Sterile Processing Workforce Shortages in the United States: Risks to Surgical Safety and National Health System Resilience

Abstract

Abstract
In the United States, a dependable and competent sterile processing (SP) workforce is the silent sentinel underpinning surgical safety and the resilience of our healthcare systems. This review highlights and synthesizes evidence on a burgeoning workforce shortage in Central Sterile Processing Departments (CSPDs). This workforce crisis is multifactorial, directly endangers patient safety, and is a significant weak link in the U.S. healthcare system’s pandemic and other disaster preparedness and resilience. Root causes of CSPD shortages include non-competitive pay and benefits, lack of recognition, occupational exposures, workplace violence, and inconsistent education and training. The effect of staff turnover and vacancies, including inability to recruit and retain new SP technicians, is a steepened learning curve for SP; missed or incomplete steps in SP processing that can lead to surgical site infections (SSIs) and surgical device failures; equipment shortages and backlogs; and SP technician burnout. The patient safety, healthcare delivery, and national disaster preparedness implications of this workforce crisis must be addressed with urgency by hospital leaders, healthcare system and government executives, federal and state lawmakers, accrediting and certifying bodies, healthcare and public health professional organizations, and other healthcare stakeholders. Recommendations for immediate and longer-term actions to stabilize and address CSPD workforce shortages include advocating for standardized education and competency requirements for SP technicians; improved and standardized SP technician compensation; leveraging technology and process improvement to streamline SP processes and reduce SP technician workload; and building national health emergency preparedness and response plans and capacity in part by measuring and planning for CSPD capacity.