The document provides an overview of the Central Sterile Supply Department (CSSD) in a hospital. It describes the CSSD's functions like receiving, cleaning, sterilizing and distributing medical supplies and equipment. It outlines the layout, staffing, equipment and processes used in different areas of the CSSD like receiving, cleaning, packing and sterilization. Quality assurance procedures like the use of indicators and records maintained are also summarized.

1. CSSD
PREPARED BY:
JIKHIL JOHN
SHIVANI R. BANGERA
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3. Introduction:
The Central Sterile Supply Department (CSSD) comprises services within
a hospital which receives; processes, distributes and controls professional
supplies and equipment, both sterile and non-sterile from to and from all
departments of the hospital for the care and safety of patients.
Ideally CSSD is an independent department with facilities to receive,
clean, pack, store and distribute instruments and supplies as per well
delineated protocols.
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4. Aim:
• Provide sterilized material from a central
department where sterilizing process is carried
out under properly controlled conditions.
• Alleviate the burden of work of the nursing
personnel, there by enabling them to devote
more of their time to patient care.
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5. Objectives and Functions
a) Provide sterilized material
b) Contributing a reduction in the incidence of hospital infection.
c) Maintains record of effectiveness of cleaning, disinfection
sterilization process.
d) Establish an inventory of supplies and equipment
e) Providing a safe environment for the patients and staff
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6. Layout
The department is designed in such a way that it is physically separated from
all other work areas.
The department is facilitate a unidirectional row from the “Dirty” area to
“Clean” area.
There is a changing area for the workers including toilet facilities and lockers
in proximity to the de-contamination area
The wash rooms, clean rooms and sterilizing is free from open windows and
unclean materials.
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7. Staffing:
Name Job Description Qualification Experience
Mrs Ninet D’Souza Hospital Aid SSLC 4 Years
Mr. Ivan Monteiro CSSD Technician ITI 8 Years
Mr. Supin Babu Staff Nurse GNM 9 Months
Mr. Jackson D’Souza Hospital Trainee SSLC 1 Month
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Duty Timings:
Designation Working Hours Staffs
CSSD Incharge 8:00 AM- 5:00 PM 1
Staff Nurse 7:30 AM- 4:00 PM 1
Hospital Aid 7:30 AM- 4:00 PM 4
CSSD Technician 11:00 AM- 7:00 PM 4
Junior Clerical Staff 8:00 AM-5:00 PM 1

8. Role OF CSSD Incharge
• Maintenance and repair of equipment
• Inventory management of supplies and consumable
• Ensure quality of sterilization
• Ensure proper distribution and transport
• Cost control measure, to analyze and reduce the number of cycle
• Record keeping and data analysis
• Motivation of staff and training
• Inter departmental coordination
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9. a
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10. Cleaning Area
• Here the instruments are washed either manually or in the machines
• For manual washing, sinks with water supply and working counters are
organized. Detergents and brushes of various sizes and shapes are
required in this area.
• Ultrasonic washer is a machine used for cleaning surgical instruments.
It converts high frequency sound waves into mechanical vibration that
produces small bubbles that burst on the internal surfaces of
instruments and dislodge the waste particles.
• After the instruments are washed, they are dried in oven dryer and
shifted to packing area.
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11. Receiving Area
• Used item from various departments of the hospital are shifted to
CSSD for cleaning and sterilization.
• Ideally, the items that get soiled with blood or bodily fluid should be
decontaminated with Sodium Hydrochloride solution in the user
department itself before sending to CSSD.
• The receiving area of CSSD should have access to outside through a
window with a counter
• Necessaries entries and are made for records.
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12. Q
Manual Washing Of Instruments Ultra Sonic Washer
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13. Packing Area
• Clean and dry instruments are packed before sterilization. So that they
are not contaminated while handling after they are sterilized. Most of
the instruments are packed in trays that are wrapped with double layer
of cotton cloth
• Sealing machine is used for the sealing the plastic bags in which
instruments are packed. After packing and sealing the instruments are
shifted for sterilization.
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14. Items Commonly Handled by CSSD
1. Syringes
2. Procedure Sets: Lumbar Puncture; sternal puncture; aspiration;
tracheotomy ; suturing; cardiac resuscitation etc.
