Introduction in Central Sterilization Department

OBJECTIVES

• What is the CSSD?

• CSSD layout design

• Decontamination life cycle

• Overview of CSSD standard

• Environmental Cleaning Methods

What is CSSD?

• Central Sterile Service Department (CSSD) is a place in or healthcare facilities

that performs reprocessing of medical devices used by health workers in the

operating room for surgical and other patient procedures.

• Break the chain of infection and prevent disease transmission.

• Reprocessing medical devices from the moment of use on Patient ‘’A’’ until reuse

with Patient ‘’B’’ Under the precaution criteria of infection prevention and control

(IPC)

IMPORTANCE OF DOING A GOOD JOB AT EACHSTEP

Quality Assurance for each activity!

We deal with the unseen microorganisms

Patient’s lives depend on our work

CSSD LAYOUT DESIGN

CSSD LAYOUT DESIGN and WORK FOLLOW

• CSSD areas must be physically separated into 3 areas at least two zones to

prevent cross-contamination.

• The workflow processes allow items to move progressively from the dirty phase to

the high disinfection phase.

• CSSD Technicians should be organized so that activities and objects flow in a

unidirectional way.

• Visitors must be accompanied by authorized personnel should be allowed in the

restricted areas and wear detected gown, shoes.

• This arrangement reduces the risk of cross contamination of areas and the items

being sterilized, which both improves safety and increases the efficiency of sterile

processing operations.

The objective of Decontamination RMD?

To make an item safe for reuse on patient and for handling

by staff working in healthcare facilities.

Decontamination Life Cycle

Removing all visible soils involve:

- Pre-cleaning

- Ultra sonication

- Manual/automated cleaning

CLEANING

Cleaning and kills most microbial

life except spores by (Chemical)

or heat (Thermal).

DISINFECTION

INSPECTION

Check for:

-Cleanness

-Functionality

-Damage

PACKAGING

Rigid container

wrapping

peel pouches

To prevent microorganisms from

entering the pack until time of use.

(maintain sterility)

STERILIZATION

Kills all microbial life

Sterile mean: zero live

microorganisms

TRANSPORT

Sterile RMD transported to

storage:

•Prevent damage

•Rupture to the packaging

•Prevent recontamination

STORAGE

Stored in clean room conditions.

Clean

USE

Once RMD used on patient it is

contaminated by microorganisms

and must send it for reprocessing.

TRANSPORT

Standards precautions are implemented.

Dirty

ACQUISITION

PURCHASE

LOAN

CLEANINGDISINFECTION

INSPECTION

PACKAGING

STERILIZATION

TRANSPORT

STORAGE

USE

TRANSPORT

General overview of CSSD standards

• The hospital provide centralized CSSD.

• Apply the policy and procedure of central sterilization service.

• CSSD stuff qualified by (certification,education,training).

• Immunization against Hepatitis B and record kept.

• One work flow dirty to clean.

• Environmental conditions differ between each area.

• Washing hands when visibly soiled, after gloves are removed for any reason, after

the removal of PPE, and in accordance with good personal hygiene practices and

departmental policy.

• PPE requirements, including space for donning and removing, disposal, and storage;

• quantity and placement of hand sanitizers and sinks designated only for hand hygiene;

• provision for the disposal of liquid and solid body wastes.

• storage requirements, including space for ( decontamination supplies, chemicals, cleaning

tools)

• safety data sheets (SDSs) for decontamination chemicals

• All surfaces (e.g., floors, walls, ceilings, cabinets) should be smooth, and cleanable.

• hazardous waste disposal systems.

• Closed containers for collection contamination devices .

• in-service training on all new instrumentation, devices, and equipment.

• Sharps must be placed in puncture-resistant sharps containers

Clean work area/room should include space for:

a) storage of attire for visitors ( head covers, cover gowns);

b) supplies for cleaning the preparation area .

c) monitoring and record-keeping supplies (e.g., sterilization process monitoring

devices, log books);

d) packaging materials and preparation supplies (e.g., cotton balls, gauze dressing,

tip protectors);

e) computers, if used, along with computer accessories (e.g., printer, bar code

,paper,scanner data ports);

f) incubators for BIs;

ENVIRONMENTAL CONTROL PARAMETERS

Decontamination Area

■ 18°C - 20°C

■ Negative

■ 30%-60%

Inspection, Assembly & Packaging Area

■ 20°C – 23 °C

■ Positive

■ 30%-60%

Sterile Storage Areas

■ 20°C – 23 °C

■ Positive

■ < 70 %

Environmental Cleaning Methods

• Floor are swept & wet mopped at least after each decontamination procedure in the

decontamination area.

• Floor are swept and wet mopped at least after each shift in the cleaning area.

• All areas must be free of dust, and insects etc.

• The Process of cleaning should be from dirty areas to clean areas, from high areas to

low areas (i.e., top of walls to floor).

• In case of hazardous chemicals spill etc. disinfection must be performed immediately

using the spill kit according to the steps of spill management.

• High touch horizontal surfaces must be cleaned and disinfected at the beginning and end

of each shift & more frequently during the shifts e.g. tabletops, counter tops etc.

• Decontamination sink should be cleaned after each shift and more frequently as needed.

• Work tables preferably cleaned before starting the sorting process in the

decontamination area & Inspection process in the IAP area.

• Shelves, cabinets, racks, wall, and ceiling are cleaned based on regular cleaning

schedule using a checklist

• Offices. Changing /locker room etc are cleaned at least daily. - Light fixtures, and air vent

should be cleaned at least every six months or as necessary (by Environmental Service

or Maintenance department)

Thanks