Policy Objectives
- Certification Requirements
Require all Surgical Technologists (ST) and Certified First Assistants (CFA) to:
o Obtain national certification through the National Board of Surgical Technology and Surgical Assisting (NBSTSA).
o Graduate from a Commission on Accreditation of Allied Health Education Programs (CAAHEP)-accredited program.
o Grandfather in currently employed surgical technologists and assistants as of the policy enactment date. - Recognition of Surgical Technology Week
Establish a Presidential Proclamation recognizing Surgical Technology Week, as modeled by the Association of Surgical Technologists (AST). - National Recognition for Surgical Technologist role in Emergency and Critical Care.
Officially recognize Surgical Technologists critical roles in emergency surgical care. - State Scope of Practice
Mandate that states develop a clear and consistent scope of practice for Certified Surgical Technologists (CST) and Certified Surgical Assistants (CSA). Oversight will align with existing hospital/ASC licensure processes to minimize administrative burden. - Acknowledgment of Responsibilities
Recognize the critical contributions of Surgical Technologists, including but not limited to:
o Maintaining sterile fields and preventing infections.
o Assisting in hemostasis, retracting tissue, cutting sutures, and managing cancer specimens.
o Supervising team members for compliance with sterile techniques and safe patient positioning.
Rationale and Supporting Data
Role and Impact of Surgical Technologists
• Surgical technologists autonomously perform tasks critical to patient safety and surgical outcomes.
• They prevent severe complications such as surgical site infections (SSI), unintentional retention of foreign objects, and surgical fires.
• Despite these responsibilities, surgical technology remains one of the few allied health professions that does not require licensure.
Statistics on Surgical Risks and Costs
• Unintentionally Retained Foreign Objects (URFO): Occurs in approximately 1 in 5,500 surgeries, resulting in significant patient harm and legal costs.
• Surgical Site Infections (SSI):
o Account for an estimated 13,088 deaths annually.
o Cost hospitals approximately $25,546 per infection (U.S. Department of Health and Human Services).
o Estimated total annual cost of SSIs: $3.2 billion.
• Surgical Fires: Though rare, they pose catastrophic risks. Enhanced protocols and oversight can reduce these events.
• Surgical Errors (e.g., wrong-site surgery, implant errors): Preventable errors significantly increase healthcare costs and legal liabilities.
Closing Gaps in Rural Healthcare
• Allowing CSTs and CSAs to operate with a defined scope of practice enables Physician Assistants ¶ and Nurse Practitioners (NP) to focus on other healthcare needs, reducing provider shortages in rural areas.
• Increased utilization of surgical technologists can reduce costs associated with delayed surgeries and patient transport to larger facilities.
Economic Impact
• Certification through the NBSTSA is associated with increased wages for surgical technologists, making the profession a viable and affordable career path.
• Hospitals with certified STs and CSAs report better patient outcomes and long-term continuity of care, reducing costs associated with complications.
• Licensure of surgical technologists could save billions annually by reducing SSIs, surgical fires, and retained objects.
Comparative Profession Licensing
• Professions such as cosmetology and dog grooming require licenses, yet individuals managing surgical instruments and human tissue do not. This policy seeks to rectify this inconsistency to align surgical technologist regulation with patient safety priorities.
Statements of Support
• American College of Surgeons (ACS): Advocates for accreditation and certification standards to improve surgical outcomes.
• Association of Surgical Technologists (AST): Supports mandatory certification and the development of clear scopes of practice.
Projected Outcomes
• Reduction in Healthcare Costs: Implementation could save over $5 billion annually by preventing surgical errors, infections, and associated complications.
• Improved Patient Safety: Enhanced protocols will reduce morbidity and mortality.
• Economic Growth: Higher wages and demand for certified technologists will stimulate workforce development.
References
• Association of Surgical Technologists. (n.d.). Surgical technologists: Redefining the profession. Retrieved from www.ast.org
• Joint Commission. (2011). Noncompliance with standards to reduce infection risk associated with medical devices.
• U.S. Department of Health and Human Services. (2010). National action plan to prevent healthcare-associated infections: Roadmap to elimination.
• Zimlich, R. (2020). Statistics on surgical site infections and associated costs. Infection Control Today.