Process flow, CSSD IS A SERVICE UNIT IN A HOSPITAL

CSSD IS A SERVICE UNIT IN A HOSPITAL THAT
PROCESSES, ISSUE & CONTROLS THE STERILE
STORES SUPPLY TO ALL DEPARTMENTS OF THE
HOSPITAL.
CSSD IS THE DEPARTMENT WHICH DEALS WITH
RECEIVING, CLEANING, PACKING,
DISINFECTING, STERILIZING, STORING AND
DISTRIBUTING ALL SURGICAL INSTRUMENTS
AND EQUIPMENTS AS PER WELL-DELINEATED
PROTOCOLS AND STANDARDIZED PROCEDURES.

1. ALL YOU NEED
TO KNOW ABOUT
CENTRAL
STERILE SUPPLY
DEPARTMENT

2. CENTRAL STERILE & SUPPLY
DEPARTMENT
IN A QUATERNARY CARE HOSPITAL
CSSD presentation 2024
BY TALAL ALBUDAYRI

3. CSSD IS A SERVICE UNIT IN A HOSPITAL THAT
PROCESSES, ISSUE & CONTROLS THE STERILE
STORES SUPPLY TO ALL DEPARTMENTS OF THE
HOSPITAL.
CSSD IS THE DEPARTMENT WHICH DEALS WITH
RECEIVING, CLEANING, PACKING,
DISINFECTING, STERILIZING, STORING AND
DISTRIBUTING ALL SURGICAL INSTRUMENTS
AND EQUIPMENTS AS PER WELL-DELINEATED
PROTOCOLS AND STANDARDIZED PROCEDURES.
OR

4. FIRST CSSD WAS SET IN INDIA AT JASLOK
HOSPITAL IN JULY, 1973 BY NALINI GAITHONDE
ANALYSTS SAY THAT 85 PER CENT OF MOST OF THE
UPCOMING HOSPITALS HAVE A WELL-EQUIPPED
CSSD.
FACTS

5. WHY CSSD ???
By having separate CSSD, we can decrease the cost of sterilizers through
centralization of equipment in one department. Besides, this would also ensure
that a dedicated staff can effectively monitor the sterilization process as
per the Standard Operative Procedures (SOPs).”
“CSSD requires technical competency, which implies that the department
controls all the activities of asset management pertaining to selective
procurement of general and specialised surgical instruments and other
inventory.

6. WHY CSSD ???
“The rise in incidence of nosocomial infection with corresponding
increase in mortality, length of stay and cost can be brought down
by establishing a good CSSD set-up.”
CSSD was generally looked upon as an essential part of an OT as
the use of sterile supplies in a hospital is maximum to the OT.
However, all that has changed. CSSD is considered today, integral to
the function of Out Patient Department (OPDs), wards and other
departments.”

7. COST OF
INFECTIONS
Prolonged stay in hospital
Additional resources and burden on hospital.
Loss of manhours - doctors and patients
Mental agony
Significant economical loss.
Poor surgical results

8. Function of CSSD
Receiving unsterile stores, instruments, equipment & linens from medical stores & various
consumer department of hospital.
1.
Sorting out the items.2.
Washing, disinfection & drying.3.
Checking & packing of sets/trays/instruments.4.
Sterilization of all items received, by using the appropriate techniques as applicable to the items.5.
Storage & issue of the sterilized items to the consumer departments.6.
Maintaining records of the stores received, processed & issued.7.
Validation of the effectiveness of sterilization techniques.8.
Training of staff in techniques of sterilization.9.
Advice to consumer departments on sterilization of items of different nature10.

9. Quality Management of services in CSSD
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 clientele.
The clients in case of CSSD are all internal (Consumer
departments/clinicians).

10. QUALITY MANAGEMENT OF SERVICES IN CSSD
High quality CSSD services to them means:
Hundred percent 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.)

11. SPACE, LAYOUT, SURFACE FINISH
The space requirement in CSSD is 7-10 sq. F/ bed.
The layout must follow the zoning concept & functional flow with receipt (dirty) counter
on one end & sterile issue on other end.
Inside CSSD there should be no criss crossing & area should be divided by partitions into
dirty, clean & sterile zones.
Similarly, gas & steam sterilization should be separated.
The entrance lobby should have….
A changing room with toilet & hand washing facility.
The flooring should be non-skid type.

12. Department should be under overall control of
HOD of OT/Nursing.
Should be headed by trained & experienced
manager.
Should have trained staff(technicians,
attendants) on each shift at each zone
irrespective of volume
2. ORGANIZATION &
STAFFING

13. 3. Equipment Quality /Availability
Ultrasound cleaners.
Instrument washers
Steel racks for storage of unsterile & sterile sets.
Work tables
Gas sterilizers
ETO
Autoclave machines fitted with sterimeters for temperature/time recording,
Self recording pressure gauze for pressure/ time recording.
Computer terminals.

14. 4. QUALITY OF
MATERIALS
Quality of disinfectants,
detergents, cotton-wool gauze
& other supplies should be of
ensured.

15. 5. ENGINEERING SUPPORT SERVICES
Stable & uninterrupted power supply.
Running water of desired quality
Temperature with comfort zone.
Ventilation with 10 air change per hour.
Humidity level 50-60 %
Illumination level of 200 Lux

16. Operation Theater. Wards
Receiving Instrument Room
Decontamination Room
Drying & Packing
Sterilization
Sterile Storage
Trolleys Cleaning
Operation Theater Ward
Process followed Currently
IN QUATERNARY CARE CENTER
CURRENT SITUATIONS

17. OT Instruments
Ward Instrument
Trolleys
Chemicals
Plastic Apron
Preparation Tables
Bins
Sealing Machine
Loading trolleys
Paper holding trolleys
Racks
Linens
Computers
Registers
Measurable Cups
Items Handled by CSSD currently

18. MAN POWER
CSSD Manager
Technicians(4)
Helpers(6)

19. SHORT COMINGS
Manpower.
Instruments
Door bell.
Keys.
Drying cabinet.
Water jet in decontamination.
Exaust fan in ETO room.
Plastic crates
Validation not done by IC

20. SWOT ANALYSIS
Strengths
Weakness
Opportunities Threats

21. Training Staff
Physical structure
Structure (Validation)
Lack of trained staff
Increased HAI
Back up for packing
Security
Safety
Untrained Staff
Instruments
Inappropriate changing
room
Other essential
requirements compromised.
Technology
Instrument
Accessories
STRENGTH WEAKNESS
OPPORTUNITIESTHREAT

22. Improvement initiated
Manuals & SOPS are ready.
Key are provided to department.
Backups have been planed.
Safety is been considered.
Checklist is provided.

23. THANK YOU
Keep it up!!
Talal Albudayri
[email protected]
https://t.me/tolioCSSD