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    CSSD Central Sterile Supply Department

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    Ansari Shariq
    The document discusses the Central Sterile Supply Department (CSSD) and its role in providing sterilized materials from a central location. It outlines the history and development of CSSDs. The CSSD aims to provide sterilized supplies under controlled conditions and reduce the workload of nursing staff. Advantages include safe sterilization, cost-effectiveness, standardized procedures, quality control and availability of supplies. The document details planning, layout, equipment, staffing, distribution systems, and sterilization methods like steam and radiation used by CSSDs.

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    CSSD Central Sterile Supply Department

    Uploaded by

    Ansari Shariq
    2K views35 pages
    The document discusses the Central Sterile Supply Department (CSSD) and its role in providing sterilized materials from a central location. It outlines the history and development of CSSDs. The CSSD aims to provide sterilized supplies under controlled conditions and reduce the workload of nursing staff. Advantages include safe sterilization, cost-effectiveness, standardized procedures, quality control and availability of supplies. The document details planning, layout, equipment, staffing, distribution systems, and sterilization methods like steam and radiation used by CSSDs.

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    CSSD

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    The document discusses the Central Sterile Supply Department (CSSD) and its role in providing sterilized materials from a central location. It outlines the history and development of CSSDs. The CSSD aims to provide sterilized supplies under controlled conditions and reduce the workload of nursing staff. Advantages include safe sterilization, cost-effectiveness, standardized procedures, quality control and availability of supplies. The document details planning, layout, equipment, staffing, distribution systems, and sterilization methods like steam and radiation used by CSSDs.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    2K views35 pages

    CSSD Central Sterile Supply Department

    Uploaded by

    Ansari Shariq
    The document discusses the Central Sterile Supply Department (CSSD) and its role in providing sterilized materials from a central location. It outlines the history and development of CSSDs. The CSSD aims to provide sterilized supplies under controlled conditions and reduce the workload of nursing staff. Advantages include safe sterilization, cost-effectiveness, standardized procedures, quality control and availability of supplies. The document details planning, layout, equipment, staffing, distribution systems, and sterilization methods like steam and radiation used by CSSDs.

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    The passage discusses the history and role of Central Sterile Supply Departments (CSSD) in hospitals, as well as factors that impact sterilization effectiveness.

    CSSD stands for Central Sterile Supply Department. It is a service within hospitals that is responsible for sterilizing supplies and ensuring sterile materials are provided to different departments.

    1928 - CSSD established by American College of Surgeons. 1942 - Sterile supply unit established in Cairo during World War 2. 1955 - First regular CSSD established in UK. 1965 - First CSSD established in India.

    CSSD

    Central Sterile
    Supply Department
     “ No Stronger Condemnation of
    any hospital or ward could be
    pronounced than the simple fact
    that ZYMOTIC DISEASE has
    originated in it or that such
    disease attack other patients than
    those brought-in with ”
    - FLORENCE NIGHTINGALE
     BHATTA CHARJEE DEFINES –
    CSSD
    as that service, with in the
    hospital, catering for the sterile
    supplies to all departments , both
    to specialized units as well as
    general wards and OPDs.
     1928 – American College Of
    Surgeons – CSSD.
     1942 – World War II .Cairo, British

    SDS Unit .
     1955 – Cambridge Military Hospital

    – Regular CSSD in UK.


     1965 – First CSSD in India –

    Safadarajan Hosptial
    AIMS
     To provide sterilized material from
    a central department where
    sterilizing process is carried out
    under properly controlled conditions

     To alleviate the burden of work of


    the nursing personnel, there by
    enabling them to devote more of
    their time to patient care .
    ADVANTAGES ;
    1. Bacteriological safe sterilization.
    2. Less expensive.
    3. Elimination of unsound practices &
    establishment of standard procedures.
    4. Assurance of adequate supply of sterile
    products immediately and constantly
    available for sometime as well as
    emergency use.
    5. Conservation of trained staff.
    6. Better quality control
    7. Better good of material flow
    8. Prolonged life by proper care of
    equipment
    ITEMS COMMONLY HANDLED BY

