- General Chair side and Radiation Health and Safety; Certificate of Radiological Proficiency; and Certified Expanded Function Dental Assistant. She describes herself as an organized, flexible person who is a team player. She has conducted departmental in-services and trained and given competencies for new employees in Sterilization and other areas. This makes her a very vital resource within the department. Cindy s Manager, Lisa Murphy feels she is a great candidate for the Technician Board representative position. OFFICIAL CBSPD BALLOT TECHNICIAN NOMINATIONS TO THE CBSPD BOARD OF DIRECTORS SELECT OR WRITE IN A NAME ~ TECHNICIAN ~ Adrienne Bell Christen Smith Cindy Buell (Write In) PLEASE NOTE: Only official CBSPD ballots will be accepted. ALL BALLOTS MUST BE RECEIVED IN THE CBSPD OFFICE BY MARCH 15, 2008. Mail to: CBSPD, 2 Industrial Park, Suite 3, Alpha, NJ 08865. Or Fax to: 1-908-454-9554.
PRE-APPROVED IN-SERVICE What Can You Do To Avoid Wet Packs In Your Steam Sterilizer? By: Sue McManus, RN, CEH, CSPDM Karen Swanson, LPN, CSPDM A wet pack can provide a mode of transportation for microorganisms to enter the pack and contaminate it. A pack is determined to be wet when you can detect dampness or see droplets on or within a tray, pack, peel pouch or basin set after the item has completed a steam sterilization cycle and has cooled for at least one hour at normal room temperature. Moisture found on the outside of the pack may be the result of condensation from the upper shelves of the sterilizer cart or condensation coming through the steam lines into the chamber. It can also be from metal items from the upper shelf dripping condensate on the packs on the lower shelves. If the moisture is found on the inside of the pack it may be the result of positioning the items in a way that they trap water or steam that later condenses to water. Failing to properly position items on the sterilizer cart is frequently a major cause of wet packs. Packs can be adequately prepared but improperly loaded on a sterilizer cart resulting in moisture remaining in the tray. Internal moisture can find it's way to the outside by wicking which provides a route for microorganisms to enter and contaminate the pack. Packs containing textiles could possibly be wrapped too tightly to allow adequate steam penetration and air removal resulting in the failure of the pack to adequately dry during a normal sterilization dry cycle. When preparing basin sets each basin should be separated from the one beneath it with a cotton surgical towel or similar wicking material. This will help the sterilant contact all surfaces. It also aids in the removal of air and drying between the basins. The wrapper should be of the correct size for the set. A wrapper that is too large could possibly cause drying problems because of the additional layers created by the multiple folds. The set, when completed, should not weigh more than seven pounds. When preparing instrument sets, use a mesh bottom tray that will allow the instruments to be completely opened, unlocked, and/or disassembled and spread evenly within the tray. Generally, it is allowable to make two layers, the heavy instruments on the www.sterileprocessing.org bottom and the lighter or more delicate ones on the top. It is advisable to separate these two layers with a cotton surgical towel. A fully opened cotton towel or other types of absorbent liners can also be used in the bottom of the tray to facilitate drying. Keep in mind though, weight and density of a set has an effect on drying also. If you are experiencing wet packs you may need to rearrange the contents or actually separate larger sets into smaller sets. Some of the multi tiered sets also present a challenge for drying. Sometimes these sets need to have each tier wrapped separately if all other factors have been eliminated. Some heavy metal instruments should be wrapped separately in a cotton surgical towel to absorb moisture and allow for drying. Special instruments may require a different arrangement. Always consult the manufacturer for their recommendations. Always remember to follow the manufacturers instructions for set arrangement when using rigid sterilization containers. Not all manufacturers have validated their containers with towels or other absorbent materials inside. Rigid container manufacturers should provide the user with information on how to load and process their containers. Some may require extended sterilization and drying times. Some can be stacked and some can't, others may require a specific arrangement for their sterilization process. When loading the steam sterilizer, solid bottom trays, mayo trays and basin sets should be positioned on edge, top side forward toward the drain so that air will not be trapped and condensation can drain out of the sets. These sets should be placed on the bottom shelf if you are processing a combined load of textiles and metal. Wrapped mesh bottomed instrument trays should be placed flat on the shelf to maintain even distribution. Paper plastic pouches should be placed standing on edge, with plastic side of one facing the paper side of the other. Textile packs are positioned with the folds vertical in relationship to the cart. An absorbent shelf cover on the sterilizer cart may be used, this will aid in absorbing moisture and drying the load. The shelf cover will absorb moisture that could possibly drip onto the shelf below. Packs/instruments that go in wet may also be wet at the end of the cycle. The shelves should not be over loaded or the items tightly compressed. There should be significant space to allow sterilant contact, air removal and drying without the items touching the walls of the chamber. Preconditioning may also be helpful in avoiding wet packs. This is accomplished by positioning the sterilizer cart inside the sterilizer and closing the door. Allow the cart to warm up to the temperature of the chamber, (about 15 minutes) prior to starting the cycle. When unloading the sterilizer, remove the cart and position it where the contents are not exposed to air