Sterile processing departments (SPDs) are the unseen backbone of safe surgical care. Following surgery, these teams ensure every instrument is properly cleaned, sterilized, and ready for the operating room. Chronic understaffing, overwhelming workloads, and overly complex Instructions for Use (IFU) documents create persistent strain—impacting both staff well-being and patient outcomes. These challenges create risks to both patient safety and hospital liability.   

In the first part of our two-part blog series, we’ll explore the challenges SPD teams face trying to keep up in the fast-paced surgical environment.  

The Strain of Understaffing and Overburdened Teams 

Surgical Directions published a whitepaper, “Unseen but Essential: The Sterile Processing Knowledge Demand and Staffing Crisis”, discussing the impacts these issues in sterile processing are having on patient safety and the hospital. 

The article notes that the popular assumption that SPD teams are just there to wash tools grossly underestimates the skill and knowledge required to perform the role successfully. It goes on to note that, “Research has found that SSIs occur in 2-5% of all surgical patients and are frequently linked to contaminated instruments or improper sterilization. These infections increase hospital stays, drive up healthcare costs, and in some cases, result in long-term disability or death for patients.”  

According to an article from Moab Healthcare, “In late 2025 and early 2026, multiple investigative reports exposed what frontline teams have been warning about for years: contaminated, damaged, and improperly reprocessed surgical instruments reaching patients despite prior internal alerts. In each case, corrective actions were eventually implemented—but only after patient risk, operational disruption, and public scrutiny had already occurred.”  

Understaffing remains one of the most urgent issues facing SPDs. Hospitals frequently report persistent vacancies, with positions staying unfilled for weeks or months due to low pay relative to the job’s demands, limited career advancement, rigorous certification requirements, and physically and mentally taxing work. The result is heightened pressure on existing staff, leading to burnout, reduced morale, and compromised processing quality.  

Surgical volumes can surge unpredictably, forcing already lean teams to scramble. This often means longer hours, rushed processes, and shortcuts that increase the risk of errors—such as incomplete cleaning or misassembled trays.  

Under-resourced SPDs also face higher regulatory risks, including Joint Commission citations, and downstream effects like lost revenue and staff dissatisfaction. 

Complicated, Large Numbers of Instructions for Use (IFU) Documents 

According to One Tray’s article, “The Anatomy of a Compliant Department, “Despite all the labor and money that goes into writing and reviewing device IFUs, the sad reality is that the majority of Sterile Processing Techs will never get the time or chance to read it.  They follow the standard procedures of their department, maybe not even aware that IFUs exist for all these instruments.  If they have a question about how to wash a particular scope, they go ask their tenured coworker rather than turning to the IFU.  The co-worker shares the “way we’ve always done it,” and they move on.”  

Even well-staffed teams struggle with the complexity of manufacturer IFUs. These documents often contain contradictory steps, unrealistic expectations (such as precise brushing counts or extended rinsing times that don’t align with real-world time constraints), and varying requirements across instruments—even within the same tray or from the same maker. Specialized tools called for in IFUs may be unlabeled or unavailable, and device designs frequently include hidden lumens, grooves, or cavities that standard cleaning methods can’t fully address.  

A 2025 study, “Unseen threats: Lumens 2.0 study reveals the hidden challenges of cleaning lumened surgical instruments conducted at a major academic medical center”, highlighted in Infection Control Today , noted that inspection of instruments  with a borescope show contamination ranging from rust colored patches to debris, and persistent contamination after up to 3 rounds of cleaning.  

In our next post, we’ll look at the impacts the challenges are having on hospitals and what can be done to alleviate the pressures on Sterile Processing.