Introduction to CSSD

Brief introduction to CSSD for the core elements in introduce new CSSD in a hospital

1. Introduction to CSSD Dr. Mohamed Eleraky Infection Control Board Hospital Management Diploma Project Management Diploma ESIC / APIC member KFH-MED Dr. Moh Eleraky 30-July-19

2. Definition The Central Sterile Supply Department (CSSD) is the service responsible for receiving, storing, processing, distributing and controlling the professional supplies and equipments(both sterile and non sterile) for all user unit s of hospital for the care and safety of patient under strict quality control . Dr. Moh Eleraky 30-July-19

3. History & Development Dr. Moh Eleraky 30-July-19

4. 1 9 28 American College of Surgeon first started CSSD in their Hospital 1942 World II war, Cairo – British SDS unit 1955 Cambridge Military Hospital, UK 1958 Belfast ,  Northern Ireland Dr. Moh Eleraky 30-July-19 (The modern concept of CSSD was derived during second World War)

5. Aims & Objectives Aim: To provide safe supplies to all the user unit s of the hospital . Objectives: To provide an efficient, economic, continuous & quality supply of reprocessed materials to all areas of the hospital. To provide a safe environment for the patients and staff. Contributing to a reduction in the incidence of HAIs rates . To monitor and enforce controls necessary to prevent cross infection. To maintain an inventory of supplies and equipment. To reduce the burden of work of the nursing personnel. To assist purchase department for decision-making and selection of goods. To assist management of hospital in standardization of goods To maintain record of effectiveness of cleaning, disinfection, sterilization and monitoring process (medico legal) To educate students, nurse, technicians and others Applied research for improvement techniques. Dr. Moh Eleraky 30-July-19

6. Advantages Processing, issue & control Infection free atmosphere Economic ,Efficient and uniform source M aintains standards Reduces burden on nursing staff Prevents cros s -infe ct ion Shortens patient’s stay Ensures safe environment Inventory M aintena n ce Q ua l i t y of care Dr. Moh Eleraky 30-July-19

7. 1. PHYSICAL 2. FUNCTIONAL 3. PERSONNEL 4. EQUIPMENT 5. FINANCIAL 6. PREVENTIVE 7. QUALITY Dr. Moh Eleraky 30-July-19

8. 1. PHYSICAL 30-July-19 Dr. Moh Eleraky The space requirement in CSSD is 7-10 sq. F/ bed.

9. Dr. Moh Eleraky 30-July-19

10. Dr. Moh Eleraky 30-July-19

11. STRUCTURAL DESIGNING The Central Unit comprises of three zones, separated by two distinct barriers. One collection window One distribution window on the other end. S O ILED ZONE C LE A N I N G AREA CLE A N ZONE P A C K A G ING AREA S T E R I L I Z A T ION AREA C L E A N I N G B A R R I E R S T E R I L I Z A T I O N BA RR IE R STERILE STORAGE COLLECTION D I S T R I BUT I ON L O W HI G H Dr. Moh Eleraky 30-July-19

12. Receiving Disas s em b l i ng Area Issuing counter>> Dist r ibut i on S t o r a g e Condemnation Cleaning Sterilization IC U , L abor Room,OT Rep rocessing Assembling ( Drying and Packing) All Ward s , Emergency, OPD & other units soiled ( C ont a min a t ed ) Zone Clean Zone Sterile Zone Dr. Moh Eleraky 30-July-19

13. CSSD- Work Flow Dr. Moh Eleraky 30-July-19

14. LAYOUT OF CSSD Dr. Moh Eleraky 30-July-19

15. 2. FUNCTIONAL Dr. Moh Eleraky 30-July-19

16. Work flow of CSSD The functional area should be clearly differentiated and there should be no cross by work flow, particularly the sterile and contaminated good s . CSSD layout should be designed for unidirectional flow and have four zone for smooth workflow i.e Unclean and washing area Assembly and packing Sterilization area The storage area Dr. Moh Eleraky 30-July-19

17. 30-July-19 Dr. Moh Eleraky FUNCTIONS & ACTIVITIES

18. 3. PERSONNEL 30-July-19 Dr. Moh Eleraky

19. O R G A NOGR A M Head of CSSD Supervisors of CSSD CSSD Technician Clerks Assistant or Helper Messenger Cleaners . Dr. Moh Eleraky 30-July-19

20. Dr. Moh Eleraky 30-July-19

21. 4. FINANCIAL 30-July-19 Dr. Moh Eleraky Infra structure Equipments & Machines Human resources Supplies Maintenance Operating coast

22. 5. PREVENTIVE 30-July-19 Dr. Moh Eleraky Safety measures should be applied to prevent occupational hazards in CSSD: Biological Agents: Infection e.g. Legionnaires' disease, CJD & Blood Borne Viral diseases. Chemical Agents: Fire, Explosion & Health effects such as respiratory problems, allergies or dermatitis. Electricity: Fire, Electrocution & Burns . Equipments: Burns, Cuts, Explosion, Physical injury & Death . Ergonomic Hazards: Pain in back, hands or arms. Manual Handling: Musculoskeletal disorders. Noise: Hearing damage or loss, Physiological effects, Work related stress & Increased risk of accidents. Non Ionizing Radiation: Heating / skin burns & Eye damage - cataracts. Sharps: Cuts & Infection . Slips & Falls: Minor injuries such as cuts to major injuries such as broken bones, concussion and even death. Temperature: Heat stress & Burns . Wet Work: Dermatitis

23. 6. EQUIPMENT Examples for some equipments in CSSD: Cleaning and decontamination machines Ultrasonic Washer Steam Boiler Hot air ovens Autoclaves . Ethylene oxide sterilizer. Plasma sterilizer Testing material to check effectiveness of sterilization . Sealing machine Material :labels, pack ag ing rolls, chemicals , ………. Others : trolleys, work surface, telephones, ………

24. 7. QUALITY Quality management of services in CSSD is extremely important in view of its role - In hospital infection control - The catastrophic effects the poor quality service may have on patients. However, quality of services can be judged from level of satisfaction of the clients . The clients in case of CSSD are all internal (Consumer departments/clinicians).

25. High quality CSSD services to them means: 100% reliability of sterility of stores supplied by CSSD. Timely supplies in right time. Contents of the trays/ sets are as per the standard list provided by users & all the contents are in full operational order. Trays/ Sets are labeled correctly. The sterile items supplied remain sterile up to their pre- determined shelf life. Quality of the items does not deteriorate by the sterilization technique used. (The quality of outcome, however, depends upon the quality of infrastructure & process used in CSSD.)

26. THANK YOU 30-July-19 Dr. Moh Eleraky