a) Area Specific Safety Standards i) OSHA/Blood Borne Pathogens ii) Microbiology (e.g. cross contamination, chain of infection, microbial transmission, how CS supports infection prevention) iii) Where to obtain area specific safety awareness standards (e.g. safety data sheets (SDS), regulatory agencies & professional associations) iv) Sharps safety v) Equipment operation vi) Chemical safety & handling (e.g. spill kit, interpreting the Manufacturer’s Instructions for Use (IFU) & SDS, disposal) vii) Location, operation & testing of eyewash station & shower viii) Ergonomics (e.g. work-flow, proper body mechanics) ix) Traffic flow x) How to contain, transport & receive soiled items into decontamination or soiled utility rooms (e.g. inspecting for & reporting inadequate point of use cleaning) xi) Hand-hygiene (e.g. frequency) b) Personal Protective Equipment (PPE) i) What type of PPE to use ii) Donning & doffing PPE iii) When to change & how to dispose of PPE c) Temperature & Humidity of the Work Environment i) Standards for temperature ii) Standards for humidity iii) Recording & documenting temperature & humidity (e.g. frequency) iv) Corrective actions taken if not within the parameters (e.g. who to notify) d) Preparing Work Area For Decontamination i) Correct cleaning agent or chemicals for cleaning process ii) Supplies Needed (e.g. brush, towels, location of restock) iii) Equipment (e.g. washer disinfector, ultrasonic, cart washer, leak tester) iv) How to determine & prepare chemicals following the Manufacturer’s IFU (e.g. dilution, equipment) v) How to check & replenish chemicals in equipment vi) How to determine the correct chemicals for the equipment vii) Testing the functionality of light & magnification devices viii) How to clean sink strainer/drains (e.g. frequency) e) Quality Tests i) Efficacy testing process for washer/disinfector ii) Efficacy testing process for ultrasonic iii) Efficacy testing process for Automated Endoscope Reprocessor (AER) iv) Efficacy testing process for cart washer v) Frequency of quality tests (e.g. washers, ultrasonic, AERs, cart washers) vi) How to document & interpret quality test results (e.g. quality assurance testing program) f) Maintenance & Troubleshooting of Equipment i) How to interpret the Manufacturer’s IFU (e.g. operator’s manual, locate) ii) How to identify, respond & report malfunctions and/or alarms iii) How to clean equipment strainers/drains iv) Identification of outlets (e.g. on/off, regular, emergency) v) Chemical feed line functionality (e.g. identifying detergent dosage) vi) How to clean & test spray arms vii) How to check washer manifolds & baskets g) Identification & Separation of Reusable & Disposable Items i) Sorting reusable & disposable items (e.g. laparoscopic tips, linens, drapes, third-party recycling vendors, sustainability) ii) How to dispose of sharps & non-reprocessed items (e.g. biohazards vs non-regulated trash, sharps container) h) Preparing Items for Decontamination i) Identify manual and/or mechanical cleaning according to the Manufacturer’s IFU ii) Proper opening & positioning of instruments iii) How to disassemble instruments iv) What goes in each sink (e.g. two or three sink method) v) Soak process (e.g. water temperature, dilution) vi) Brushes (e.g. selection, size & care, single use vs reusable) vii) Prevention of aerosols viii) When & how to use high-pressure water & air gun/hose (e.g. critical water) ix) Visual inspection of bioburden removal (e.g. magnifying devices) x) How to properly load items into the equipment xi) Selection of appropriate wash cycle xii) Methods for reducing the risk of Toxic Anterior Segment Syndrome (TASS) xiii) Special precautions for Creutzfeldt-Jacob Disease (CJD) instruments i) Selecting & Using Appropriate Disinfectant i) Disinfectant family (e.g. quats, halogens, aldehydes) ii) Three levels of Spaulding Classification (e.g. non-critical, semi-critical, critical) iii) How to identify, select & use the appropriate chemicals (e.g. exposure times, rinsing) iv) Documentation of chemical testing (e.g. temperature, Minimum Effective Concentration(MEC)) v) Corrective actions for failed quality tests (e.g. temperature, MEC) j) High Level Disinfection (HLD) Process i) Safety measures when using HLD (e.g. PPE, spill kit, ventilation) ii) Dilution requirements (e.g. concentration, expiration, end of use date, labeling) iii) Rinsing requirements (e.g. critical water) iv) Proper documentation (e.g. technician information, patient information, exposure time & solution temperature, lot control number) v) Care, handling & storage (e.g. drying, expiration date) vi) Proper disposal methods (e.g. neutralizer) vii) Transport guidelines (e.g. closed container, clean labeling) k) Transferring Items to Preparation Area i) How to maintain appropriate air flow (e.g. negative pressure, positive pressure) ii) How to prevent cross-contamination (e.g. point of use cleaning & decontamination prior to IUSS) iii) Performing a visual check for cleanliness

