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Background  Proper sterile processing is fundamental to safe surgical practice and optimal patient outcomes. Sterile processing practices in low and middle-income countries often fall short of recommended standards. The impact of education and training on sterile processing practices in low and middle-income countries is unknown. We designed a sterile processing education course, including mentoring, and aimed to evaluate the impact on participants’ personal knowledge, skills, and practices. We also aimed to identify institutional changes in sterile processing practices at participants’ work places.    Methods  A mixed methods design study was conducted using a Hospital Sterile Processing Assessment Tool, knowledge tests, and open-ended interviews.    Results  Education and mentoring improved how workers understood and approached their work and to what they paid attention. Sterile processing workers were also better able to identify resources available to do their work and showed improved understanding of the impact of their work on patient safety.    Conclusions  Health care organizations seeking to improve surgical outcomes can find easy wins requiring minimal cost expenditures by paying attention to sterile processing practices. Investing in education and low-cost resources, such as cleaning detergents and brushes, must be part of any quality improvement initiative aimed at providing safe surgery in low and middle-income countries.    Electronic supplementary material  The online version of this article (10.1186/s13756-018-0312-6) contains supplementary material, which is available to authorized users.

antimicrobial resistance and infection control

Mixed methods evaluation of the impact of a short term training program on sterile processing knowledge, practice, and attitude in three hospitals in Benin