3. Needles
4. Gloves
5. I.V Fluids
6. Treatment Trays
7. O.T. Instruments
8. O.T. Linen
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15. Equipment's Used In CSSD
• Jet water cleaning gadgets
• Ultrasonic washers
• Needle sharpener
• Testing apparatus for efficiency of sterilization
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16. Sterilizing Area:
• Sterilization is done by either of the two methods in CSSD:
Steam Sterilization by Autoclaves
Gas Sterilization by ETO (Ethylene Oxide) Machines
• Autoclave:- Steam under pressure is the most cost effective method of
sterilization , “Autoclave” generates stem at a temperature of 121 degree
centigrade under 15 pounds of pressure. An exposure of 20 minutes is
required for sterilization
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17. a
• ETO Sterilizer: The items like cardiac catheters are thermos sensitive and
therefore cannot be sterilized by steam. Such items are sterilized by
Ethylene Oxide(ETO) Gas sterilization. The ETO is an expansive and toxic
gas. It is absolutely necessary to ensure that these items are made free of gas
molecules before using them on a patient. This is achieved by subjecting the
items to forced ventilation. The entire Cycle may take about 8-12 hrs.
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18. A
Autoclave ETO Sterilizer
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19. Recall Policies for Sterilizations
In case of the failure of all cycle, the CSSD staffs informs to all concerned
department to return storial material issued from the CSSD Autoclaving
The recall procedure include:
• Sending a recall notice to the department for which news is intended
• Includes the action to be taken by person recalling the notice
Report is prepared and completed defining:
• The reason for recall
• Number of patients potentially exposed
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20. Quality Indicators
• Mechanical Indicators:
Monitoring record time, temperature , humidity and pressure during the
sterilization cycle.
• Chemical Indicators:
Devices with a sensitive chemical/dye to monitor one or more parameters of a
sterilization cycle
• Biological Indicators:
Employ the principle of inhibition of growth of micro organism of high
resistance
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21. Chemical Indicator
Biological Indicator
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22. Quality Assurance
In order to ensure the quality of sterilization, the following measures are
taken:
• Ensure the equipment is fit i.e. in Autoclave the temperature is maintained
at 121 degrees centigrade, 15 pound pressure and holding time is minimum
20 minutes. Modern machines assure that and are fitted with good quality
monitors. They provide print outs of reading. The doors of the Autoclave do
not open unless the cycle is complete.
• Bowie Dick’s Tapes are fixed with every pack of items to be sterilized. This
tape changes color whenever the required temperature is attained. After a
cycle the tapes are checked for change of color.
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23. Contd..
However the change in color only indicates that the specific temperature has
been achieved during the cycle but cannot guarantee that the items are
sterilized. Indicators are also available for checking the quality of ETO
sterilization
Bowie Dick Strips Strip Indicator Test
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24. Quality Indicators:
• Class 1: External Indicator ( daily)
• Class 2: Internal Indicator
• Class 3: Single Parameter
• Class 4: BOWIE DICK ( Test Pack Daily)
• Class 5: Biological Indicator
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25. Records Maintained
• Duty Register – 1
• Autoclave Register – 1
• Steris Register – 1
• Sterrad Register – 1
• Training Register – 1
• Recall Register - 1
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26. Biological Waste
Is the waste that is generated during diagnosis treatment or
humanization of human beings in research activities in the production
or testing of biological matter, must be displaced within 40 hours of
collection and must be segregated as per categories:
Categories Of Health Care Waste:
1) Hazardous Health Care-waste: Used or unused sharps (E.g. auto
disable syringe, infusion set, blades and broken glass)
2) Infectious Waste:- Waste suspected to create pathogens and that
poses a risk of disease transmissions.
3) Non Hazardous Waste:- Waste that does not posses any particular
biological, chemical or physical hazard.
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27. SWOC Analysis
STRENGTH :
Dedicated Staff
Good Maintenance and Cleanliness level
WEAKNESS :
Poor Ventilation
Inadequate Space
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28. Contd..
OPPORTUNITIES :
Technology development in the market
Lower Prices of Raw Material
Better Physical Structure
CHALLENGES :
The transferring of packed items for sterilization from upstairs to ground
floor is difficult
Soft Wrap packing is prone to pinholes and tear
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29. Conclusion:
In most healthcare facilities, the Central Sterile Supply
Department(CSSD) plays a key role in providing the items required to
deliver quality patient care. A well planned, well managed and well
staffed CSSD can ensure an infection free environment of hospital and
save valuable life and money.
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30. A
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