a) Area Specific Safety Standards i) Area specific safety awareness (e.g. hot carts, wet floors, hot trays) ii) Sharps safety (e.g. skin hooks, K-wire, towel clips) iii) Equipment operation (e.g. heat sealers, insulation testers, scope inspectors) iv) Where to find Safety Data Sheets (SDS) v) Chemical safety & handling (e.g. interpreting the Manufacturer’s Instructions for Use (IFU) & SDS, disposal) vi) Ergonomics (e.g. work-flow, proper body mechanics) vii) Traffic flow viii) Hand-hygiene b) Temperature & Humidity of the Work Environment i) Standards for temperature ii) Standards for humidity iii) Recording & documenting temperature & humidity (e.g. frequency) iv) Corrective actions taken if not within parameters (e.g. who to notify) c) Preparing Work Area for Packaging i) Dress code ii) Supplies needed (e.g. indicators, tip protectors, tray liners, tape) iii) Work area requirements (e.g. cleaning requirements, lighting, magnification) d) Receiving Items for Preparation i) How to unload equipment (e.g. instrument, cart washers) ii) How to accept manually cleaned items (e.g. pass-through window) iii) How to identify & sort items (e.g. service, facility, loaner) e) Inspecting Items for Cleanliness & Functionality i) How to check for cleanliness & functionality ii) Proper testing tools & process for checking functionality of items (e.g. sharpness testing) iii) Process of handling broken and/or damaged instrumentation (e.g. dull, misaligned, documentation) iv) Lubrication of items (e.g. according to the Manufacturer’s IFU, when & how to lubricate) v) How to assemble, test & disassemble items according to the Manufacturer’s IFU f) Identifying Correct Contents for Assembly i) Utilizing count sheets, peel pack lists, tray lists ii) How to identify items (e.g. catalogs, product number, computers, tape, etching, crossreferencing) iii) How to size & measure items g) Assembling Contents for Packaging i) Instrument protection devices (e.g. tip protectors, foam, mats, tray liners) ii) Proper instrument placement (e.g. facilitate sterilization, protect instruments) iii) Instrument organizers (e.g. stringers, racks) iv) Class/type & appropriate use of chemical indicators/integrators (e.g. proper placement, intended cycle) v) Weight limits & weight distribution h) Packaging Method i) Types of packaging method (e.g. flat wrap, peel pack, container, size, packaging weight ii) Sterilization method/cycle to be used iii) External indicators (e.g. locks, tape) iv) Inspecting packaging (e.g. wrap, rigid containers) v) Closure methods (e.g. tape, locks, heat seal, self-seal vi) Proper packaging methods (e.g. peel packs, rigid containers, wrap (simultaneous vs sequential)) vii) Proper wrapping techniques (e.g. square fold, envelope) i) Labeling Method i) Approved writing instrument ii) Placement of labeling & writing (e.g. write on plastic side of peel pouch, write on tape not wrapper) iii) Proper label information (e.g. missing items, tray information, technician identification, storage destination) iv) Special information identifiers (e.g. implant, loaners, sterilization methods/cycle) v) Date of sterilization/date of expiration (e.g. event-related vs time) j) Transferring Items to Appropriate Area i) Proper item handling (e.g. stacking, rough handling (sliding), package integrity) ii) How to prioritize for rapid turn-around iii) Ergonomics (e.g. workflow, body mechanics) iv) How to track items (e.g. manual, computer)