    CSSD STORES
    1. Syringes

    2. Procedure Sets
    Lumbar puncture ; sternal puncture ; venesection ;
    paracentesis ; aspiration ; catheterization ;
    tracheotomy ; suturing ; dressing ; biopsy ;
    incision & drainage ; aortography ; cardiac
    resuscitation ; etc

    3. Needles

    4. Gloves
    5. I.V.Fluids.
    6. Treatment Trays.
    7. O.T Instruments.
    8. O.T. Linen
    9. Infusion Fluids for Renal Dialysis.
    10. At times LINEN. (other than O.T)

    NB: Diet , drugs , bedpans & urinals are


    not included by convention .
    PLANNING A DEPT ; (COPP)
    1. Physical Planning.
    2. Functional Planning.
    3. Personnel Planning.
    4. Equipment Planning.
    5. Financial Planning.
    6.Quality Control.
    7.Preventive Maintenance.
    PHYSICAL PLNG
    1. Location & Grouping .
    2. Lay Out & Space Reqts.
    3. Fixturtes & Furniture .
    RULE OF THE THUMB
    ROUGHLY – 10 SQFT / BED - MCGIBONY
    ADM & STORAGE 21² M
    (UNSTERILE) AREA SCALES OF
    RECEPTION,CLEANING, 35² M ACCN FOR
    CHECKING,ASSEMBLY ARMED
    & PACKING AREA FORCES
    AUTOCLAVING AREA 28 ² M HOSPITALS
    AH/CH/ SAY >
    STERILE STORAGE & 28 ² M
    700 BEDS
    ISSUE AREA
    EQPT IN CSSD
    1.Jet water cleaning gadgets.
    2.Ultrasonic Washers
    3.Glove sharpener
    4.Needle sharpener.
    5.Gas, Chemical or steam autoclaves.
    6.Testing apparatus for efficiency of
    sterilization
    OTHERS
    1.Maint & Repair EQPT
    2.Adequate number of cabins &
    Furniture
    3.Telephone or intercom.
    4.Adequate no of syringes &
    procedure sets.
    NUMBER OF SETS/SYRINGES
    A - 1½ Daily requirement in use at wards /
    Departments
    B - 1 Daily requirement in sterile state at CSSD, ready
    for issue
    C - 1 Daily requirement being processed at CSSD
    D – 1to 1½ Daily requirement held in reserve – dome
    in CSSD, some in medical stores

    Total: 4.5 to 5 times of the daily requirement


    Methods Of Sterilization / Disinfection

    Natural Chemical Physical


    Sun Light (UV) Solids Dry Heat

    Air Lime, Bleeching Powder, Burning or Dry Air


    KMNO4
    (Desiccation) (160°C for 60 Min)
    Liquids
    Moist Heat
    Formalin, Phenol , Alcohol ,
    Boiling Steam
    Glutaraldehyde
    Radiation
    Gases
    Ionising Radiation
    Formaldehyde, Ethylene
    U V Rays
    Oxide
    CHEMICAL
    CIDEX – A Glutaraldehyde derivative is most
    effective as it destroys spores too.
    ETHYLENE OXIDE (ETO) ;
    - Quite effective against spores too.

    - Useful for delicate instruments and item which

    can’t be immersed in liquids


    - Low Boiling Point (10 degree C)
    - Prolonged Aeration
    - Highly Expensive / Explosive / Toxic
    Types Of Sterilization Techniques
    1.Dry Heat
    2.Steam High Pressure Autoclaves operated by Gas, K.oil or
    Electricity ( Flash, Pulse)
    3. Ethylene Oxide Sterilization.
    4. Chemical Sterilization.
    5. Radiation Sterilization.
    - Infra Red Radiation – Syringes
    - Ultra Violet Radiation – Decontamination of Air
    - Ionising Radiation / Gamma Radiation
    ISOMED at BARC
    STERILISATION .

    It is a process of freeing an article from


    all living organisms including bacteria
    ,fungal spores and viruses.

    A material is pronounced sterile if it


    achieves 99.99% kill of bacterial spores.
    STEAM STERILATION
    - Water  Saturated  Wet vapor  Dry
    saturated Vapor  Super Heated Vapor / Steam

    - Steam with <0.95 Dryness Factor is not useful


    for Sterilization.

