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Ji and Ihn: Knowledge and Educational Need of Central Supply Room Nurses for the Sterilization Process
Original Article

J Nosocomial Infect Control 2013;20(2):70-81.

Published online: 3 May 2013

DOI: https://doi.org/10.14192/kjnic.2015.20.2.70

Knowledge and Educational Need of Central Supply Room Nurses for the Sterilization Process

Hyun Yun Ji, Sook Jeong Ihn

1Department of Nursing, Pusan National University Hospital, Korea

2College of Nursing, Pusan National University, Yangsan, Korea

Address reprint requests to Ihn Sook Jeong, College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea Tel: 051-510-8342, Fax: 051-510-8308 E-mail: jeongis@pusan.ac.kr

Received 28 April 2015       Accepted 16 June 2015

Copyright © 2013, the Korean Thyroid Association. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

This study aimed to assess central supply room nurses’ knowledge on and educational needs for the sterilization process.

Methods

The participants were 88 nurses working at central supply rooms of hospitals in Busan, Ulsan, and Gyeong-nam. From August to September 2014, knowledge and educational needs of the sterilization process were measured by using self-reported questionnaires. Data were analyzed by descriptive statistics, t test or analysis of variance (ANOVA), Scheffe test, and repeated-measures ANOVA with the SPSS 21.0 program.

Results

The mean score for knowledge on the sterilization process was 39.58 out of 50 points and was highest in keeping sterilization (8.94 out of 10 points) and lowest in packing sterilization (6.82 out of 10 points). The mean score for knowledge was significantly higher in the nurses with postgraduate studies (F=3.35, P=0.040), in those with internal training (t=2.03, P=0.045), with three or more internal trainings (F=9.72, Pä0.001), with external training (t=3.48, P=.001), with two or more external trainings (F=8.40, P=0.001), and in those working in hospitals with 700 beds or more (F=15.88, Pä0.001). The mean score for educational need was 4.06 out of 5 points, ranging from 3.99 to 4.12 points. It was significantly higher in nurses aged 40 years and older (F=4.28, P=0.017) and in those working in hospitals with 700 beds or more (F=4.82, P=0.010).

Conclusion

Nurses working in central supply rooms need education on the sterilization process. We recommend the development of a standardized textbook and an educational program based on the results of this study.

