Public Health Committee
JOINT FAVORABLE REPORT
AN ACT CONCERNING PERSONS WHO DECONTAMINATE REUSABLE MEDICAL INSTRUMENTS OR DEVICES.
Joint Favorable Substitute
SPONSORS OF BILL:
The Public Health Committee
Rep. Cook, 65th District, Rep. Conroy, 105th District, and Rep. Sayers, 60th District
REASONS FOR BILL:
The bill requires central service technicians (CSTs) who begin working on or after January 1, 2016, to be nationally certified within two years of starting such work. It defines a CST as someone who decontaminates, inspects, assembles, packages, and sterilizes reusable medical instruments or devices in an outpatient surgical facility or a hospital other than a chronic disease hospital, either as an employee or under contract.
The bill also 1) exempts licensed health care providers and certain others from certification requirement and 2) requires CSTs to complete 10 hours of continuing education annually.
Made technical change on line 10.
RESPONSE FROM ADMINISTRATION/AGENCY:
Commissioner Jewel Mullen, The Department of Public Health (DPH): HB 5913 would amend title 19a of the general statutes. DPH is unaware of any accrediting organization that has established uniform requirements for persons involved in medical instrument or device decontamination. The bill is silent on who would develop proposed requirements.
The intentions of the bill are unclear and DPH would suggest a regulatory or enforcement component of this proposal and/or a new licensure category be created. DPH would not be able to perform these functions within existing resources.
NATURE AND SOURCES OF SUPPORT:
Karen Swanson, Chairman of the Board, Certification Board for Sterile Processing and Distribution: Surgical devices are extremely complex with multiple parts and hidden channels that require cleaning. Device manufacturers must present detailed cleaning and sterilization instructions to the Federal Drug Administration (FDA). Central Service Technicians must interpret and follow these instructions. There are multiple cleaning steps and multiple sterilization cycles that cannot be deviated from. Failure to perform just one step can cause serious harm to not only the patients, but co-workers too.
Josephine Colacci, Government Affairs Director, International Association of Healthcare Central Service Material Management: Connecticut passed a bill last year to start tracking surgical site infections, which is the only data on this issue. No state tracks whether an infection came from a dirty surgical instrument. The Center for Disease Control estimates that approximately 1.7 million patients developed healthcare acquired infections in 2002, resulting in 99,000 deaths. The study estimates that 22% of the infections were from surgical site infections.
New Jersey requires central service technicians to be certified. New York passed similar legislation in 2013 and legislation is pending in Massachusetts and Pennsylvania.
Marcia Zello, Sterile Processing Manager: The central service profession continues to evolve at a rapid pace with new surgical instruments being introduced regularly. The processing of robotics, endoscopes, joint replacement, and related instruments and equipment requires an advanced technical knowledge that only a certification will provide.
Central Service professionals are responsible for first-line processes to prevent surgical site infections. Improperly sterilized instruments used in surgical procedures can introduce bacteria into a patient, which sets up the risk for infection. Certified central service technicians are educated in microbiology, cleaning and decontamination, infection control, tools for cleaning, sterile packing, surgical instrumentation, high and low temperature sterilization, medical terminology, and anatomy and physiology.
Connecticut Hospital Association(CHA): HB 5193 seeks to create a new category of statutory recognition for healthcare workers who decontaminate, inspect, assemble, or package and sterilize reusable medical instruments and devices. During 2014 Legislative Session, CHA worked with representatives of the International Association of Healthcare Central Service Material Management to draft legislative language that would create statutory recognition for central service technicians that establishes credentialing standards and continuing education requirements, and recognizes the individuals currently serving as central service technicians. The draft also contains provisions that recognize the variety of instruments and devices used in hospitals to ensure that the health and safety of patients is always protected.
If the committee moves forward with this bill, CHA requests that language developed during the 2014 Legislative Session be used.
NATURE AND SOURCES OF OPPOSITION:
Mag Morelli, President, LeadingAge Connecticut: We cannot support the bill due to the brief description of the mandate contained in the bill. The terms used could be interpreted very broadly and may impact post-acute and long term care facilities serving older adults. The mandate requirements are unclear and we cannot provide comments on that aspect at this time.
Reported by: Lori Littmann