Tackling problem of non-sterile equipment

A hospital's central sterile supply department provides sterile instruments and supplies used in patient care.

The process is complex and requires close coordination between the central sterile supply department, other hospital departments and even external vendors (Some dental patients treated with not fully sterilised tools; Dec 11).

It is further complicated by a shortage in experienced central sterile supply department staff, with new technicians typically requiring at least six months of closely supervised on-the-job training.

Despite the critical nature of this work and the complexity involved, it is remarkable how little attention it receives from senior management.

Incidences of non-sterile equipment use are frequently due to process failures within both the central sterile supply department and downstream departments.

To address these issues, several broad measures should be considered:

 • Recognise the critical role central sterile supply departments play and lead a systemic review of the recent process failures.

 • Develop national standards for annual competency checks on central sterile supply department staff. Singapore lags behind regional healthcare competitors like Thailand, which has already embarked on this journey.

 • Encourage central sterile supply departments to undergo voluntary accreditation. Ministry of Health (MOH) audits keep everyone on their toes, but how many MOH auditors have actual central sterile supply department work experience?

 • Consolidate central sterile supply departments across the country and invest in technology. China has hub facilities that service multiple hospitals within a region. Operating at such scale allows investment in advanced equipment and software that reduce reliance on manpower through automation and enable end-to-end tracking of individual instruments from sterilisation to patient use.

Sharing of learning points and timely reminders can only do so much. Concerted effort and strong leadership is needed if we are to take the next leap forward.

Louis Tan (Dr)

A version of this article appeared in the print edition of The Straits Times on December 13, 2018, with the headline 'Tackling problem of non-sterile equipment'. Print Edition | Subscribe