APPASAHEB BIRNALE
COLLEGE OF
ARCHITECTURE
TOPIC : CENTRAL STERILE SUPPLY DEPARTMENT
GUIDED BY : AR. AMOL CHOUGULE
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 of hospital
for the care and safety of patient under strict quality control.
• CSSD has a great role in reducing Hospital Acquired Infection(HAI).
Normally the following types of articles are entertained by CSSD :
• Diagnostic sets like L.P set, sternal puncture set etc.
• Treatment sets like cut down sets, aspiration set etc.
• Dressing materials.
• OT linen and instruments.
• Rubber gloves, Catheters.
• IV sets and infusion sets.
AIM
• To provide an efficient, economic, continuous and quality supply of sterilized
material to various areas of the hospital to deliver quality and infection free
patient care.
• Contributes to reduction in hospital infection rate.
• To educate students, nurse and ancillary persons.
• To save nursing time at nursing station.
FUNCTIONS OF CSSD
• Receiving and sorting soiled materials used in the hospitals.
• Determination whether the item should be reused or discarded.
• Carry out the process of decontamination or disinfection prior to sterilization.
• Carry out the specialized cleaning of the equipments and supplies.
• Inspecting and testing instruments, equipments and linen.
• Assembling treatment trays, instruments sets, linen packs etc.
• Packing all material for sterilization.
• Sterilization.
• Labeling and dating materials.
• Storing and controlling inventory.
• Issuing and distributing.
ADVANTAGES OF CSSD
• Bacteriological safe sterilization.
• Less expensive.
• Elimination of unsound practices and establishment of standard procedures.
• Assurance of adequate supply of sterile products immediately and constantly
available for sometime as well as emergency use.
• Conservation of trained staff.
• Better quality control.
• Better good of material flow.
• Prolonged life by proper care of equipment.
STERILIZATION
• 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 is achieves 99.99%
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METODS OF STERILIZATION
Natural Chemical Physical
Sun Light (UV) Solids Dry Heat
Air Lime, Bleeching Powder, Burning or Dry Air
(Desiccation) KMNO4 (160°C for 60 Min)
Liquids Moist Heat
Formalin, Phenol , Alcohol , Boiling Steam
Glutaraldehyde
Radiation
Gases
Ionising Radiation
Formaldehyde, Ethylene U V Rays
Oxide
NATURAL STERILIZATION
• SINLIGHT-
The microbicidal activity of sunlight is mainly
due to the presence of UV rays in it.
This method is used to disinfect hospital
furniture like table ,lockers,coat mattresses.
-every 15 days to 2 months
• AIR
It is a natural disinfectant.
-by keeping rooms with well and cross
ventilation.
-door and windows should be kept open for
enough light and air.
CHEMICAL STERILIZERS
• CIDEX – Is the most effective as it destroyes spores too.
- It is a high level disinfectant. It kills spores within 12hrs
and viruses within 10 min.
- Widely used becaused of their biocidial
properties,activities in presence of organic matter,
noncorrosiveness, noncoagulation of proteinacious
material.
• HYDROGEN PEROXYDE –Is an effective
bacterial,fungicidal,viricidaland sporicidal.
-Is commercially available as 3%solution but can be used
upto 25% concentration.
STEAM STERILIZATION
- 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)
-Total time required-:
Autoclave - 45 to 50 min
ETO (ethylene oxide)sterilizer- 11 to 12 hrs
Basic dimensions
• ``
STORAGE
• After sterilization the sterilizer items are
kept in different racks as per labelling.
• Supplies as per demand of different area.
• To ensure continuous availability of sterile
supply five times of daily requirement
should be available in storage.
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
PLANNING OF CSSD
The CSSD can broadly be classified into two parts:
1. central unit 2. peripheral unit
Central unit: It responsible for receiving dirty utilities cleaning, processing,
sterilization, storage and supply.
Peripheral unit: Mainly responsible for distribution to various areas of hospital.
TSSU(theater sterile supply unit).
LOCATION:
• This department should ideally located in close proximity to Casualty
ward, OT and labor room for effectiveness and efficiency.
• The location should have adequate supply of water both hot and cold,
steam compressed air and three phase electricity.
LAYOUT DESIGNING PRINCIPLE
• There is no back tracking of sterile goods.
• One way movement from receiving counter to issue counter.
• Sterile area should be prior to sterile storage and issues.
• The receiving counter must be away from the issue counter.
• Separate receiving and issue counter.
• There should be minimum six basic division in CSSD :
Cleaning area drying area packaging area sterilization area
Storage issue counter.
• In a well design state of the art CSSD there are three organised zones;
soiled area , clean area and sterile area.
• Soiled items from the various user departments of the hospital are
received at the solid reception area in the same trolleys, instrument
trays.
• In the clean area clean disinfected materials are sorted, inspected and
packed.
• After packing the instrument trays are put into baskets for sterilization
in the double door pass through autoclaves.
• After sterilization the autoclaves are unloaded in the sterile area and
the materials stored there.
ITEMS HANDED BY CSSD STORE
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. [Link].
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 .
Space requirement : the minimum area in sq. Ft. required per bed as recommended.
NO. OF BEDS SPACE REQUIREMENT
75 TO 99 BEDS 10 SQ. FT. PER BED
100 TO 149 BEDS 9 SQ. FT. PER BED
150 TO 200 8.5 SQ. FT. PER BED
200 TO 249 8 SQ. FT. PER BED
250 TO 299 7.5 SQ. FT. PER BED
MORE THAN 300 7 SQ. FT. PER BED
STAFFING:
• Supervisor of CSSD
• CSSD Technician
• Clerks
• Assistant or helper
• Messenger
• Staff strength varies from hospital to hospital depending upon bed strength and
work load. For 30 bedded hospital 1 supervisor and CSSD worker is
recommended.
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.
• CSSD layout should be designed for unidirectional flow. and have four zone for
smooth work flow. i.e. [Link] and washing area [Link] and packing area
[Link] area [Link] sterile area.
CLEANING AREA:
EQUIPMENTS
• High capacity pass through washer disinfector at 80* to 90*C having various shapes
and sizes.
• Cold and hot water streams.
• Detergent solution
• Steam when available.
• Hot air ovens for drying instruments.
STERILIZATION AREA:
• Autoclaves using dry heat, moist heat.
• Ethylene oxide sterilizers.
• Testing material to check effectiveness of sterilization.
STORAGE AND DISTRIBUTION:
• Cup boards, selves, tables, chairs, racks, trolleys, instrument trays, wire baskets and
containers.
Total space is functionally divided into following areas:
• Receiving and clean up area – 10%
• Clean work area including area for sterilization – 30%
• Unsterile storage area – 15%
• Sterile storage area – 16%
• Syringe needle and instrument processing and sterile area – 12%
• Glove processing area – 5%
• Office room/rest room/gauze/dressing assembly – 14%
