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This series contains positions the duties of which are to provide wards, clinics, operating rooms, and other hospital facilities with medical supplies, instruments, sets, and equipment. Duties require a knowledge of aseptic techniques and sterilization practices; the care, functioning, and uses of supplies, equipment, sets, and instruments; and methods for the preparation, storage, and issue of sterile and non-sterile medical supplies and the maintenance of adequate stock levels.

Medical supply aides and technicians clean, package, assemble, sterilize, and distribute supply items used for patient care in hospital wards and clinics. Usually they are assigned to the central supply service of the hospital, but may work in either a central supply processing and distribution area or the patient care areas. At one time, these employees, dealt with a limited number of reusable, sterile, medical supply items. Now, most process, prepare, and distribute the complete range of clean and sterile medical supplies required for patient care, including a wide range of disposable items. In addition, many process, prepare, and distribute all the supplies, including instrument trays and sets used in the full range of surgical operations.

The term "medical supply item" as used in this standard refers to disposable and reusable supply items for patient care, including instruments (scissors, forceps, retractors), medical equipment (suction machines, K-thermia units, inhalation therapy machines), trays and sets (suture sets, major orthopedic sets, aortogram trays), and various other items such as thermometers, needles, tubing, glassware, and metalware.

The following work is commonly performed by medical supply aides and technicians. The description is divided into three main areas, and typically these employees perform duties in all three areas. When this is not the case, they are at least familiar with the duties carried out in the other areas. These divisions of work, and the specific work procedures used, vary depending upon the facilities of the hospital and management expectations.

1. Processing/Decontamination -- Processing and decontamination involve all the actions required prior to sterilizing and issuance. The primary function of processing is cleaning the supply items. Cleaning consists of one or more methods of removing gross contamination, such as soaking in a germicide, washing with a detergent-blood solvent, scrubbing with a brush and scouring powder, rinsing in tap and then distilled water, or washing in washer-sterilizer and ultrasonic units. Some items must be disassembled before cleaning. In some cases (e.g., biological contamination), items must be presterilized before being handled in the processing unit. During processing (and during preparation as described below) the employees visually examine the items for damage, deterioration, or imperfections such as rust, pitting, and cracks. They operate the medical equipment to determine whether it is operating correctly and to ensure that the items were reassembled correctly after cleaning. For example, the suction machines are checked for suction, mattresses of K-thermia units are filled and checked for holes and overheating, and inhalation therapy machines are checked to see if the bellows are moving and if the movement varies with the different settings on the machine. Medical equipment that is malfunctioning or damaged is sent to another office to be repaired or discarded.

Processing requires knowledge of varied cleaning procedures; knowledge of which procedures to use for the different items; and knowledges and skills to operate the medical and other equipment such as washer-sterilizers, automatic washers, automatic dryers, and ultrasonic units.

2. Preparation -- Preparation involves all duties required to assemble, package, wrap, and sterilize the medical supply items. The items are packaged individually (e.g., scissors, tubing, gauze) or are assembled into trays and sets. Frequently, some items are packaged both individually and as part of a tray or set. In any case, the items are first visually examined for cleanliness and, as described above in the processing section, for signs of damage, deterioration, and imperfection. Tests of the condition of the supply items are also required such as scissors for smooth and easy opening.

If the item is to be packaged individually, the technician packages the item, determines the method of sterilization, puts a piece of chemical indicator tape on the package, labels the package if the supply item is not visible, and places the package on the carrier that is used in the sterilizer.

If the items are to be assembled into a tray or set, the technician selects the various supply items needed; assembles the items according to guides that specify kinds and numbers of instruments and supplies to be included; arranges the items on the tray in a logical manner that permits effective penetration of the sterilizing medium and prevents damage to points, blades, and delicate instruments; wraps and labels the tray; determines the correct method of sterilization; puts a piece of chemical indicator tape on the package, and places it on a carrier that is used in the sterilizer.

A tray or set is a group of various supply items, primarily instruments, specified for a given purpose. The instruments required for each tray or set differ as to the general class or kind of instrument; the specific type within the general class or kind of instrument (e.g., curved mosquito forceps, straight mosquito forceps, toothed tissue forceps, rat tooth tissue forceps, thumb forceps); and frequently, as to size. There may be variations due to a particular request of a physician or nurse. A tray or set often is used for a variety of different procedures, sometimes supplemented by other supply items. A tray or set can vary in complexity from one with a single, common-use item that takes a few seconds to assemble to one with over a hundred items that may take as long as an hour to assemble.

