OBJECTIVES
• What is the CSSD?
• CSSD layout design
• Decontamination life cycle
• Overview of CSSD standard
• Environmental Cleaning Methods
What is CSSD?
• Central Sterile Service Department (CSSD) is a place in or healthcare facilities
that performs reprocessing of medical devices used by health workers in the
operating room for surgical and other patient procedures.
• Break the chain of infection and prevent disease transmission.
• Reprocessing medical devices from the moment of use on Patient ‘’A’’ until reuse
with Patient ‘’B’’ Under the precaution criteria of infection prevention and control
(IPC)
IMPORTANCE OF DOING A GOOD JOB AT EACHSTEP
Quality Assurance for each activity!
We deal with the unseen microorganisms
Patient’s lives depend on our work
CSSD LAYOUT DESIGN and WORK FOLLOW
• CSSD areas must be physically separated into 3 areas at least two zones to
prevent cross-contamination.
• The workflow processes allow items to move progressively from the dirty phase to
the high disinfection phase.
• CSSD Technicians should be organized so that activities and objects flow in a
unidirectional way.
• Visitors must be accompanied by authorized personnel should be allowed in the
restricted areas and wear detected gown, shoes.
• This arrangement reduces the risk of cross contamination of areas and the items
being sterilized, which both improves safety and increases the efficiency of sterile
processing operations.
The objective of Decontamination RMD?
To make an item safe for reuse on patient and for handling
by staff working in healthcare facilities.
Decontamination Life Cycle
Removing all visible soils involve:
- Pre-cleaning
- Ultra sonication
- Manual/automated cleaning
CLEANING
PACKAGING
Rigid container
wrapping
peel pouches
To prevent microorganisms from
entering the pack until time of use.
(maintain sterility)
TRANSPORT
Sterile RMD transported to
storage:
•Prevent damage
•Rupture to the packaging
•Prevent recontamination
USE
Once RMD used on patient it is
contaminated by microorganisms
and must send it for reprocessing.
ACQUISITION
PURCHASE
LOAN
CLEANINGDISINFECTION
INSPECTION
PACKAGING
STERILIZATION
TRANSPORT
STORAGE
USE
TRANSPORT
General overview of CSSD standards
• The hospital provide centralized CSSD.
• Apply the policy and procedure of central sterilization service.
• CSSD stuff qualified by (certification,education,training).
• Immunization against Hepatitis B and record kept.
• One work flow dirty to clean.
• Environmental conditions differ between each area.
• Washing hands when visibly soiled, after gloves are removed for any reason, after
the removal of PPE, and in accordance with good personal hygiene practices and
departmental policy.
• PPE requirements, including space for donning and removing, disposal, and storage;
• quantity and placement of hand sanitizers and sinks designated only for hand hygiene;
• provision for the disposal of liquid and solid body wastes.
• storage requirements, including space for ( decontamination supplies, chemicals, cleaning
tools)
• safety data sheets (SDSs) for decontamination chemicals
• All surfaces (e.g., floors, walls, ceilings, cabinets) should be smooth, and cleanable.
• hazardous waste disposal systems.
• Closed containers for collection contamination devices .
• in-service training on all new instrumentation, devices, and equipment.
• Sharps must be placed in puncture-resistant sharps containers
Clean work area/room should include space for:
a) storage of attire for visitors ( head covers, cover gowns);
b) supplies for cleaning the preparation area .
c) monitoring and record-keeping supplies (e.g., sterilization process monitoring
devices, log books);
d) packaging materials and preparation supplies (e.g., cotton balls, gauze dressing,
tip protectors);
e) computers, if used, along with computer accessories (e.g., printer, bar code
,paper,scanner data ports);
f) incubators for BIs;
ENVIRONMENTAL CONTROL PARAMETERS
Decontamination Area
■ 18°C - 20°C
■ Negative
■ 30%-60%
Inspection, Assembly & Packaging Area
■ 20°C – 23 °C
■ Positive
■ 30%-60%
Sterile Storage Areas
■ 20°C – 23 °C
■ Positive
■ < 70 %
Environmental Cleaning Methods
• Floor are swept & wet mopped at least after each decontamination procedure in the
decontamination area.
• Floor are swept and wet mopped at least after each shift in the cleaning area.
• All areas must be free of dust, and insects etc.
• The Process of cleaning should be from dirty areas to clean areas, from high areas to
low areas (i.e., top of walls to floor).
• In case of hazardous chemicals spill etc. disinfection must be performed immediately
using the spill kit according to the steps of spill management.
• High touch horizontal surfaces must be cleaned and disinfected at the beginning and end
of each shift & more frequently during the shifts e.g. tabletops, counter tops etc.
• Decontamination sink should be cleaned after each shift and more frequently as needed.
• Work tables preferably cleaned before starting the sorting process in the
decontamination area & Inspection process in the IAP area.
• Shelves, cabinets, racks, wall, and ceiling are cleaned based on regular cleaning
schedule using a checklist
• Offices. Changing /locker room etc are cleaned at least daily. - Light fixtures, and air vent
should be cleaned at least every six months or as necessary (by Environmental Service
or Maintenance department)