    - Superheated Steam acts like Dry Hot Air only . (


    Strength Of Steam is its Latent Heat)
    MODE OF ACTION.

    Dry Heat  Oxidation


    Steam  Denaturation = Coagulation of Proteins

    Sterilization Time Pressure Temperature


    (Holding Time + Safety (PSI) ( C° )
    Time)
    2' + 1′ = 3' 30 134
    8' + 2' = 10' 20 126
    12' + 3' = 15' 15 121
    TYPES OF AUTO CLAVING
    MACHINES

    1. Downward Displacement
    2. Vacuum Assisted.
    3. Pulsed Steam Dilution
    TESTS FOR EFFICENCY OF
    STERILISATION
    1. Specially treated paper strip.

    2. Pressure sensitive tape to be fixed to the


    final fold

    3. Brown indicator tubes - (very expensive)

    4. Biological. Green strip containing bacteria


    (Color must change to black)
    5. Cellophane wrapped tablet containing
    - Lactose - 75%
    - Starch - 24%
    - Magnesium Trisilicate – 1% (Tablet turns
    brown during autoclaving)

    6. Microbiological examination of finished


    products.

    7. Thermo - couples .
    ADVANTAGES OF STEAM
    STERILISATION
    1. Rapid heating & penetration of
    loads.
    2. Destruction of all forms of
    microbial life
    3. No residual toxicity.
    4. No damage to supplies being
    sterilised.
    5. Easy Quality Control
    6. Economical & Reliable

    This method is unsuitable for heat


    sensitive and non- permeable material
    RADIATION STERILISATION ;
    ‘ ISO MED ‘ at ‘BARC’ Trombay; dose - 2.5
    Mega Rhontgen; Source – Cobalt-60 /Caesium
    – 137/ Electron Beam (generated by linear
    accelerator)
    Reliable, can penetrate all types of packing.
    Large & diverse shaped articles can be
    sterilised. No residual radio activity at 2.5 mega
    rhontgens.
    Glass becomes dark, cotton looses tensile
    property, food gets undesirable flavor. Not
    practicable in hospitals
    STAFFING :CSSD
    BHATTA CHARJEE RECOMMENDS :
    SUPERVISORS (sister/male ward masters) 4
    STAFF NURSES 5
    TECHNICIANS (ORA) 6
    ATTENDANTS 24
    SWEEPER 4
    CLERK 1
    TOTAL 44

    CENTRALISED SUPPLY (RULE OF THUMD 2PER 100 BEDS)


    DISTRIBUTION SYSTEMS :

    1. Regular issue of one day’s requirement.

    2. Clean for dirty exchange.

    3. Milk round system (topping up


    predetermined stock level)

    4. As on required basis. (Grocery system)


    FLOW PROCESS : CSSD
    WARDS/DEPTS BULK STORES

    DIRTY RECEIPT CLEAN RECEIPT COTTON & GAUGE

    DISASSEMBLY

    INSTRUMENT GLOVES RUBBERWARE


    WASHING AREAS

    ASSEMBLY
    INSPECTION
    PRE – STERILE STORAGE

    STERILISATION STERILESTORAGE

    DISTRIBUTION
    A SUGGESTED LAYOUTOF
    CSSD

    AUTOCLAVE
    ASSEMBLY
    (PARKING) ROOM
    STERILE
    CLEANING&
    WASHING
    GLASS PARTITION STORAGE
    Supervisors
    Clean disasse office
    storage mbly
    Verandah

    clean
    Dirty ° ° ° STERILE
    recep
    recepti tion ° 0 ° ISSUE
    on ° °
    °
    RAMP
    INTRA MURAL COMMUNICATION LINE
    Thermal Death Time (TDT)


    TDT is the time required to kill a known
    population of microorganisms in a specific
    suspension at a particular temperature


    Increasing temperature decreases TDT


    Lowering the temperature increases TDT
    Thermal Death Time ( cont.)

    Acidic or basic pHs decrease TDT


    Fats and oils slow penetration and increase
    TDT

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