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We’ve all been there, standing around in a little half circle trying to hear some twenty-something former frat guy explain to our sterile processing team how to follow his instrument’s instructions for use (IFUs) in the decontamination stage. Thirty seconds in and everyone realizes he doesn’t understand his own IFUs and we’d be better off trying to figure it all out by ourselves.
This kind of experience is not universal for every sales representative or every sterile processing department, but it happens often enough for it to become the cliché in our industry. How should leaders handle situations when the competence of the rep is in question and teams are still trying to figure out which way is up? The answer has to take into account department culture, training, industry standards, and human nature. Here are a few important concepts to keep in mind.
Reps are people, too
Lest I give the impression that every rep is a former frat boy, or even that frat boy should have a negative connotation to it, let me state the obvious: reps are people, too. And like all people, they can and do make mistakes. It is more likely for people to make mistakes when they are asked to do something that they have received little to no training in, or do very rarely as a part of their normal job functions. While there are some naturally gifted sales reps out there who enjoy teaching from IFU documents and have a good feel for a basic sterile processing workflow, those kinds of folks are often the exception to the rule. To make a living as a sales rep, you have to spend most of your time, and mental brainpower selling, which means by the time you hit the second shift huddle down in SPD, you’re probably exhausted from getting up at 5 a.m. that morning, after getting in at midnight the night before. Keep all of this in context when we cover the next few concepts.
Take it with a big grain of salt
Knowing all this about our sales rep partners, it is imperative that we build a culture and expectation among our team that we welcome rep-based education, but always take everything we hear with a big grain of salt. In other words, listen for insights, but verify everything with a more reliable external source (more on that in a moment). This does not mean that we are rude, dismissive, or ungrateful for the information we receive from our reps. In fact, astute reps will recognize the fact that you are double-checking them, which presents a fantastic opportunity for you and your team to turn the education tables on them, and help them understand the important information they are currently missing from their product/IFU communication with sterile processing teams. Any rep worth their salt will want to know when and where they are wrong, and seek to improve when they can.
Industry standards and what surveyors will expect
Let’s take a step back and ask the real question: “If we can’t believe the rep, who or what can we believe?” As alluded to above, many times the rep is sharing good, helpful information that will benefit your team in properly reprocessing the device or using the equipment in question. However, there is no industry standard that requires or advises sterile processing users to follow the advice or education presented verbally by a device sales rep. The gold standard and foundation for compliance is the manufacturer’s written instructions for use. When an accreditation surveyor shows up in your decontamination department and asks how long that Kerrison rongeur should be flushed under running water, they will not be looking for you to respond, “Well, Samantha from Zimmer told us last week it was supposed to be 30 seconds.” The expectation is that you will be able to reference specific documentation from the manufacturer which backs up your reprocessing practices. If you do not have that and can’t find it, nothing a rep ever told you really matters.
It’s natural to assume that someone who shows up at your department with a name tag and shirt logo that matches the name of the medical device you use will provide the best information available pertaining to that device. As many of us already know, that is simply not the case. These are not bad people who don’t care about the impact that misinformation can have on patient safety. For the vast majority of them, they simply don’t understand the complexity involved in reprocessing these devices at the volume that our departments handle, or the tight regulatory oversight our departments are under.
The ultimate responsibility for what goes on in our decontamination, prep and pack, and sterilization areas rests on our shoulders. Neither surveyors nor attorneys care what or what was not said by a particular vendor representative if the written instructions for that manufacturer were ignored. To ensure that your department is heading in the direction of compliance and consistency, education provided by sales reps should be seen as a complement to, not replacement of, written instructions for use. If there is ever a disagreement between what was said and what is written, the written word should win out each and every time.
While none of this is new, it is a good reminder for technicians looking for a source of truth amid the many questions that come up in our fast-paced departments. Yes, you can listen to the rep, but the IFU is the only thing you should trust with your patient and career.
Hank Balch is the Founder and President of Beyond Clean, the global leader in Sterile Processing education & networking. You can follow him on Linkedin at Hank Balch and find his Fighting Dirty video series on YouTube. Hank is an international thought leader and has written over 200 other Sterile Processing articles and commentary, along with published articles in Becker's Hospital Review, Infection Control Today, AAMI News, AAMI BI&T Journal, Outpatient Surgery Magazine, and contributions to Healthcare Purchasing News. Hank's CS/SPD team in Louisville, KY was named the "2016 CS/SPD Department of the Year" by HPN. He has also served as the founding President of the South Texas Association of Sterile Processing Services and President of the Kentuckiana IAHCSMM Chapter, in additional to being nominated for the 2017 President-Elect & 2018 President-Elect of the International Association of Healthcare Central Service Materiel Management, now HSPA.
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