The number of trays and sets the medical supply unit is responsible for assembling varies among hospitals and depends upon the variety of medical specialties provided by the hospital, the facilities of the hospital, and whether the medical supply unit provides complete supply service to the operating room.

Sterilizing the items involves determining the proper sterilizing method, placing the carrier containing the supply items in the sterilizer and operating the sterilizer (typically a gas, steam high vacuum, or steam gravity sterilizer). Usually, all items in a set are treated for the same period of time, the one common exception being liquids. Liquids usually are sterilized separately for varying times. The employee adds to the carriers any required control tests such as a Bowie-Dick test or spore strips according to established procedures. At the end of the sterilizing period, the employee compares the control tests with a graph for each sterilizer to determine whether the correct parameters (e.g., time, temperature, pressure) were obtained. Any deviations from the normal or expected parameters are noted and corrective steps are taken. All supply items sterilized by gas are placed in an aerator for an established period. On each sterile supply item, the employee places a label that shows the expiration date, the date sterilized, the sterilizer used, and, when necessary, the number of times the sterilizer is used each day. Many medical supply units also color code the sterile supply package, to show the expiration date.

Preparation of the medical supply items requires knowledge of the nomenclature of the items, the physical characteristics of each item, the general use of each item, and the method of sterilization for each item.

3. Distribution -- Distribution involves providing the user wards, clinic units, and operating room suites with medical supply items. Items are usually distributed to the ward and clinic units on an established quota basis, supplemented by special requests and to operating rooms based on scheduled activities. The technician may (a) replenish a supply cart to reattain the established quota level for each item on the cart and exchange the cart with one on the ward or clinic unit or (b) go to the user units to inventory supplies and then obtain supplies for each unit to fill needs as determined by the inventory. In either case the technician checks the expiration date on all sterile supply items, removes all outdated items, and rotates the stock. The rest of the supply items are distributed upon special request. In some hospitals, the supply items are distributed only on a requisition basis.

To distribute medical supply items, technicians must know the names of the different supply items including the trays and sets, and must understand, generally, how items are used in case the user refers to them by another name (e.g., a bone marrow tray is the same as a Sterno puncture tray). The technician must know how to modify trays (e.g., how to change a liver biopsy tray to a kidney biopsy tray with the addition of one specific needle).

In many hospitals, technicians must operate equipment such as dumbwaiters, elevators, or automatic transport systems to distribute items.

In addition to the work outlined above, medical supply aides and technicians typically perform some clerical, stock control, and storage work. This includes such tasks as receiving new supplies from supply sources; checking supplies delivered for shortages, breakage, etc.; recording errors or damages detected; placing items in proper storage locations in supply rooms; and participating in periodic physical inventory of medical supply items.

There are two major approaches to medical supply operations in Federal hospitals with, of course, variations in between. In the first approach, the supply operation is not managed by medical personnel but instead by technically trained and oriented medical supply specialists. Ward, clinic, and operating room medical personnel are not involved with the details of procuring supplies; establishing stock levels; setting up procedures and techniques for decontaminating, preparing, sterilizing, stocking, and issuing supplies; and managing and supervising the medical supply operation personnel. Instead, medical supply technical personnel, in consultation with medical personnel, establish procedures, assure quality control, and systematically provision ward, clinic, and operating room areas with supplies and equipment to meet established stock levels and scheduled activities. The "two-way closet" system is indicative of this approach where medical supply personnel replenish individual rooms and ward areas from closet doors opening to the corridor while nursing personnel obtain the supplies and return contaminated equipment from doors that open into the patient area. This allows patient care personnel to minimize their concern for the ready availability of supplies and equipment.

In this approach, the medical supply technician is in more frequent contact with medical personnel and has occasion to explain supply operations, equipment resources and limitations, and to help resolve malfunctions of equipment. The higher grade-level benchmark descriptions in this standard apply to this kind of situation where the medical supply technician uses a background of experience and training in processing medical supply equipment and in advising on the medical supply resources.

In another approach, the medical supply operation is managed by medical personnel as a part of the overall hospital patient care administration. Since the managers and supervisors are the users of the service the individual medical supply technician has less need for contacts outside the immediate organization. Contacts between users and the supply organization are more structured and are usually through supervisory channels. The individual technician does not need to have or use as extensive a knowledge of medical procedures and medical supply resources.

Nature, range, and complexity of work

Performs a few limited duties required to process, prepare, and distribute medical supply items while maintaining sterile or clean condition of items. Also, receives on-the-job training for additional and more complex duties.

Assembles a limited number of different trays and sets that consist of a few different instruments and other medical supply items such as towels, gauze, and basins.