a) Record Maintenance i) Record Keeping (e.g. policy & procedure, what needs to be kept, type of records, record location, quality test results) ii) Purpose of record keeping (e.g. standards, legal documents) b) Environmental Condition Monitoring & Corrective Action i) Appropriate air exchanges & pressures for all work areas ii) Corrective action plan for environmental conditions out of compliance (e.g. temperature, humidity, air flow, regulatory bodies) c) Employee Education, Safety & Risk Management i) Accident/incident reporting policy (e.g. patient tracing procedure, in event of needle stick, cut) ii) Orientation (e.g. health care facility, state & federal regulations, disaster plan, risk management & safety management policies) iii) Personnel monitoring (e.g. exposure control plan, badges) iv) Education & training record requirements (e.g. certification, competencies, continuing education, new equipment & processes)

a) Area Specific Safety Standards i) Area specific safety awareness (e.g. hot carts, wet floors, hot trays, Personal Protective Equipment (PPE), traffic flow, hand-hygiene) ii) Equipment operation (e.g. high & low temp sterilizers, incubators) iii) Sterilization chemical safety & handling (e.g. interpreting the Manufacturer’s Instructions for Use (IFU) & Safety Data Sheets (SDS), disposal) iv) Ergonomics (e.g. work-flow, proper body mechanics) b) Temperature & Humidity of the Work Environment i) Standards for temperature ii) standards for humidity iii) Recording & documenting temperature & humidity (e.g. frequency) iv) Corrective actions taken if not within the parameters (e.g. who to notify) c) Preparing the Work Area for Sterilization i) Supplies needed (e.g. printer supplies, test packs, label/load gun supplies) ii) Cleaning equipment (e.g. according to the Manufacturer’s IFU, drains, chamber) iii) Checking equipment functionality (e.g. error codes, printer, incubators) d) Sterilizer Tests i) Leak tests ii) Bowie Dick/air removal tests iii) Biological tests (e.g. high & low temperature, cycle changes) iv) When to perform tests (e.g. repair, construction, malfunction, routine) e) Sterilization Methods & Cycles i) High temperature (e.g. steam, dry heat) ii) Low temperature (e.g. gas plasma, vaporized, ethylene oxide, liquid chemical) iii) Anatomy & phases of the high & low temperature sterilizers iv) Different types of cycles (e.g. gravity, dynamic, standard, advanced, IUSS) f) Pre- & Post-Sterilization Package Integrity i) What compromises integrity (e.g. moisture, holes, filters, broken locks & seals) ii) Filter placement, locks, seals & external indicators g) Load Sterilizer i) Load configuration (e.g. metal, wrapped, rigid container, peel pouch) ii) Sterilization method verification (e.g. high vs low temperature) iii) Biological tests/process challenge devices (e.g. selection, placement) iv) How to identify appropriate use of external indicators (e.g. sterilization method, placement) h) Operating & Monitoring Sterilization Equipment i) Sterilizer component checks (e.g. according to Manufacturer’s IFU, door gaskets, drains, carts, incubator temperature verification) ii) How to select & change cycle for high & low temperature sterilizers (e.g. exposure, dry, temperature) iii) How to replace & dispose of empty cartridges/tanks/cassettes i) Cycle Parameter Verification i) How to interpret the printout (e.g. temperature, time & pressure exposure, cycle type) ii) Verification procedures to ensure accountability (e.g. initialing the printout) j) Unloading Sterilizer i) What compromises sterility (e.g. cooling time, temperature, handling, equipment failure) ii) ii Traffic flow (e.g. cart placement) k) Test Results i) Proper handling & incubation of the biological tests/process challenge devices ii) Quarantine (e.g. implants, early release) iii) How to interpret & document test results l) Potential Process Failures i) How to identify a process failure (e.g. wet packs, color change, failure to meet sterilization parameters) ii) Procedure for follow-up after process failure (e.g. recall, documentation, contact) m) Load Control (Lot) Number i) Required information for a load control (lot) number n) Documenting Sterilization Load Contents i) How & what to record (e.g. computer or manual load log sheet) ii) Rationale for documentation (e.g. recall, traceability)