ducts or air condition vents. Do not touch the items until they are cool. Visually inspect for dryness. Visible moisture renders the tray unacceptable cannot be used. AAMI and AORN make specific recommendations regarding wet packs, both support the practice of not using the tray if moisture is detected. Remove the items from the cart when the load has reached room temperature, 68-73 degrees F. This may take up to an hour. If you must remove hot items from the sterilizer cart shelf, use sterile gloves and sterile towels for pot holders, you must not touch the trays/packs and they should not be placed on a cold surface. Sterility is most easily compromised during this cool down period. After the items have cooled, carefully lift wrapped packages when removing them from the sterilizer shelf. Never push, pull or drag them. Continued on Page 6 **Key to In-service Quiz:** 1:B, 2:C, 3:C, 4:D, 5:A, 6:A, 7:B, 8:B, 9:A, 10:A 4
CBSPD In-service Continued 6 Routine sterilizer maintenance is extremely important in helping to avoid wet packs. The sterilizer and carts should be cleaned weekly and the drain checked for debris on every shift to avoid clogged drain lines. POST-TEST What Can You Do To Avoid Wet Packs In Your Steam Sterilizer? This Pre-Approved In-service is worth 1 CEU with a Passing score of 70. Your manager must generate a certificate or letter of completion on facility letterhead with your name, signature of your manager, date of test, title of test, and name of journal (Criterion). You will keep this with your re-certification records. DO NOT SEND THIS TEST TO THE CBSPD OFFICE. 1. Which of the following is most negatively affected by the sterilization cycle when wrapped too tight A. Basin Set B. Textile Pack C. Weighted speculum inside a rigid container D. Double wrapped orthopedic set. 2. Internal moisture can find it's way to the out side of the pack by A. osmosis B. evaporation C. wicking D. condensation 3. If a tray of instruments is determined to be wet, which of the following is the first thing to check in determining the cause? A. Weight of the tray B. Number of instruments on the tray C. The tray's position on the sterilizer cart D. The time of day the load was processed 4. Which of the following is most likely to contaminate packs that are wet? A. dust B. mites C. sterilizer cart D. Microorganisms 5. How long should a sterilizer cart of instruments stay outside the sterilizer before checking for dampness? A. one hour B. forty five minutes C. thirty minutes D. fifteen minutes 6. Wet packs represent one of the greatest problems in A. sterility maintenance B. aging sterilizers C. unloading the sterilizer D. water quality 7. If an item is determined to be wet inside a rigid container, AAMI and AORN recommend that A. the tray be used as is B. the tray not be used C. the wet items be removed and the dry ones used D. flash all the items using the rigid container prior to placing it on the sterile field 8. A clogged drain line on a steam sterilizer can A. flood the department B. contribute to wet packs C. explode peel pouches D. alter the sterilization time 9. Preconditioning is done to A. heat the instruments and reduce condensate B. heat the instruments and increase moisture C. allow steam to penetrate quickly D. decrease the drying time 10. To facilitate steam penetration and air removal textile packs should be arranged on the sterilizer cart A. with the folds vertical in relation to the cart B. with the folds horizontal in relation to the cart C. tightly packed with the label toward the drain D. tightly packed and turned on their side April/May/June 2007 CBSPD Re-certification Stats (Passing names listed on our website) October 2007 not available at this time but will be posted on our website and in next Criterion. Manager: Total Eligible = 6; Total Re-certified = 1 (17%) Supervisor: Total Eligible = 20; Total Re-certified = 2 (10%) Technician: Total Eligible = 927; Total Re-certified = 290 (31%) **Reminder to All Upcoming April Re-certs** Why retake the exam when after working full time for 5 years, you only need 10 points of education per year to re-certify (except for Supervisors/Managers)? If you were originally certified on 4/24/93, 4/25/98 or 4/26/03, you are due for recertification in April 2008. Please have your completed recertification packet with payment of $100 into the CBSPD office no later than 10/31/07. The CBSPD mails out re-certification packets 6 months before you are due to expire. If you have not received your packet yet, please contact our office or print one out from our downloads page at www.sterileprocessing.org. www.sterileprocessing.org
Back Page Upcoming Certification Exam Windows in 2008 (within the U.S.) Exam Window 1 FEBRUARY 4-9, 2008 Exam Window 2 MAY 5-10, 2008 Exam Window 3 AUGUST 4-9, 2008 Exam Window 4 NOVEMBER 3-8, 2008 August & November 2007 CBSPD Certification Exam Stats (Passing names listed on our website) Technician: Total Sat for Exam = 1,081; Total Passed = 429 (40%); Total Failed = 652 (60%) Manager: Total Sat for Exam = 27; Total Passed = 8 (30%); Total Failed = 19 (70%) Supervisor: Total Sat for Exam = 41; Total Passed = 16 (39%); Total Failed = 25 (61%) Instrument Processor: Total Sat for Exam = 88; Total Passed = 13 (15%); Total Failed = 75 (85%) Ambulatory Surgery: Total Sat for Exam = 26; Total Passed = 18 (69%); Total Failed = 8 (31%) Sterile Processing University, LLC... NEED CONTINUING EDUCATION POINTS? NEED TO GET UPDATED IN STERILE PROCESSING? WANT TO LEARN ABOUT STERILE PROCESSING BUT THERE IS NO SCHOOL NEARBY OR YOU DO NOT HAVE TIME TO ATTEND SCHOOL? The on-line Basics of Sterile Processing course is being completely updated for 2008 with more information and modules. NOW AVAILABLE The new, expanded SECOND Edition of The Basics of Sterile Processing. The textbook has been updated with 29 more photos, more charts and an additional section on table-top sterilizers for Ambulatory Surgery Centers. Get your copy now! Visit: www.spdceus.com for all your sterile processing education needs. Quality education at affordable prices!