Keywords: Central supply, Education, Knowledge, Sterilization

References

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Table 1.
Characteristics for central supply room nurses (N=88)
Characteristics Categories n % MSD
Age ≤39 21 23.9  
40-49 37 42.0  
≥50 30 34.1 45.138.04
Education 3 year college 32 36.4  
4 year college 32 36.4  
Master and higher 24 27.3  
Total career as a nurse <10 13 14.8  
(year) 10-19 27 30.7  
≥20 48 54.5 20.348.62
Career in central supply <1 15 17.0  
room (year) 1-2 34 38.6  
3-4 15 17.0  
≥5 24 27.3 4.835.45
Position Staff nurse 32 36.4  
Charge nurse, head nurse 42 47.7  
Team leader and higher 14 15.9  
Exposure to internal None 26 29.5  
education within 1 year 1 30 34.1  
(time) 2 14 15.9  
≥3 18 20.5  
Exposure to external None 18 20.5  
education within 1 year 1 33 37.5  
(time) 2 25 28.4  
≥3 12 13.6  
Preferred type of education Standardized textbook 47 53.4  
On-site continuing education 19 21.6  
  On-line continuing education 13 14.8  
Seminar 9 10.2  
Preferred time of education >4 hours 63 71.6  
≤4 hours 25 28.4  
Hospital bed size ≤299 26 29.5  
300-699 30 34.1  
  ≥700 32 36.4 565.67332.31
Table 2.
Knowledge and educational need on sterilization process (N=88)
Category (number of item) Knowledge Educational need
MSD MSD
Return and cleaning (10) 7.651.34 3.990.74
Packing (10) 6.821.66 4.040.60
Sterilization method (10) 8.131.57 4.110.65
Sterilization indicator (10) 8.052.11 4.120.77
Sterilization maintenance and release (10) 8.941.23 4.030.81
Total 39.586.09 20.293.35
F (P) by category 37.96 (Pä0.001) 3.17 (P=0.02)
Table 3.
Knowledge and educational need on sterilization process by each question (N=88)
Question Knowledge (Correct answer, %) Educational need (MSD)
ä Return and cleaning â    
Return room containing the used things is considered as the clean area.* 95.5 3.850.98
Return area for the used things is separated. 100.0 3.980.93
The used things are separated by contamination source. 95.5 4.110.93
The used things are carried by closed box. 97.7 3.971.00
The used disposable gloves are abrogated by a damageable wast box.* 44.3 3.970.81
The recommended temperature of cleaning room is 24-28C.* 70.5 4.000.66
Eye-wash station should be within a cleaning room. 89.8 4.060.88
In cleaning, a worker should wear personal protective equipments, including gloves, gowns, masks, and eye protection. 84.1 4.080.94
In hand-washing, a stopper of sink is not closed.* 50.0 3.890.86
In using an automatic washer, the working time of the unit can be arbitrarily changed according to the type of patient-care devices.* 37.5 3.970.65
ä Packing â    
The devices are packed when the water remains on the surface of them.* 98.9 4.011.02
Sharp devices are packed by a pouch pack.* 72.7 3.990.90
The individual device within a instrument set is repacked by a waterproof paper.* 63.6 4.020.64
Linens are suitable for the use of package material after EO gas sterilization.* 93.2 4.020.77
The device with hole is horizontally laid in the instrument set. 59.1 4.130.64
The surface of cup-shaped device is faced up in the instrument set.* 50.0 4.110.67
The end or edge of a damageable sharp instrument is protected by using latex tube.* 21.6 4.020.86
The total weight of a sterilized instrument should be 11.3 kg or less after packaging it. 53.4 4.160.52
Two persons check the instrument set. 88.6 4.000.71
The devices are repacked when they are returned in central supply 80.7 3.950.76
room because of the elapsed expiration date.    
ä Sterilization I: Sterilization methodâ    
Leave the door of the steam sterilizer open when it is not activated.* 73.9 3.950.73
Steam sterilization is suitable for sterilizing surgical instruments that are not damaged by heat, steam, pressure or moisture. 96.6 4.030.89
Within a steam sterilizer, textile products are laid at the bottom and metal products are laid at the top.* 61.4 4.190.60
In loading things within a steam sterilizer, the pouch is laid horizontally on the tray.* 61.4 4.130.58
In loading things within a steam sterilizer, concave-shaped instrument or vessel is laid in oblique. 79.5 4.090.65
When the eye is contaminated to E.O gas, immediate washing of the eye by running water should be required. 94.3 4.250.78
In E.O gas sterilization room, specified ventilation system is equipped. 97.7 4.180.90
In loading pouch of E.O gas sterilization, there are no gap between the surfaces of plastic and paper. 52.3 4.170.68
All things are densely placed within E.O gas sterilizer chamber.* 97.7 4.030.88
All things are placed with a gap between them and wall of EO gas sterilizer chamber. 97.7 4.060.79
ä Sterilization II: Sterilization Indicatorâ    
Bowie-dick test is performed in the empty sterilizer. 90.9 4.190.95
Bowie-dick test time ranges from 3.5 to 4 minutes. 78.4 4.160.87
Result paper of Bowie-dick test is immediately abrogated after its confirmation.* 90.9 4.070.96
In wrapping a linen, internal chemical indicator is located in the midline. 87.5 4.060.91
All internal chemical indicators are put in the sterilized packs. 77.3 4.100.80
External chemical indicator is applied on common tape after fixing it.* 73.9 4.050.90
Biological indicator is located in the most upper portion of steam sterilizer.* 79.5 4.140.87
The bacterium of Biological indicator for steam sterilization is Bacillus atrophaeus.* 51.1 4.080.73
In sterilization of implant devices, biological indicator is used in each sterilization cycle. 89.8 4.160.83
In cultivation of Biological indicator, control biological indicator is used. 85.2 4.190.79
ä Sterilization maintenance and release â    
A storage room of sterilized things is off-limits to visitors. 100.0 4.070.96
A storage room of sterilized things maintains negative pressure.* 61.4 4.000.93
Recording paper for temperature and humidity in a storage room of sterilized things is immediately abrogated after its confirmation.* 94.3 3.990.84
Hand cleaning is performed before managing the sterilized things. 97.7 4.010.95
The sterilized things are kept in an open cabinet.* 83.0 4.050.79
A storage cabinet is set up with no gap from the wall.* 88.6 4.050.82
Expiration date of packing is not different according to its type.* 84.1 4.130.86
When a thing drops on the floor, it is considered as uncleanness. 94.3 4.000.96
In releasing sterilized things, there is the determined order (for example, from up to down, etc). 94.3 4.050.91
Release recording paper for sterilized things is kept. 96.6 4.000.82

*Reverse coding.

Table 4.
Knowledge and educational need according to characteristics (N=88)
Characteristics Categories Knowledge Educational need
MSD t or F (P) MSD t or F (P)
Age ≤39a 38.767.31 0.41 3.760.96 4.28
40-49b 40.225.61 (0.669) 4.260.40 (0.017)
≥50c 39.375.85   4.010.62 aäb,c
Education 3 year collegea 37.976.06 3.35 4.050.67 0.89
4 year collegeb 39.316.15 (0.040) 3.960.83 (0.415)
Master & higherc 42.085.43 a,bäc 4.200.37  
Total career ä10 39.697.15 0.97 3.800.99 2.15
as a nurse 10-19 38.265.54 (0.385) 3.960.68 (0.123)
(year) ≥20 40.296.09   4.180.54  
Career in central ä1 38.135.71 0.61 4.080.76 0.46
supply room 1-2 39.886.49 (0.610) 3.970.76 (0.709)
(year) 3-4 41.005.40   4.210.47  
≥5 39.176.25   4.080.60  
Position Staff nurse 40.506.93 0.76 4.070.92 0.02
Charge, Head nurse 38.765.93 (0.469) 4.040.42 (0.980)
Team leader & higher 39.934.27   4.070.65  
Exposure to Yes 40.425.97 2.03 4.100.68 0.90
internal education No 37.585.99 (0.045) 3.960.66 (0.373)
Time of 1a 38.005.98 9.72 3.980.77 1.03
internal education 2b 39.866.16 (ä0.001) 4.280.41 (0.362)
(hrs) ≥3c 44.892.49 a,bäc 4.150.67  
Exposure to Yes 40.665.70 3.48 4.070.64 0.45
external education No 35.395.86 (0.001) 3.990.79 (0.654)
Time of 1a 38.095.77 8.40 4.010.52 1.02
external education 2b 42.245.28 (ä0.001) 4.040.86 (0.367)
(hrs) ≥3c 44.422.27 aäb,c 4.310.36  
Hospital bed size ≤299a 36.656.58 15.88 3.890.80 4.82
300-699b 37.704.91 (ä0.001) 3.900.70 (0.010)
  ≥700c 43.724.27 a,bäc 4.340.40 a,bäc
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