a) Customer Relations i) Communication etiquette (e.g. phone, email, text, active listening) ii) Decision-making skills (e.g. prioritizing, critical thinking) iii) Communication types (e.g. formal, informal, service recovery skills) iv) Medical terminology (e.g. anatomy & physiology, surgical terminology, instrumentation) b) Teamwork & Work Groups i) Types of work groups (e.g. quality, cross-functional) ii) Decision making & accountability (e.g. identify roles & responsibilities) iii) Task prioritization (e.g. reading the schedule, turnover, anticipating customer needs)

a) Area Specific Safety Standards i) Area specific safety awareness (e.g. traffic flow, hand-hygiene, Safety Data Sheets (SDS)) ii) Ergonomics (e.g. work-flow, proper body mechanics) b) Temperature & Humidity of the Work Environment i) Standards for temperature ii) Standards for humidity iii) Recording & documenting temperature & humidity (e.g. frequency) iv) Corrective actions taken if not within the parameters (e.g. who to notify) c) Preparing the Work Area for Storage i) Dress code ii) Supplies needed (e.g. carts (closed, open), rack system (closed, semi-closed, open)) iii) Work area requirements (e.g. cleaning requirements) d) Ordering & Inventory Replenishment i) Inventory replenishment & distribution systems (e.g. periodic automated replenishment, exchange cart system, requisition systems) ii) The ordering process (e.g. computerized vs manual) iii) How to identify the product (e.g. catalog numbers, item number, descriptions) iv) Unit of measure (e.g. each, box, package, case) v) How to handle inventory deficiencies (e.g. outages, substitutes, communication) e) Receiving & Inspecting Inventory i) Proper break-out area (e.g. corrugated cardboard, external shipping containers) ii) Inspecting for integrity (e.g. what & when to check) iii) Expiration & manufacturing dates (e.g. symbols, what & when to check) f) Stocking & Rotating Inventory i) Location of supplies (e.g. shelf/cart location, sterile supplies) ii) Shelf life policy (e.g. expiration, event-related) iii) Process for rotating inventory (e.g. First in First Out (FIFO)) iv) Proper storage requirements (e.g. height, weight, distance from wall/floor, shelving) g) Distributing Sterile & Non-Sterile Items i) Distribution methods (e.g. just in time, exchange cart, case cart) ii) Proper handling of items (e.g. maintain sterility) iii) Transport guidelines (e.g. closed cart, bins, dust covers, off-site transport) h) Monitoring & Tracking Items Distributed i) High dollar items (e.g. ABC analysis) ii) Specialty carts (e.g. code carts, emergency carts, c-section) iii) Critical items (e.g. special order, non-stock items, doctor specials, patient specific items) iv) Vendor-owned items (e.g. loaner, consignment) v) How items are organized & tracked (e.g. manual, RFID, computerized) vi) Distribution to user departments (e.g. ER, OR, clinics, ICU) i) Loss of Sterile Items i) How to handle manufacturer product recalls ii) Common causes of waste & loss (e.g. damaged, expired & obsolete items)

