Hospital Planning and Management - Supportive Services - Presentation - Symbiosis Institute of Health sciences, Pune, Maharashtra.

1. CENTRAL STERILE SUPPLY
DEPARTMENT
Submitted by-
Kirti Choukikar (12040141020)
Rashi Thaper (12040141021)
Stuti sangada (12040141022)
Vineeth Sukumaran (12040141023)

2. CONTENTS
• Definition
• Aim
• Functions and Activities
• Advantages
• Planning of CSSD
• Rule of Thumb
• Layout Design Principle
• Structural Designing
• Equipment
• Staffing
• Sterilization
• Flow Pattern
• Quality Control
• Management Process

3. Definition
“as that service, with in the hospital, catering
for the sterile supplies to all departments ,
both to specialized units as well as general
wards and OPDs.”

4. AIM
• Centralizing the activities of
receipt, cleaning, assembly, sterilization, storage and
distribution of sterilized materials from a central department
where safe sterilization is done under controlled conditions with
adequate managerial and technical supervision at an optimum
cost.
• 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 reduce the burden of work of the nursing personnel, there by
enabling them to devote more of their time to patient care .

5. FUNCTIONS & ACTIVITIES
Rinsing
Receipt cleaning
Issue &
Drying
Distribution
CSSD
Storage
checking
Labelling sterilization

6. Reduces
burden on Prevents
nursing staff cross-infection
Maintains Shortens
standards patient’s stay
Economic Ensures safe
,Efficient and environment
uniform source
Infection free Inventory
atmosphere Maintenance
Processing, iss Quality
ue and control Advantages
care

7. PLANNING OF CSSD
The CSSD can broadly be classified into two parts
Central Peripheral
unit unit
-Responsible for receiving dirty - Mainly responsible for distribution
Utilities cleaning, processing, to various areas of hospital.
Sterilization, storage and supply - TSSU (Theater Sterile Supply Unit)

8. Location
Water
and
Size
steam
supply
CENTRAL
UNIT
Physical
Equipment
facility
Staffing

9. QUALITY PHYSICAL
PREVENTIVE FUNCTIONAL
FINANCIAL PERSONNEL
EQUIPMENT

10. LAY OUT 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 issue.
 The receiving counter must be away from the issue counter.
 Separate receiving and issuing counter
There should minimum six basic division in CSSD
Cleaning Packaging Sterilization Issue
Drying Area Storage
Area Area Area counter

11. STRUCTURAL DESIGNING
The Central Unit comprises of three zones, separated by two distinct
barriers.
One collection window
one supply window on the other end.
C S
L T
COLLECTION E E DISTRIBUTION
R
A I
SOILED N CLEAN PACKAG
L STERILIZATION STERILE
ING
ZONE CLEANING
AREA I ZONE AREA I AREA STORAGE
N Z
G A
T
I
B O
LOW A N HIGH
R
R BA
I RR
IE
E
R
R

12. EQUIPMENT
 High capacity pass through washer disinfector at 800C to 900 C having
various shapes and sizes.
 Cold and hot water streams.
 Detergent Solution.
 Steam when available.
 Hot air ovens for drying instruments.
 Wall fixtures for drying.
 Autoclaves using dry heat, moist heat.
 Ethylene oxide sterilizers.
 Testing material to check effectiveness of sterilization.
 Cup boards, selves, tables, chairs, racks.
 Trolleys, instrument trays, wire baskets and containers.

13. OTHER EQUIPMENT
 Cleaning and decontamination devices
 Hot air Oven for drying & heat sterilization
 Glove processing unit for surgical gloves
 Instrument sharper e.g.. Needle sharper
 Testing apparatus for emergency sterilization
 Others :- trolleys, work surface, telephones
 Maintenance and repair of equipments
 Material : chemicals for washing and cleaning
 Steam Boiler

14. At times Syringes
LINEN. Needles
(other than
O.T)
Infusion
Fluids for
Renal
Dialysis.
Articles Procedural
Sets
to be
O.T. Linen
sterilized Gloves
O.T
I.V.Fluids.
Instruments.
Treatment
Trays.

15. STAFFING
 Staffing should be planned based on following factors:-
1. Three shift working
2. Messenger service
3. Maintenance service.
4. Staff for 6 areas.
5. Leave and off duty
– Average 02 technicians for 100 beds and one technical
supervisors.
– One clerk for keeping records, accounting and supply/ 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.

16. Organogram
CSSD Supervisor.
CSSD Attendant.
CSSD Technician.
Messengers.
Boiler attendant.
Clerks.
Safaiwala.

17. TRANSPORT TO
OT
STERILE
USED
STORAGE
MATERIALS
TRANSPORT
STERILIZATION
CSSD
CLEANING
PACKAGING
TRAY
DISINFECTION
ASSEMBLY
INSPECTION

18. 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
achieves 99.99% kill of bacterial spores.

19. Sun Light UV
NATURAL
Air Dessication
SOLIDS (Lime, Bleaching Powder, KMNO4
Formalin, Phenol, Alcohol, Glutar
CHEMICAL LIQUIDS
aldehyde
METHODS OF STERILIZATION
GASES Formaldehyde, Ethylene Oxide
Burning or Dry Air(160 C for 60
Dry Heat
Min)
PHYSICAL Moist Heat Boiling Steam
Radiation Ionizing Radiation U V Rays

20. TYPES OF AUTO CLAVING
MACHINES
Downward
Displacement
Vacuum
Assisted.
Pulsed Steam
Dilution

21. QUALITY CONTROL
1.Indicator tapes
• Time, temperature, pressure sensitive tapes.
• Does not indicate for sensitivity for sterilization but only suggest the required
time and pressure the items have been subjected
2.Bacteriological indicator :
• Kept in center of pack before the process and later on subjected to lab for
colony count and growth
• A pack of non- pathogenic bacterial spore (stearo- thermopiles) is placed in
each load to check quality.
• If the level of sterilization is satisfactory, the green/ brown color change to black.
3.Personnel should be adequately trained to handle the equipments.
4.Regular maintenance of equipments be done.
5.The hospital infection control committee monitors the sterilization by drawing
samples and growing in medias for colony count.

22. STORAGE
• After sterilization the sterilized items are kept in different racks as
per labeling.
• Supplied as per the demand of different area.
• To ensure continuous availability of sterile supply five times of
daily requirement should be available in storage.

23. Take stock
position of each
items on receipt
Check the
Clean and dry
receipt status
them in
and issue taking
packaging area
signature
Distribution of
items through sorting, packing
distributing and labeling
window
MANAGEMENT
Proper storage
of sterile items
PROCESS Put a indicator
inside the
in sterile area packet
Proper
monitoring and
Check the
Temp control
indicator status
during
sterilization
Remove the
items after
completion of
process

24. THANK YOU !!