WELCOME

CENTRAL STERILE SUPPLY DEPARTMENT

CSSD OVERVIEWThis Department is Heart of any Hospital as it receive impure (Used patient care and reprocessible) supplies, purifilies (Decontaminates ,cleans,assembles,packs and sterilizes) and supplies pure (Sterile) material to patient

care areas.

To provide sterilized material to all the patient care area from single department where cleaning & sterilized practice are conducted under conditions, which are controlled, there by contributing to reduction of Hospital acquired Infections.

To Give More Prompt service to the user department so they can devote more time to theirs patient care activities.

To avoid duplication of costly equipment's which may be infrequently used.

OBJECTIVE OF CSSD

To maintain record of effectiveness of sterilization process.

To maintain proper inventory of supplies & equipment.

To stay updated regarding development in the field of sterilization with the interest of effiency,economy accuracy and provision for the better patient care.

To provide a safe environment for the patient & staff.

Step 3-

CLEANING & STERILIZATION PRACTICES

QUALITY ASSURANCE

Used Instruments From Wards

Used Instrument from OT

Receiving through receiving Window

Through Unsterile Lift

CSSD WORK FLOW

Decontamination Area

Manual Cleaning Mechanical Cleaning

Washer Disinfector/Ultrasonic

Drying of Instruments

Check for Functionality

Visual Inspection For Damage

ETO Sterilization

Steam Sterilization

Confirm Sterility

During Sterilization

Failure

Recycling of Load

Storage in Sterile Area

Assembling & Packing of Instruments into respective Sets (Pack)

Dispatch

Pick up at delivery Counter

Through Sterile Dumbwaiter

Wards O.T.

Receiving Area (Cleaning Zone) Processing Area (Instrument Assembling Zone) Sterile Zone

AREA OF CSSDCSSD is divided into mainly Three Zones

Cleaning is the first & most important step in the sterilization process “We can clean without sterilizing, but cannot sterilize without cleaning & we can clean without disinfecting but cannot disinfect without cleaning” So cleaning is a critical step in decontamination, and it must be done effectively and timely.

Cleaning of Medical Devices in CSSD

Cleaning is the removal of both visible and non-visible soil(such as blood,protine substance, and other debris) from the surface,crevices,joints,and lumens of instrument,devices,and equipment-usually with a detergent and water.

DECONTAMINATION

Decontamination is the use of physical or chemical procedure to remove, nactive,or destroy blood-borne pathogens on a surface or item. The purpose of decontamination is to make devices safe to handle for people who are not wearing gloves.

DEFINITION OF CLEANING

Disinfection kills or reduce the number f pathogenic microorganism on the surface of inanimate surface the level of disinfection required depends upon the purpose for which the item last used, and the purpose for which it will next be used.

IMPORTANCE OF CLEANING

Surgical instrument that has not been properly cleaned after use can load to post operative complication, include infection. “if it is not clean, it cannot be sterile”

Heat sensitive item that has not been properly clean & dry it can be react with ETO to form ethylene glycol, which is a toxic acid.

DISINFECTION

The cleaning and decontamination cycle for the surgical instruments and medical devices starts at the point of use. Instrument that have been soiled by patient blood and protein should be put into the cleaning process as soon as possible.

Step 1-Rinsing with tap water immediately after use at the point of use.

Step 2-The item should be transported to the CSSD Receiving area within 15 to 60 minute.

PROCEDURES OF CLEANING

Step 3-Complete disassembly and opening the hinge joints of the surgical instrument.

Step 4-pre inspection is performed prior to placing instruments in the automated washer.

Step 5-cleaning by manual or automated methods.I. Manual cleaning:-use friction to physically remove

deposits that were only softened and not remove during pre-soaking .manual cleaning may be done:Using nylon bristle brushes is an effective way to remove bio-burden from instrument jaw serrations and box hinges. always use the correct size brush, when cleaning a lumen.

Automated washer:-Automated washer are effective for cleaning instrumentation, instrument container,basins,bowls,and pitcher. They should not ,however ,be used to wash electrical ,battery-operated or pneumatic devices.

Washer effectively disinfect instrument through thermal action (Heat)

Ultrasonic Cleaners:-Ultrasonic cleaners are effective for cleaning instrument with delicate structure which cannot withstand mechanical force and having complex design that cannot be easily cleaned.

All instrument and devices are correctly packed as per the method of sterilization, to contain and protect the product, to facilitate sterilization, to maintain sterility while storing and transporting and to allow procedure to be carried out aseptically while using for patient care.

Labeling:- Label is clearly written with the titles include the pack contents.

The label include date of expiry and signature of the packed by

PACKING & LABELING

Policy- All Sterile packs are having a sequential batch number to enable batch traceability and /or recall.

Batch Number_ The batch label indicates the following details-1. Date of Sterilization2. Date of Expiry3. Sterilizer Number4. Process/Cycle NumberThis is to facilitate batch traceability and recall of all

the items expired or in the event of a sterilization failure.

RECALL POLICY

Recall may be necessary while the sterile items are not being used within the date of expiry.

• The User Department is responsible for checking their stock of expiry in daily basis.

• Any item found expiring will be removed from the stock prior to one day of the expiry date and send back to CSSD receiving counter for reprocessing.

• A replacement of the same is issued to the department from sterile issue counter.

Recall may be necessary during a process failure which is subsequently required to process all the items in the same load-the user will be informed by through phone and through e-mail.

PROCEDURE

Indicators are used for check the quality of sterilization & monitoring of the sterilization process.Indicators are two types –1-Phycical indicator 2-Chemical indicator3-Biological Indicator

Physical indicator- Physical indicator are used for monitoring of sterilization process-like that Print out,gauge,and graph of sterilization machine.

Chemical Indicator-These indicator also used for monitoring of sterilization and quality purpose. we are using many types of Indicators.

Biological Indicator-Biological Indicator are used for control the quality of the sterile packs. Geo bacillus sterothermophilus are used in BI Indicator.

Category of chemical indicator are divided into 6 Classes .

CLASS 1 INDICATOR-Autoclave tape(Labling tape) these indicator are called Process indicator, it will be color change after processing.

INDICATOR

CLASS 2 INDICATOR- Bowie & Dick Teste- these indicator are used for quality of Air Removal Teste.

CLASS 3 INDICATOR-These are single parameter indicators used mainly in the industry for recording the exact temperature in a water bathe Temp Tubes

CLASS 4 INDICATOR -These indicator are also called as multi parameter indicators as they confirm to two or more parameters, they confirm to quality of steam and time or temperature.

CLASS 5 INDICATOR-These indicator also called as a integrator, as they integrate all temperature and time over 110C in this temperature spores start to be eliminated.

CLASS 6 INDICATOR-Class 6 indicator are called the emulating indicators and they change colors only on stead value like 121C for 15 minute and 134C for 4 minute. they are said to be the most stringent indicator and is more difficult to pass than a class 5 indicator. A class 6 indicator is said to integrate all the critical parameters of a process (VIZ) steam quality, Time and Temperature.

“STERILIZATION IS THE PROCESS OF KILLING ALL MICROBIAL LIFE LIKE THAT VIRUS, BACTERIA,FUNGI INCLUDING SPORE FROM THE MEDICAL DEVICES”

We are doing three types of sterilization-1. Steam sterilization (Steam)2. Gas Sterilization (ETO)3. Chemical Sterilization (Cydex)

STERILIZATION

SLIDE CREATED BY-VIKAS DHYANI

VERIFIED BY-MR.SHIVPUJAN SINGH

THANK’S