Packages a limited number of different, single items such as gauze, scissors, thermometers, and catheters.

Folds sheets and other linen used for surgical operations. Assembles packs of linen.

Puts a strip of the correct chemical indicator tape on items to be sterilized and places items on carriers.

Operates equipment such as cleaners and heat-sealer machines.

Cleans the work area.

Nature, range, and complexity of work

Rotates among the various duty assignments in a central medical supply operation, e.g., decontamination, instrument preparation, and storage and issue.

Decontaminates the full range of reusable medical supplies and equipment used within the wards and clinics of the facility. Uses selected methods for removing gross contamination. Disassembles and reassembles equipment where the internal parts have become contaminated. Operates various kinds of equipment such as ultrasonic cleaners and washer-sterilizers.

Prepares the full range of trays and sets used on the wards and in the clinics of the hospital. Removes trays of instruments from presterilizing equipment, inspects items to be sure that gross contamination has been removed and that instruments function properly. Sorts the instruments by size and type, and reassembles trays and sets based on recognition of key items or inventory needs. Uses care in packing to protect points, cutting edges, and delicate instruments and to insure effective penetration of sterilizing medium. Receives instructions on obtaining a compact, logically arranged set.

Operates the various sterilizers, as directed. Periodically tests operation of equipment for effectiveness of sterilization. Removes carts and packages from the sterilizers. Inspects packages for indications of proper sterilization. Aerates gas-sterilized packages for appropriate length of time. Labels items to show date of sterilization and shelf-life and stores the items on shelves. Fills requests for items based on daily schedules of needs or on individual requisitions. Reports to the supervisor items that are out of stock and discusses possible substitutions. Periodically inventories stock.

Nature, range, and complexity of work

Performs a variety of duties in the medical supply issuing unit of a general medicine and surgery hospital.

Removes carts and packages from the sterilizers when the cycle is completed. Inspects packages for indications of proper sterilization. Aerates gas-sterilized packages for appropriate times. Labels items to show date of sterilization and shelf-life and stores the items on shelves. Fills requests for items based on daily schedules of activities or on individual requisitions. Consults with requisitioners on items in short supply or out of stock, recommending possible substitutions. Sends requested items to wards and clinics via automated delivery systems. Periodically inventories stock. Maintains records on stock levels and recommends revisions in stock levels as the need for supplies changes.

Nature, range, and complexity of work

Provides a wing of a medical and surgical hospital with a wide variety of medical supplies, equipment, and instrument trays and sets. The wing contains such clinics as hematology, dermatology, hemodialysis, pulmonary, gastrointestinal, and cardiac catheterization, along with ward areas for the patients. Anticipates needs through periodic inventory and discussion with ward and clinic personnel, maintains stock levels, returns reusable supplies to the central processing area, and advises clinic and ward personnel on new or changed equipment and supplies, current medical supply resources, turnover time, proper use of equipment, and troubleshooting procedures.

Nature, range, and complexity of work

Rotates among the various duty assignments in the central medical supply organization. Assignments include decontamination, instrument preparation, equipment maintenance and supply, and storage and issue. Regularly serves as the senior or only employee on night and weekend duty.

Decontaminates the full range of reusable medical supplies and equipment used in the hospital's wards and clinics. Determines and uses the appropriate method for removing gross contamination. Disassembles and reassembles equipment where the internal parts may become contaminated. Operates various kinds of equipment such as ultrasonic cleaners and washer-sterilizers. Prepares the full range of trays and sets used on the wards and in the clinics of the hospital. Removes trays of instruments from presterilizing equipment, inspects items to be sure that gross contamination has been removed and that instruments function properly. Sorts the instruments by size and type and reassembles trays and sets based on recognition of key items or inventory needs. Uses care in packing to protect points, cutting edges, and delicate instruments and to insure effective penetration of the sterilizing medium. Strives for a compact, useful arrangement.

Selects appropriate methods for sterilizing, balancing time constraints with possible detrimental effects of quicker methods. Periodically tests operation of equipment for effectiveness of sterilization.

Equipment duties consist of collecting used equipment, removing gross contamination by appropriate methods, disassembling, cleaning, and sterilizing component parts, testing the operation of equipment, obtaining needed repairs, preparing components for sterilization, storing clean and sterile equipment, issuing equipment, troubleshooting the equipment, and explaining the proper use of the equipment. Maintains records on the use, issuance, stock levels, and maintenance of equipment.