a) Area Specific Safety Standards i) Area specific safety awareness (e.g. OSHA/blood borne pathogens, Personal Protective Equipment (PPE), electrical safety, hand-hygiene, regulatory agencies & professional associations) ii) Equipment operation & how to interpret the Manufacturer’s Instructions for Use (IFU) (e.g. operator’s manual) b) Temperature & Humidity of the Work Environment i) Standards for temperature ii) Standards for humidity iii) Recording & documenting temperature & humidity (e.g. frequency) iv) Corrective actions taken if not within the parameters (e.g. who to notify) c) Preparing the Work Area for Distribution i) Supplies needed (e.g. sleeves, pads, equipment covers, clean labels/stickers) ii) Work area requirements (e.g. cleaning requirements, charging stations, plugs) d) Receiving Items for Preparation i) Identifying types of patient care equipment ii) Process for recording & tracking equipment (e.g. rental, loaned) iii) The flow of patient equipment (e.g. one way flow) e) Inspecting Equipment for Cleanliness & Functionality i) How to check for cleanliness ii) How to check for compliance with safety standards (e.g. frayed cords, preventative maintenance label, damage) iii) Corrective action plan for equipment out of compliance (e.g. missing/expired preventative maintenance label, who to notify) iv) Equipment requiring charging or battery replacement f) Preparing Equipment for Distribution i) How to assemble equipment for distribution (e.g. disposable components, Manufacturer’s IFU) ii) How to test equipment (e.g. per Manufacturer’s IFU) g) Care & Handling i) Location and proper storage of equipment (e.g. dry, clean) h) Distributing & Tracking Equipment i) Systems used (e.g. manual, computer, RFID, hybrid) ii) How to record & track distribution of patient care equipment iii) Transport guidelines to end user departments (e.g. OR, ED, Labor & Delivery)

• Central Service Work Flow • The Processing Cycle • Basic Job Knowledge and Skills • Basic Job Responsibilities

• Importance of Medical Terminology • Anatomy of a Medical Term • Anatomy of a Surgical Procedure • From Minimally Invasive Surgery to Open Procedure • Procedure Approach and Purpose • Case Carts and Instrument Trays • The Value of Medical Terminology in the Operating Room

• Cells, Tissues and Organs • Body Systems: Skeletal, Muscular, Nervous, Endocrine, Reproductive, Urinary and Excretory, Respiratory, Digestive, and Circulatory • Anatomy and Instrument Names

• Overview of Microbiology • Beneficial vs. Dangerous Microorganisms • How Microorganisms are Identified and Classified • Controlling and Eliminating Microorganisms

• Regulatory Agencies • Professional Associations

• Central Service Processes • Principles of Asepsis • Personal Hygiene and Attire • Managing the Environment to Manage the Spread of Bacteria • Occupational Safety and Health Administration (OSHA) 29 CFR 1910.1030 • Environmental Concerns in Central Service Areas • Elements of Transmission and the Chain of Infection

• Goals of Point-of-Use Preparation and Transport • Sources of Contaminated Items • Point-of-Use Preparation: Reasons and Guidelines • Transport of Soiled Items • Off-Site Processing • Education and Training

• What is Clean” • Introduction to the Decontamination Work Area • Mechanical Cleaners • Equipment Testing • Cleaning Chemicals and Lubricants • Instructions for Use • Steps in the Process of Decontamination • Decontamination

• Introduction to Disinfectants • Types of Disinfectants • Safe Work Practices when Performing Manual Disinfection • Achieving Disinfection Using Mechanical Processes • Quality Assurance for Disinfection • Quality Assurance Testing for High-Level Disinfectants

• The Important Role of Instrument Selection and Inspection • Instrument Manufacturing Process • Classification and Overview of Surgical Instruments • Postoperative Care of Surgical Instruments • Solutions that Damage Instruments • Instrument Sharpness Testing and Identification • Instrument Identification Methods • Instrument Lubrication • Tips to Protect Instruments from Damage

