SPD Staffing Shortages: Implications for Patient Safety and Outcomes

Sterile processing departments (SPDs) are an essential part of healthcare facilities' infection prevention measures, ensuring proper cleaning, disinfection, and sterilization of instruments. However, the critical role played by SPDs in patient safety can be overlooked, leading to issues with inadequate staffing. The impact of staffing shortages on SPDs can be severe, including burnout, lower productivity, and poor quality, ultimately compromising patient safety and outcomes.

The COVID-19 pandemic has exacerbated staffing shortages in healthcare, including SPDs. High staff turnover means existing employees have to work more shifts, which can lead to stress and burnout. Moreover, fewer staff members mean decreased productivity, which can result in increased instances of improper practices, such as immediate-use steam sterilization (IUSS) or shortened sterilization cycles.

In addition to these challenges, improper sterilization and disinfection practices can lead to healthcare-associated infections and outbreaks of multi-drug resistant organisms. Certification of sterile processing technicians is becoming increasingly important to ensure qualified staff performs the critical roles needed to keep up with the complexity of instruments and manufacturers' instructions. However, staff turnover makes it harder for employees to gain the knowledge and skills required for certification.

Robby Miller, BSHA, CRCST, CIS, CER, CHL, SPD Manager for CommonSpirit Health at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona, highlights the severity of the issue, stating that staffing shortages have the potential to cause procedural delays, processing inefficiencies, regulatory non-compliance, and a threat to patient safety.

To address these challenges, infection preventionists should understand the workflow and key steps during cleaning, disinfection, and sterilization, developing relationships with SPD departments to advocate for resources and link patient safety outcomes to staffing shortages. Process changes, such as acquiring instruments for the most frequent procedures and researching disposable instruments, can help decrease the need for IUSS. Additionally, SPD leaders can develop career ladders to show staff that their education and skills can build cross-training of SPD staff, ensuring they can perform all department tasks and understand how each step of the process impacts the department.

Without a strong, well-trained SPD staff, healthcare procedures and surgeries can come to a halt, hospital revenue can decrease, and patients are at risk for disease and pathogen transmission. It is crucial for infection preventionists to collaborate with SPD partners to address staffing shortages and overcome the challenges ahead.