Storage and issuing duties consist of removing items from sterilizers; inspecting packages for indications of proper sterilization; aerating packages, as needed; labeling items to show date of sterilization and shelf-life; and storing the items in such a way as to preserve the sterile condition. Fills requests for items based on daily schedules of needs or on individual requisitions. Suggests substitutions for items that are not available. Periodically inventories stock.

Nature, range, and complexity of work

Rotates among the various medical supply operations assignments in a medical and surgical facility requiring a complete range of medical supplies, instruments, and equipment.

Decontamination

Receives, disassembles, and inspects for damage reusable medical supplies, instruments, and equipment

Determines correct method for presterilizing. Removes soil, blood, tissue fragments, body fluids, and other gross contaminants by wiping, soaking, rinsing, scrubbing, and use of ultrasonic equipment. Loads and operates presterilizers

Reassembles medical equipment, including such complex equipment as cell centrifuges, which require skilled, careful positioning of parts and the complete elimination of dust particles or lint from the chambers

Removes items from presterilizers and determines type of tray or set to assemble based on recognition of key items and the operating room and clinic schedules

Examines items to insure that gross contamination has been removed

Assembles sets and trays by selecting appropriate tray, lining it with a towel, and arranging instruments in the tray in the correct manner, e.g., hinged instruments in open position, ring-handled instruments on a spreader, heavy instruments on the bottom, delicate items prewrapped to prevent damage, blades and points properly covered. Strives for a compact, logically arranged package that will permit effective penetration of the sterilizing medium. Places devices in the tray, selects correct wrapping for the tray, and wraps and labels it

Selects correct sterilizing medium and cycles, and operates sterilizer

Aerates gas-sterilized items for correct period of time

Periodically monitors operation of sterilizer with prescribed tests

In emergencies, uses less than optimum techniques such as flash sterilizing or faster heat techniques which might tend to deteriorate the piece of equipment

Supply

Receives sterilized trays, sets, and equipment from the sterilizer, checks for effectiveness of sterilization (color change on marker tapes, dampness of the packages), places tags on sterilized material indicating date of sterilization and expiration date, and stocks shelves with sterilized material

Assembles and loads ward and operating room carts according to schedules, and fills special and emergency request for supplies

Advises medical personnel on availability of supplies, possible substitutes, and effective use of equipment

Equipment

Receives used and contaminated equipment such as bed frames, mattresses, and vacuum pumps. Disassembles equipment, removes gross contamination from the component parts, reassembles the equipment, and checks its functioning

Determines appropriate method for cleaning and sterilizing the equipment, operates sterilizers, and stores and issues the equipment

Advises medical personnel on the proper use of the equipment and on problems that arise in connection with its use

In addition:

Receives periodic training in such areas as the use and functioning of new medical supplies, instruments, and equipment; new or improved sterilization practices; and developments in microbiology, bacteriology, and therapeutic practices as they affect the sterile supply operation

Periodically inventories medical supplies and equipment, keeping records and determining reordering needs. Removes outdated material from shelves for resterilization

Provides training and orientation to medical personnel on sterile supply techniques and procedures

In many cases, a high school diploma or equivalent is necessary for a job as a Medical Supply Aide. Specific qualifications vary by occupation, State laws, and work setting. Advancement opportunities are limited.

Education and training. Medical Supply Aide training is offered in high schools, vocational-technical centers, and some community colleges. Hospitals may require previous experience as a Medical Supply Aide. Some States also require Medical Supply Aide to complete a formal training program. However, most Medical Supply Aides learn their skills on the job from experienced workers.

Some employers provide classroom instruction for newly hired aides, while others rely exclusively on informal on-the-job instruction by an experienced aide. Such training may last from several days to a few months. Aides also may attend lectures, workshops, and in-service training.

For some individuals, these occupations serve as entry-level jobs. For example, some high school and college students gain experience working in these occupations while attending school. And experience as an aide can help individuals decide whether to pursue a career in healthcare.

Information about employment opportunities may be obtained from local hospitals, nursing care facilities, home healthcare agencies, psychiatric facilities, and local offices of the State employment service.

Information on obtaining Medical Supply Aide positions with the Federal Government is available from the Office of Personnel Management through USAJOBS, the Federal Government's official employment information system. This resource for locating and applying for job opportunities can be accessed through the Internet at http://www.usajobs.opm.gov or through an interactive voice response telephone system at (703) 724–1850 or  (703) 724–1850  or TDD (978) 461–8404 and   (978) 461–8404. These numbers are not toll free, and charges may result. For advice on how to find and apply for Federal jobs, download the Insider's Guide to the Federal Hiring Process” online here.

Last Modified Date: February 17, 2011