• Power Surgical Instruments • Endoscopes • Rigid and Semi-Rigid Endoscopes • Rigid and Semi-Rigid Endoscope General Guidelines for Decontamination • Rigid Endoscopic Instruments • Endoscopic and Robotic Instrumentation • Flexible Endoscopes • Cleaning and Processing Flexible Endoscopes • Flexible Endoscopic Accessories • Flexible Endoscope Regulations and Guidelines • Infection Prevention Issues • Flexible and Rigid Endoscope Care and Handling • Endoscope Camera Care and Handling • Endoscopic Repair • Staff Education • Loaner Instrumentation

• Assembly and Packaging Area • Primary Goal of Pack Preparation • General Guidelines for Preparation of Pack Contents • Quality Assurance Measures – Internal Chemical Indicators • Basic Packaging Procedures • Reusable Packaging Materials • Disposable Packaging Materials • Wrapping Techniques • Methods of Packing Closure • Package Labelling • Special Packaging Concerns

• A Brief History • Immediate Use Steam Sterilization • Procedures for Immediate Use Steam Sterilization • Quality Control Monitors for Immediate Use Steam Sterilization • Point-of-Use Processing for Heat-Sensitive Devices

• Factors that Impact Sterilization • Advantages of Steam Sterilization • Anatomy of a Steam Sterilizer • Types of Steam Sterilizers Used in Central Service • Steam Sterilizer Cycles • Conditions Necessary for Effective Steam Sterilization • Basic Work Practices for Steam Sterilization • Sterilization Quality Control

• Low-Temperature Basic Sterilization Requirements • Ethylene Oxide • Hydrogen Peroxide Systems • Ozone Sterilization

• Storage Considerations • Receipt of Sterile Items into Storage • Event-Related Sterility • Basic Storage Guidelines • Cleaning • Sterile Storage Professionals • Transporting Sterile Items • Transportation Guidelines

• The Importance of Accurate Records • General Monitoring • Decontamination Area Monitoring • High-Level Disinfection Monitoring • Sterilization Monitoring • Sterilizer Specific Monitoring • Personal Monitoring • Staff Education

• Quality in Central Service Operations • Components of Quality • Quality Control Indicators • Analysis of Quality Concerns • Quality Program Alternatives • Quality Central Service Procedures • Quality in Central Service Processing Areas

• What is Inventory? • Where Does Inventory Come From? • Handling Commercially-Sterilized Items • Item Locator Systems • Loss of Sterile Items • Transport of Commercially-Sterilized Packages • Distribution of Supplies • Sustainability • The Role of Central Service in Inventory Management

• Identifying the Central Service Department’s Scope of Service • Patient Care Equipment • Procuring New and Additional Equipment • Other Patient Care Equipment Concerns • Procedural Support • Utensils and Other Medical Equipment • Communication and Coordination is Key

• Role of Computer-Based Information Systems • Tracking Systems for Central Service • Features of Instrument and Equipment Tracking Systems

• Risk Management • Common Workplace Safety Hazards • General Hazards • Area Specific Safety Concerns • Other Areas of Concern • Disaster Preparedness • Employee Accidents and Injury • Patient Accidents and Injuries • Employee Information and Training • Employee Preparedness

• Need for Effective Communication and Human Relations Skills • Common Communication Barriers • Central Service Technicians are Professionals • Basics of Communication • Human relations • Central Service Technicians and Teamwork • Central Service and Diversity • Customer Service Skills for Central Service Technicians • Setting Priorities • Avoiding Work Group Comparisons • Committing to Patient Care During Disasters

• Personal Development: What Is It and Why Is It Important? • Professional Development: What Is It and Why Is It Important? • Central Service Career Paths • Planning Career Goals • Some Advice About Career Goals • The Importance of Resources • Professional Development Activities • Developing a Resume • Understanding the Interview Process • Promotions • Personal and Professional Development Timelines