cssd.pptxintroduction definition, objective types and classification
- 1. CSSD
- 2. A CSSD is a department that furnishes all supplies required for the nursing units and departments of a hospital-theatres, wards, out-patient and casualty departments with complete, sterile equipment ready and available for immediate treatment of patients. • These supplies include sterile linens, sterile kits, operating room packs, needles, syringes and other medical surgical supplies. In addition, the personnel in this department clean, inspect, repair, assemble, wrap and sterilize special treatment trays for various nursing units Definition
- 3. Ideally, CSSD is an independent department with facilities to receive, clean, pack, disinfect, sterilizes, store and distribute instruments and supplies as per well-delineated protocols. By custom diets, medicines, laundry, supply of blood and crystalloid are not included in activities of CSSD.
- 4. Objective and Functions a. To provide sterilized material. b. Contributing to a reduction in the incidence of hospital infection. c. To avoid duplication of costly equipment. d. To maintain record of effectiveness of cleaning, disinfection and sterilization process.
- 5. e. To monitor and enforce controls necessary to prevent cross infection. f. To maintain an inventory of supplies and equipment. g. To stay updated regarding developments in the field. h. To provide a safe environment for the patients and staff.
- 6. • Size and location of CSSD varies • 7 to 10 square feet per bed is recommended • It should be located as close as possible to Operation theatres, Accidents and Emergency department and wards • The CSSD layout should be designed for a unidirectional flow Designing of a CSSD
- 7. CSSD should have four zones for a smooth work flow: a. The unclean and washing area b. The assembly and packing area c. The sterilization area d. The sterile area
- 8. Bed size of the hospital • Up to 100 beds • 100-500 beds • Above 500 beds Location of CSSD • In operation theatre • CSSD centrally located in service area • CSSD in service area and a separate unit for OT to be called theatre sterile supply unit (TSSU) Planning of CSSD
- 11. PLANNING of CSSD - The materials/ items from contaminated and sterile areas should not get mixed. - There should be physical barrier between clean and dirty areas. - The floor should be smooth, impervious, non skid and robust. - Relative humidity should be maintained at 45±5 %
- 12. Location • The CSSD should be close to the casualty, Operation Theatre and wards which are the largest consumer of the sterilized material. • In multistoried buildings, CSSD may be planned in the lower floor right under the Operation Theatre, where vertical movement will be the quickest possible movement of the material.
- 13. Floor Space Serial Beds available Floor space required for CSSD 1 75-99 10 sq feet per bed 2 100-149 9 sq feet per bed 3 150-199 8.5 sq feet per bed 4 200-249 8 sq feet per bed 5 250-299 7.5 sq feet per bed 6 300 or More 7 sq feet per bed
- 14. LAYOUT OF CSSD
- 16. WORK FLOW MAJOR ACTIVITIES IN A CSSD: RECEIVING THE USED ITEMS FROM USER DEPARTMENTS CLEANING PACKING STERILIZING STORING (TEMPORARY) DISTRIBUTING TO USER DEPARTMENTS
- 17. WORK FLOW OF CSSD
- 19. CSSD- Work Flow
- 20. The receipt and issue counters are separated by a corridor to avoid contamination The receipt and issue counters are separated by a corridor to avoid contamination Counter of receipt of used items Decontamination and cleaning area Processing and packing of items Sterilization Distribution point Sterilized item store Separation of sterilized items by a partition or corridor
- 21. RECEIVING AREA • Used item from various departments of the hospital are shifted to CSSD for cleaning and sterilization. • Ideally, the items that get soiled with blood or body fluid should be decontaminated with Sodium Hypochloride solution in the user department itself before sending to CSSD.
- 22. • The Receiving Area of CSSD should have access to outside through a window with a counter. • The items (Specially for instruments in trays) are counted and Received. • Thereafter, the instruments are inspected and blunt/unsuitable Instruments are segregated/discarded. • Necessary entries are made for records. • Thereafter, the items are shifted to Cleaning area.
- 23. Equipments and materials required: • Hot and cold running water • Cleaning brushes and jet water gadgets • Ultrasonic washers • Hot air oven for drying instruments and sterilization • Globe processing unit • Instrument sharpener like needle sharpening machines • Stem sterilizers and boiler for steam • Autoclaves of various sizes including gas autoclave • Testing equipment • Chemicals to clean materials • Wall fixtures like sinks, taps • Trolleys for supply of sterilized items and separate trolleys for collection of used items are needed
- 24. Methods of sterilization: Sterilization is a process of freeing an article from all living organisms including bacteria, fungus, using dry or wet heat, chemicals or irradiation. • Steam sterilization: example:-autoclaving • Hot air sterilization: • Gas sterilization with ethylene oxide. • Sub atmospheric pressure sterilization with formalin: • Chemical sterilization with activated glutaraldehyde • Gamma irradiation sterilization: • Formaldehyde steam sterilization
- 25. STORE AFTER STERILIZATION, THE ITEMS ARE TEMPORARILY STORED IN A CLEAN STORE (ON RACKS) FROM WHERE THEY ARE DISTRIBUTED TO USER DEPARTMENTS
- 26. DISTRIBUTION AREA - IT SHOULD BE AWAY FROM THE RECEIVING AREA AND MAY COMPRISE OF A WINDOW WITH COUNTER. - IN MODERN HOSPITALS, THERE MAY BE A SEPARATE LIFT FOR TRANSPORTING THE STERILE MATERIALS TO USER DEPARTMENTS.
- 28. CSSD Supervisor. CSSD Attendant. CSSD Technician. Messengers. Boiler attendant. Clerks. Cleaners. Staffing pattern of CSSD
- 29. Staffing should be planned based on the following factors:- – Average 02 technicians for 100 beds and one technical supervisors. – One clerk for keeping records, accounting and supply per shift. – Average 04 attendants per 100 beds in all shifts. – Adequate number of cleaning attendants and transporters. – One technician and two attendants should be stationed at each zone.
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