My name is Earlene Johnson.  I left Chicago, Illinois, to take care of my mom and dad who are veterans and live on the outskirts of St. Louis, Missouri.  I took a medical technician position at John Cochran VA Hospital.  I have almost 30 years of experience in my field of Processing and Distribution (P & D), in which the private sector calls this department Sterile Processing (SPD).  I am also an operating room scrub technician, obstetrician technician, and I am also a Phlebotomist.  I was a manager in Oregon and supervised in Chicago, Illinois.  I was called by CEO's when they were having situations with Sterile Processing.  In some cases, when employees were trying to form a union, sometimes I would find management at fault due poor management skills. 

The supervisor of P & D at John Cochran knew I was a supervisor of SPD and a manager, but what she didn't know was that I was a trouble shooter for hospitals.  I have always carried myself in a professional manner and her staff had a problem with this; even the supervisor and her boss had a problem with my professionalism.

I saw a lot, and I knew the department was not being run by an experience supervisor.  In fact, I believe she is a lead technician, and everyone called her a supervisor.

Sterile processing is a very important area in every hospital.  The staff goes to school or takes a home study course to become certified in cleaning, decontamination, infection control, disinfectants, etc. 

I warned management that they needed to go to every auxiliary department to ensure no one was sterilizing any instrument or anything that pertains to Sterile Processing.  I was told that it was her department, and that she can do what she wants.  I left that situation alone until she did something to me, and I set an appointment up to see a higher boss.  I was told the same thing by her boss.  Her boss asked me if I have other issues, and I sent her an e-mail of some of the improvements needed for the department. 

Afterwards I started being harassed and intimidated because of my warning.  I was told I was not coming back to her department with a disability and all sorts of harassment.  She fired me while I was under doctor care for a torn tendon that occurred on the job.

SUPPLEMENTAL MATERIAL PROVIDED DURING THE HEARING BY MS. JOHNSON

[Notes made by Ms. Johnson of submitted documents are bracketed. Bold-italics text indicated highlighted text by Ms. Johnson.]

Excerpt from the "Central Service Technical Manual," 6th Edition
International Association of Healthcare Central Service Materiel Management

Chapter 1 – The Profession of Central Service

THE IMPORTANCE OF CENTRAL SERVICE

One can think of the central processing area as a manufacturing and production unit within the health care facility. The functions of recy­cling, decontamination, processing, inspec­tion, assembly, packaging and sterilization are production activities. In essence Central Service is a manufacturer of sterile products. While these production and sterilization ac­tivities are usually considered its primary re­sponsibility, Central Service is also responsible for other associated materiel manage­ment functions such as procurement, inven­tory control and distribution.

The term Service is key. Central Service personnel must always remember that they are an integral part of a service entity. These vi­tal services contribute greatly to the quality of patient care. Due to the impact Central Service has on operational functions, it is of­ten referred to as the hub around which other departments revolve. Virtually all areas of the facility that require processed sterile supplies, equipment and materials depend upon Central Service (see Figure 1.1).

Figure 1.1:  Central Service:  Hub of the Healthcare Facility

The term Central implies that the services are centralized.  Activities of reprocessing soiled goods and sterilization are conducted in one centralized location under the direction and management of one individual.  Many facilities find an increased demand for reprocessing services partially as a result of a growing trend: the use of more reusable products. In addition, many facilities have expanded to clinics, surgical centers, professional offices and the like, some of which may be remote from the main site of the facility. In response to the growing demand for reprocessing ser­vices, many institutions have established sat­ellite processing units with centralized management. Others have consolidated (central­ized) services for an entire integrated system (IDN-integrated delivery networks). Still other organizations outsource required ser­vices to specialized businesses. Regardless of where reprocessing activities are conducted, quality practices must be standardized in compliance with Central Service policies and procedures. (The standards of practice and resulting care must be consistent!)

Centralized management helps assure uni­form standards of practice and provides for maximum utilization of human and material resources. This eliminates the costly duplication of utilities, processing equipment personnel efforts and space.  Educated and skilled technicians must be knowledgeable about the complexities, precautions and techniques of their job.  They must carry out tasks in a manner that protects the welfare and safety of the patients, workers and the community.  Proven material handling techniques are employed to provide high levels of efficiency.

Today, greater volumes of materials can be processed in less time by fewer people. This helps to address the problem of increased workload in today's healthcare operations.

[The Supervisor of P&D gives this Test to the Employees of P&D.]

U.S. Department of Veterans Affairs

"Supply, Processing and Distribution Training Manual"
Level One Training
Page 2-1

[VA Test Book]

 Section Two: Microbiology

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VA HANDBOOK 7176
August 16, 2002

1. Open Drawers.
2. Sharps and Needle Sticks.
3. Carelessly Stacked Washer/Sterilizer Baskets.
4. Automatic Cart Washer Doors.
5. Lifting Heavy Objects.
6. Slick/Wet Floors.
7. Automatic Loaders/Unloaders and Doors of Washer Sterilizers.
8. Hot Items.
9. Improper Use of Chemicals.
10. Operating Equipment Noise.

6.   606 SOILED SUPPLY COLLECTION PROCEDURES

1. One of SPD's primary functions is the collection of contaminated supplies and equipment. All contaminated supplies and equipment will be collected in covered conveyances or containers, such as waterproof plastic bags, tote-boxes with lids, or closed or covered carts. Collection containers for holding soiled reusable supplies should be made of material that can be properly decontaminated or discarded. Care must also be taken to protect the environment when transporting contaminated items to SPD. All nursing units and clinic areas will have a dedicated soiled utility or "dirty" room. Enclosed carts or containers should be provided in these rooms, and all ward procedure trays and reusable equipment should be placed in them. These containers will be exchanged at each pick up location. Containers will be cleaned between each use. It is the user's responsibility to dispose of sharps appropriately and to remove or dispose of gross soil from items being returned to SPD.

2. The decontamination attire for picking up contaminated items from soiled pickup areas will consist of:

1. Cover Gown—may be used to protect the uniform and must be removed after completion of pickup.

2. Exam Gloves—will be changed after each pickup. Gloves should not be worn when transporting items back to the decontamination area. This prevents the contamination of elevator buttons, light switches, doorknobs, etc. Changing to clean gloves for transporting items back to the decontamination area is not required and should not be a practice that technicians use. If the technician feels that the items being picked up are soiled, e.g., IV pump & poles, commode chairs, then they should be covered and transported to the decontamination area.