29: The IFU Problem: Is Sterile Processing Information Becoming Unmanageable?

Sterile Processing's Hidden Patient Safety Risk: When Cognitive Overload Meets Complex Work Sterile processing professionals perform high-stakes work requiring sustained attention to detail, yet burnout, fatigue, interruptions, and cognitive overload receive far less attention in SPD than in many patient-facing areas of health care. Randalyn Harreld, CRCST, CIS, CER, CHL, CSPDT, CASSPT, CLS, AAS, FHSPA, clinical education manager for Steelco Belimed, wants that to change. “This particular topic, I think, is pertinent and is not something that we talk about enough,” Harreld told Infection Control Today® following her presentation at the Southern California Sterile Processing Association chapter meeting in Newport Beach, California. “Because we're such a labor-intensive and hardworking environment, I just felt like it's important to bring it up.” One major concern is interruption. “We say, and I say this all the time, ‘I'm a multitasker, and I can multitask.’ And really, there's a study that talks about how humans, we're not multitasking; we're task switching,” Harreld said. Consider an employee assembling an implant tray with 200 components. After counting 40, the technician is interrupted and later returns to the tray. “You forgot where you were,” Harreld said. “Now we're introducing rework.” But cognitive demands are only increasing. Harreld pointed to the rapidly evolving complexity of medical devices and the IFUs sterile processing professionals must follow. Some instructions she has encountered contain more than 100 steps, while formatting and organization vary considerably among manufacturers. “Just the complexity of the information that we are expected to know is getting harder, is getting faster, is getting more, bigger and longer,” Harreld said. “But how are we making it easier, and are we making it achievable to adhere to?” Harreld would like to see greater standardization of IFUs, comparing the concept with safety data sheets, where information appears in predictable sections. Meanwhile, facilities can address human factors now. Harreld suggested standardized workflows, protected safe zones, micro-rests, staff rotation, technology aids, checklists, better access to IFUs, and reinforced training. “If your staff is tired or burnt out, try to come up with some strategies,” she said. “Really support your team to make sure that they feel like they're getting the relief before you lose them and before you have an injury.”