CST Certification

Central Service Technicians (CSTs) can have as much impact on reducing surgical infections as the surgical team in the operating room does. A surgical instrument that remains contaminated with organic debris after being reprocessed by CSTs can be the source of a dangerous, painful and costly surgical infection. Over the past few years, more and more healthcare facilities have begun to require that their sterile reprocessing employees obtain CST certification.

While still not required by most states, the issue of CST certification was recently raised again in the AAMI Member Discussion Group. The discussion started with this question from Jennifer:

In reviewing 4.2.2 in ST79 it states techs should be certified-not must. I was curious how other organizations are interpreting this. We don't require CST certification as a condition of employment-though I would like to. Do you feel as though you're out of compliance if your staff is not certified? Has anyone been recently surveyed by TJC and have this raised as an issue?”
Jennifer __________, MSHM BSN RN CST, Director of Central Sterile and GI Services (1)

The question from Jennifer elicited this informative response:

“Our department is totally certified.  We are small (only 4 FTE) and Central Supply is under Material Management, so we do instruments for the entire house, physician offices and all of OR sterile supplies.  We require certification within 12 months of hire, so when hiring we do not require current certification, but do require this to happen within 12 months (if not the employee is released from duty).  Hope this helps.” Charisse _________, CST, CRCST I Lead CP Technician (2).

When it comes to the use of the word "should" in AAMI ST79, the Foreword in ST79 states that “As used within the context of this document, ‘Shall’ indicates requirements strictly to be followed to conform to the recommended practice. ‘Should’ indicates that among several possibilities one is recommended as particularly suitable, without mentioning or excluding others, or that a certain course of action is preferred but not necessarily required, or that (in the negative form) a certain possibility or course of action should be avoided but is not prohibited.” (3)

In the absence of a federal requirement for certification, Kimberly brought up a very important point regarding the legal requirement for certification at the state level.

Presently Connecticut, New Jersey, New York and Tennessee are the only states that require central service technicians be certified. Such certification can be from the International Association of Healthcare Central Service Materiel Management (IAHCSMM) or from the Certification Board for Sterile Processing and Distribution, Incorporated.

According to IAHCSMM’s website, their Certified Registered Central Service Technician (CRCST) certification program “….is designed to recognize entry level and existing technicians who have demonstrated the experience, knowledge and skills necessary to provide competent services as a central service technician. CRCST's are integral members of the healthcare team who are responsible for decontaminating, inspecting, assembling, disassembling, packaging and sterilizing reusable surgical instruments or devices in a healthcare facility that are essential for patient safety.

To earn CRCST certification, candidates are required to successfully demonstrate skills through completion of hands-on work experience as well as successful completion of an examination developed to measure the understanding of general central services and infection prevention topics. CRCST certificants are required to recertify annually through completion of continuing education requirements.

If your healthcare facility already requires CST certification for all of your sterile reprocessing employees, you should be proud of that fact. If your facility does not require CST certification, you should meet with administration (especially risk management) and suggest the need for CST certification for all of your sterile reprocessing employees. Your patients and your surgical teams are counting on you.

1 AAMI Members Discussion Group, October 3, 2019

2 AAMI Members Discussion Group, October 4, 2019

3 https://www.iahcsmm.org/publications/ansi-aami-st79.html