The Central Sterile Supply Department (CSSD) is vital for providing sterile medical equipment and supplies to various hospital departments, with functions including cleaning, sterilizing, and distributing these items. It operates through clearly defined zones to ensure a safe workflow and minimize contamination risk, and features specific layout and staffing requirements based on hospital bed capacity. The CSSD aims to enhance patient safety by reducing infection rates and maintaining an efficient inventory of sterilized materials.

1. CSSD
ANJU SINHA
M. Sc. NURSING FINAL YEAR

2. A CSSD is a department that furnishes all supplies required for
the nursing units and departments of a hospital-theatres, wards, out-
patient and casualty departments with complete, sterile equipment
ready and available for immediate treatment of patients.
•
These supplies include sterile linens, sterile kits, operating room
packs, needles, syringes and other medical surgical supplies. In
addition, the personnel in this department clean, inspect, repair,
assemble, wrap and sterilize special treatment trays for various nursing
units
Definition

3. Ideally, CSSD is an independent
department with facilities to receive,
clean, pack, disinfect, sterilizes, store
and distribute instruments and
supplies as per well-delineated
protocols.
By custom diets, medicines, laundry,
supply of blood and crystalloid are not
included in activities of CSSD.

4. Objective and Functions
a. To provide sterilized material.
b. Contributing to a reduction in the incidence of hospital
infection.
c. To avoid duplication of costly equipment.
d. To maintain record of effectiveness of cleaning,
disinfection and sterilization process.

5. e. To monitor and enforce controls necessary to prevent
cross infection.
f. To maintain an inventory of supplies and equipment.
g. To stay updated regarding developments in the field.
h. To provide a safe environment for the patients and staff.

6. • Size and location of CSSD varies
• 7 to 10 square feet per bed is recommended
• It should be located as close as possible to Operation
theatres, Accidents and Emergency department and
wards
• The CSSD layout should be designed for a unidirectional
flow
Designing of a
CSSD

7. CSSD should have four zones for a smooth work flow:
a. The unclean and washing area
b. The assembly and packing area
c. The sterilization area
d. The sterile area

8. Bed size of the hospital
• Up to 100 beds
• 100-500 beds
• Above 500 beds
Location of CSSD
• In operation theatre
• CSSD centrally located in
service area
• CSSD in service area and a
separate unit for OT to be
called theatre sterile supply
unit (TSSU)
Planning of
CSSD

11. PLANNING of CSSD
- The materials/ items from contaminated and sterile
areas should not get mixed.
- There should be physical barrier between clean and
dirty areas.
- The floor should be smooth, impervious, non skid and
robust.
- Relative humidity should be maintained at 45±5 %

12. Location
• The CSSD should be close to the casualty,
Operation Theatre and wards which are the largest
consumer of the sterilized material.
• In multistoried buildings, CSSD may be planned
in the lower floor right under the Operation
Theatre, where vertical movement will be the
quickest possible movement of the material.

13. Floor Space
Serial Beds available Floor space required for CSSD
1 75-99 10 sq feet per bed
2 100-149 9 sq feet per bed
3 150-199 8.5 sq feet per bed
4 200-249 8 sq feet per bed
5 250-299 7.5 sq feet per bed
6 300 or More 7 sq feet per bed

14. LAYOUT OF CSSD

16. WORK FLOW
 MAJOR ACTIVITIES IN A CSSD:
 RECEIVING THE USED ITEMS FROM USER DEPARTMENTS
 CLEANING
 PACKING
 STERILIZING
 STORING (TEMPORARY)
 DISTRIBUTING TO USER DEPARTMENTS

17. WORK FLOW OF CSSD

19. CSSD- Work Flow

20. The receipt and issue counters are separated by
a corridor to avoid contamination
The receipt and issue counters are separated by a corridor to avoid
contamination
Processing and
packing of items
Sterilization
Distribution
point
Sterilized item store
Separation of sterilized items by a partition or corridor

21. 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 body fluid
should be decontaminated with Sodium Hypochloride
solution in the user department itself before sending to CSSD.

22. • The Receiving Area of CSSD should have access to
outside through a window with a counter.
• The items (Specially for instruments in trays) are
counted and Received.
• Thereafter, the instruments are inspected and
blunt/unsuitable Instruments are segregated/discarded.
• Necessary entries are made for records.
• Thereafter, the items are shifted to Cleaning area.

23. Equipments and materials required:
• Hot and cold running water
• Cleaning brushes and jet water gadgets
• Ultrasonic washers
• Hot air oven for drying instruments and sterilization
• Globe processing unit
• Instrument sharpener like needle sharpening machines
• Stem sterilizers and boiler for steam
• Autoclaves of various sizes including gas autoclave
• Testing equipment
• Chemicals to clean materials
• Wall fixtures like sinks, taps
• Trolleys for supply of sterilized items and separate trolleys for
collection of used items are needed

24. Methods of sterilization:
Sterilization is a process of freeing an article from all living organisms including bacteria, fungus,
using dry or wet heat, chemicals or irradiation.
• Steam sterilization: example:-autoclaving
• Hot air sterilization:
• Gas sterilization with ethylene oxide.
• Sub atmospheric pressure sterilization with formalin:
• Chemical sterilization with activated glutaraldehyde
• Gamma irradiation sterilization:
• Formaldehyde steam sterilization

25. STORE
AFTER STERILIZATION, THE ITEMS ARE TEMPORARILY
STORED IN A CLEAN STORE (ON RACKS) FROM WHERE
THEY ARE DISTRIBUTED TO USER DEPARTMENTS

26. DISTRIBUTION AREA
- IT SHOULD BE AWAY FROM THE RECEIVING AREA AND
MAY COMPRISE OF A WINDOW WITH COUNTER.
- IN MODERN HOSPITALS, THERE MAY BE A SEPARATE LIFT
FOR TRANSPORTING THE STERILE MATERIALS TO USER
DEPARTMENTS.

27. TRANSPORT TO
OT
USED
MATERIALS
TRANSPORT
CLEANING
DISINFECTION
INSPECTION
TRAY
ASSEMBLY
PACKAGING
STERILIZATION
STERILE
STORAGE
CSSD

28. Staffing pattern of
CSSD

29. Staffing should be planned based on the following factors:-
– Average 02 technicians for 100 beds and one technical
supervisors.
– One clerk for keeping records, accounting and supply
per shift.
– Average 04 attendants per 100 beds in all shifts.
– Adequate number of cleaning attendants and
transporters.
– One technician and two attendants should be stationed
at each zone.