The Role of a Sterile Processing Nursing Manager with the Nursing Process
As a nurse entering the sterile processing department (SPD), you might feel overwhelmed due to a lack of preparation for the role. That can increase employee disagreements, decrease department productivity, and increase employee turnover. When entering the world of sterile processing, be humble and ready to learn from employees with specialized skills. In the process, take your knowledge of nursing and apply it to this specialty.
A sterilization nurse manager is a unique position among the many a nurse can choose. A lack of direct patient care in SPD doesn’t equal easy, noncritical to patient care, or not valuable in the overall patient care plan. The SPD is an indirect preventative patient care role. It is a critical department in the prevention and reduction of healthcare acquired infections (HAIs).
You might ask, “How does my nursing knowledge bring value to the sterilization role?” As a nurse, you are trained that the quality-of-care management of the patient has a direct impact on patient health and wellness. Nurses achieve this with assessment, diagnosis, planning, implementation, and evaluation (ADPIE). This is the nursing process; it is the basis of nursing care and is used in every specialty of nursing, including sterilization.
The nursing process uses ADPIE for a big-picture approach to health and wellness. ADPIE is a project management framework that includes, in order, the prerequisites needed, the breakdown of work structure, a risk analysis, and a desired-outcome review. Think of ADPIE as the plan for building a house: You can’t start with the roof. Instead, you need to gather your supplies and tools, find workers with the right talents, etc.
Implementing ADPIE in any specialty ensures the ability to meet the needs of the organization/patient with decision making and business management. It separates personal and social values with objective (measurable) goals compared to subjective (viewpoint) goals. In nursing, it decreases personal influences and increases logical and objective decisions, using critical thinking for problem solving and organizing decisions into interventions based on scientific reasoning and standards.
The nursing process delivers individualized care/goals that respond to needs in a systematic and timely manner. This ultimately allows the manager to prioritize maintenance while working to increase the client’s health/productivity. Let’s apply ADPIE to sterile processing.
When approaching a project or situation, assessment is required to define the problem and desired outcomes or goals. During assessment, consider the work and the return on investment for the time. As when working directly with patients, communicate clearly and transparently. Address barriers with facts. A strong leader creates confidence by being transparent with information.
Diagnosis is looking at the human impact of conditions or processes and at what level the impact occurs. Is the impact only within the individual department, the surgical services family, or the healthcare facility community? You define the diagnosis by manifestations—signs and symptoms of the problem. For example, the department just purchased new instruments, but they are becoming discolored. The staining, rust, and tightness of the box lock are all manifestations of the problem. Causes might be changes in detergent, water pH, or equipment impacting the instrument quality.
Manifestations that form a pattern can lead to a diagnosis label. Labeling the problem adds clarity and differentiates it from similar issues. What related factors contribute to or influence the health status of the clients? Think of the SPD as the human body: Does the diagnosis include compromised oxygen transport and circulation? In other words, does it impact the availability of the surgical team? Or does it put a critical one-of-a-kind instrument out of circulation?
Related factors include pathophysiologic, biologic, and psychological, like denial of obvious problems, projection of blame/responsibility, and rationalizing failures. Can the issue be treatment-related (chemicals), situational (change of seasons impacting water quality), or maturational (is the equipment old)? To complete the diagnosis, what level of risk is involved? This helps with prioritizing.
Planning is the formulation of goals and outcomes personalized to the unique needs of the individual (department, surgical services, or healthcare facility). The goals are broken down into components needed to deliver the desired outcome. This requires communication with workers and stakeholders, discussing the barriers identified and determining if reallocation of funds or resources is needed to meet and support the end goal.
Communication provides an opportunity for stakeholders to identify if something does not align with the organization’s strategic goals. The work plan is like the care plan of a patient: it identifies all tools, resources, and distinct talents needed to complete the project within the defined scope and budget .
Execute the plan by implementing the interventions outlined during planning. Each moving part includes the people, timeline, and budget that require supervision. A critical component of success is the buy-in of the workers and management team. Like direct patient care, if the patient refuses to participate, the goal cannot be met.
While planning, don’t make assumptions they are detrimental. Always follow up to ensure progress toward the ultimate goal. Be ready to advocate for the consumer, provider, department team, or any combination of those. It is the department manager’s responsibility to maintain cultural values during implementation. Cooperation occurs when department workers feel supported and protected. A sense of belonging occurs when these factors are met during implementation.
Has the desired outcome been met or is continuous reassessment needed? Evaluation reviews the goals vs. the outcome. Completion doesn’t equal success. This is the time to meet with the stakeholders and the team to review the original intent vs. time/budget. Evaluation of the care plan/project is an opportunity to grow your skills as a sterile processing department manager. As with direct patient care, you address one thing and another issue pops up, so you begin the nursing process again to address the next challenge.
The SPD is indirect patient care that affects the clinician’s ability to directly care for the patient, impacting patient outcomes. The SPD nurse manager takes a proactive approach to patient care by influencing infection control and reducing HAIs. You are a nurse, be the nurse—be humble and recognize that your team members are educated specialists as sterile processing technologists. Don’t demean them; work with them, advocate for them, and work together with each other’s unique skills and education to advance the SPD. Take this nursing sterilization management opportunity to advocate for the SPD team and the essential work of the SPD as another nursing specialty critical to the healthcare system.