4 min read
Instrument shortages and tight schedules can put SPD technicians under pressure to meet case demand without adequate processing time. Settrax supports sterile processing with instrument tracking and vendor coordination. But operational visibility must sit alongside clear authority, adequate resources, and leadership support.
A 2026 study by Kevin M. Bush Jr. and Brandon M. Gantt offers a reason to examine those conditions. Among 89 surveyed SPD professionals, 43% reported pressure to circumvent established sterilization protocols. That finding describes reported pressure, not verified violations or patient injuries.
Key findings and practical responses
- In a 2026 survey of 89 SPD professionals, 43% of respondents reported pressure to circumvent established sterilization protocols.
- Respondents generally expressed low to moderate confidence in leadership’s understanding of SPD workflows, highlighting a concern worth examining locally.
- The study measured self-reported experiences, not observed violations or infection outcomes; it cannot establish that a reporting structure causes harm.
- Leaders can review escalation authority, instrument capacity, quality measures, and professional development to address operational pressures within their facilities.
- Settrax can support instrument visibility and vendor coordination, but software does not replace staffing, professional competency, or accountable leadership.
What did the research establish?
The study identifies reported organizational pressures and support gaps, not a proven relationship between reporting structures and patient harm. Bush and Gantt combined survey responses with qualitative analysis, identifying 13 themes including autonomy, leadership education, collaboration, credentialing, and recognition.
The sample was modest and recruited through professional networks, social platforms, and conference promotion. Self-reporting introduced potential recall and social desirability bias. The cross-sectional design captured experiences at one point in time, and institutional characteristics could not be analyzed in detail.
Use the findings to ask better questions inside your facility. Do not treat 43% as a national prevalence estimate, or assume nursing and supply chain reporting relationships are inherently unsafe.
What we hear from Settrax clients
These findings are consistent with concerns we regularly hear from Settrax clients. In our experience, departments that manage vendor expectations most effectively share three conditions: clear policies, leadership that backs those policies, and a team committed to applying them consistently.
That consistency matters for late tray deliveries, tray and instrument condition, and required documentation. When vendor representatives know the expectations and know that the department and its leadership will uphold them, we have seen less pushback. These observations reflect our client experience, not outcomes measured by the study.
How operational pressure reaches the workbench
Instrument shortages, turnover expectations, and limited participation in planning can create competing demands for SPD teams. The article describes respondents reporting pressure associated with operational demands such as shortages and high turnover expectations.
A late loaner delivery can leave less time for required processing. A schedule change can increase demand for a set already in use. Your response should address the capacity or scheduling constraint, not shorten required processing steps.
Your loaner tray management process should account for arrival requirements, documentation, and the time needed to complete processing under applicable instructions and facility policy.
Give SPD authority and a supported escalation path
Clear decision-making authority gives staff a documented way to raise concerns when readiness or compliance is in doubt. Define who can pause release, who reviews the concern, and how OR and SPD teams resolve the scheduling impact.
Leadership should support staff who report concerns without retaliation. Include SPD in perioperative planning, infection prevention discussions, equipment purchasing, and capacity decisions. These are practical responses consistent with the article’s call for governance integration, not interventions tested by this survey.
Use shared policy to support staff decisions
A written, leadership-backed policy gives SPD staff the authority to say no when a delivery does not meet hospital requirements. Staff can point to an established hospital standard rather than defend the decision as their personal preference.
Leadership backing matters when SPD, OR teams, surgeons, and vendor representatives are working to meet the same case schedule. Clear, consistently supported policies give everyone a shared understanding of what the hospital requires.
SPD staff can communicate and uphold those requirements with confidence, keeping the conversation focused on readiness and the agreed process rather than individual judgment.
Review your loaner tray policies alongside the escalation process so arrival and readiness expectations are understood before a problem occurs.
Plan instrument capacity around required processing time
Capacity planning should match surgical demand to available sets, staffing, equipment, and full required processing time. Review repeated shortages, set utilization, equipment downtime, and late loaner arrivals with procurement and perioperative leadership.
CDC guidance states that flash sterilization should not be used for convenience, as an alternative to purchasing additional instrument sets, or to save time. Do not use immediate-use processing as a routine workaround for inventory gaps.
Your facility’s applicable standards, manufacturers’ instructions, and qualified SPD and infection prevention review must govern detailed processing decisions. Smaller facilities can use the same planning approach when reviewing instrument tracking for ASCs and small hospitals.
Measure quality and readiness alongside speed
A balanced performance review examines quality, readiness, and workload alongside turnaround time. Consider tray completeness, defects, rework, instrument-related delays, and documented nonconformances, using consistent local definitions.
Review these measures with technicians. Look for system constraints before drawing conclusions about individual performance. Support continuing education, certification, mentorship, and leadership development; the study identified professional development and recognition as recurring concerns.
Your surgical instrument tracking data can inform these conversations. Production counts alone should not define the value of a technician’s work.
Where Settrax supports the operational work
Settrax Flow provides instrument and tray visibility that can help leaders identify workflow constraints and evaluate readiness. Its tracking and analytics support discussions about workload and capacity; they do not establish that an instrument is safe independently of the required processing and release checks.
Settrax VM supports case communication and vendor instrument coordination. Kiosk check-in and check-out records can make arrivals and discrepancies more visible. This fits the coordination approach described in Settrax’s vendor management background.
Software does not grant stop-work authority, establish competency, fix staffing shortages, or guarantee compliant sterilization. The study did not evaluate Settrax or any other commercial product. Keep broader materials management workflows aligned with leadership decisions rather than treating technology as a substitute for them.
A leadership review you can use
Start your review by asking whether SPD has the authority, capacity, and support to meet required processing expectations.
- Confirm that staff know how to raise a readiness concern and who can pause instrument release.
- Communicate vendor delivery, instrument condition, and documentation requirements clearly; confirm that leadership and staff apply them consistently.
- Include SPD in decisions affecting surgical volume, instrument purchasing, equipment, and vendor arrival expectations.
- Review shortages and late deliveries against available processing capacity before changing turnaround targets.
- Balance speed measures with defects, rework, readiness, workload, and documented quality concerns.
- Fund professional development and include technicians in improvement reviews.
- Assign owners to recurring constraints and review whether corrective actions address the underlying problem.
Turn reported pressure into accountable action
The study gives your leadership team a starting point for examining local conditions. Ask staff where pressure occurs, review the operational evidence, and assign responsibility for resolving constraints.
SPD teams need resources and decision-making support to complete required work. Tracking can make that work visible. Leadership must act on what the data and the people doing the work show.
Questions about SPD leadership and pressure
Does the study prove reporting structures cause harm?
No. The study surveyed perceptions and experiences; it did not directly observe violations or measure infection outcomes. It identifies concerns worth investigating, not a causal relationship.
What should leaders review first?
Start with your escalation process and recurring capacity gaps. Confirm that staff can raise concerns safely, and that scheduling and inventory decisions allow required processing to be completed.
Can instrument tracking replace leadership changes?
No. Tracking supports operational visibility, but authority, staffing, competency, and compliance remain organizational responsibilities. Any processing-related changes require review against applicable standards, manufacturers’ instructions, and facility policy.