CSSD

 We have standard policies and procedures in place based on international benchmarks to

optimize departmental performance and services.
 It’s major responsibilities include processing and sterilization of surgical instruments,
Trays and Sets, Dressing Material, Rubber Goods etc. by means of state- of-the –art
equipment such as Washer Disinfector, Ultrasonic cleaner, Dry heat Sterilizer, EO
Sterilizer & Pre-Vacuum Sterilizers.
 Our staff ensures that these devices are properly handled, processed, stored and calibrated
to minimize the risk of contamination at the point of care.
 Mechanical, chemical and biological Indicators are used monitoring quality.
 Quality control involves continuous supervision of personnel performance work practices
and verification of adherence to established policies and procedures.
 CSSD department follows unidirectional flow concept at BCH i.e. Decontamination area,
Assembly / Process Area ,Sterilizer / Machine Room & Sterile Storage.
 CSSD receives, processes, packs, sterilizes, stores, distributes and controls supplies of
sterile materials to all the departments including wards, OPD and OT.
 Trained staff: To support infection control within the hospital, the CSSD staff members
particularly technicians who are science Graduate with 3-25 years of experience are highly
skilled, well-trained and committed to follow scientific protocols to ensure safety,
protection and welfare of patients, co-workers, caregivers and the community at large.
 The CSSD staff is highly quality conscious and understands that ultimately patient
satisfaction is also a part of their responsibility. They are trained to satisfy the internal
customer viz; operating surgeons and surgical staff, physicians, diagnostic service
personnel, delivery staff and last but not the least the patients.

The CSSD's Supportive Role in

Hospital Infection Control
Apr 27, 2010

Each day, millions of medical procedures are performed in healthcare facilities

worldwide, with caregivers and patients relying on the availability and use of a wide
range of supplies, instruments and equipment. These devices must be properly
cleaned, disinfected and/or sterilized, inspected for quality to ensure good working
condition, and available at the point of care. In the absence of proper handling,
processing and storage, these devices may become contaminated and compromise
quality patient care.

In most healthcare facilities, the central sterile supply department (CSSD) plays a key
role in providing the items required to deliver quality patient care. To support
infection control within the healthcare facility, the CSSD staff members must be well-
trained and skilled, and committed to “doing what’s right” every step of the way. That
means ensuring that shortcuts are never made and that processes and practices are
consistently followed.

Centralizing the reprocessing of reusable devices helps ensure uniform standards of

practice, while also providing for improved workflow (soiled, to clean, to sterile).
This also facilitates the training and education of skilled technicians who must be
knowledgeable about the standards, complexities, challenges, risks, and techniques
associated with the CSSD function. Every CSSD task must be performed in a manner
that protects the welfare and safety of patients, co-workers and the community.

Prioritizing Quality

It’s not enough for CSSD technicians to know how to perform their jobs; they must
also know and understand why they do what they do. As they perform their daily
tasks, they must have the knowledge to support effective problem-solving and
decision-making, and the understanding that every step in the CSSD has a direct
impact on infection control – and, above all, patient care and safety.
It is critical that CSSD personnel establish quality levels for the products and services
they produce and then ensure that these levels are consistently attained. Quality is
determined by customers and, therefore, the success of CSSD depends upon their
satisfaction. Anyone who has an expectation about the products or services of CSSD
is a “customer.” This includes surgical services personnel, physicians, patients,
diagnostic imaging technicians and other medical personnel, and delivery staff.
Quality (or lack of quality) can have dramatic consequences on the health and safety
of personnel and patients. How well quality products and services are provided will
impact the operation of the department and have a direct impact on the hospital’s
financial success.

What is “quality?” A common definition relates to the “degree or grade of excellence

of a product or service.” For example, emergency department personnel may believe
that an emergency crash cart was delivered efficiently, but may be unsatisfied with
CSSD staff because they failed to provide a needed item on the pick list. This could
indicate good quality service, but poor quality of product. By contrast, assume that a
surgical instrument set is needed quickly in the surgical suite and that set is delivered
complete (no missing instruments). If the surgical staff is not informed that the set
was delivered; however, then the CSSD essentially provided a good product, yet
failed in terms of customer service. In short, it is through the eyes of the customer
that quality is measured.

There are several ways that the quality of goods and services are described, but a key
component relates to the ability to measure quality. This is reasonable because one
must always compare ideal and actual quality levels. Identifying and completing the
many tasks performed in CSSD can be accomplished through the development of
effective policies and procedures that are supported by industry standards and
guidelines. Training CSSD team members to follow these policies and procedures
will ensure a consistent, high-quality product and level of service. This, in turn, will
support quality patient care.

CSSD’s Integrated Role

The actual work performed in a CSSD determines the knowledge, training and skills
CSSD technicians require. The “processing cycle” can help CSSD professionals
understand and define the tasks and processes necessary to provide quality products
and services to their customers; it is important to note that inspection plays an
essential part of almost all processes performed in the CSSD. This ensures that a
safe, quality product is provided to customers, especially patients.

Working in the decontamination area of CSSD requires thorough knowledge and

understanding of microbiology and the decontamination process; cleaning
techniques; steps in the cleaning process; objectives of the cleaning process; levels of
decontamination; identification and cleaning of specific to surgical instruments,
syringes, needles, rubber items, and specialty items; cleaning agents and their
application; disinfecting agents and their application; identification and effect of the
cleaning process on different metals; special instrument lubrication and
maintenance; proper disposal of all types of waste; the transportation of
contaminated items; and the operation of equipment used in the cleaning process,
such as washers, decontaminators, ultrasonic cleaners, cart washers, steam guns,
scope washers, and so on.

To perform their tasks well in the preparation, packaging and sterilization area,
technicians must be able to identify hundreds of surgical instruments. They must
understand how instruments are manufactured, what they are made of, how to
process and maintain them, and also know how to properly inspect them for
cleanliness, proper condition and function. How to care for and maintain
instruments is essential for driving quality and infection control efforts.

Surgical specialty instruments, equipment and implants that require special

handling, packaging and sterilization also require careful attention and expertise.
CSSD technicians must be able to select the proper packaging materials and use
proper techniques for wrapping and packaging items for sterilization. Items to be
sterilized must be properly identified, and the correct method and parameters for
their sterilization must be determined and precisely followed. The principles
necessary to achieve sterilization must be understood and applied. Sterilizers must
be loaded and operated properly, sterilization quality assurance measures must be
followed and interpreted to ensure that items are sterile, and records must be
maintained. Factors that can compromise sterile packaging must be understood,
prevented and promptly detected.

Tapping Infection Prevention’s Potential

Service excellence skills are essential for CSSD to support a healthcare facility’s
infection control department – and various infection control initiatives. Therefore,
assessing and meeting the needs of CSSD customers is of prime importance. It is not
enough to have the knowledge, tasks and processes in place to provide quality
products. Great service and exceptional communication skills are also required,
along with quality services and products.

CSSD professionals must understand that if they want the respect of others, they
must deserve it. It isn’t something that can be demanded; it is earned. It takes quality
products and service excellence for a CSSD to properly support infection control
within the healthcare facility, and the best place for both of these to occur is at the
front line.

Bruce Bird, CRCST, serves as central processing manager for Primary Children’s
Hospital in Salt Lake City. He also serves as president-elect of the International
Association of Healthcare Central Service Materiel Management (IAHCSMM).

Central Sterile Services Department(CSSD)

Objective and Functions:

The Central Sterile Services Department (CSSD) is divided into five major areas:
decontamination, assembly and processing, sterilizing, sterile storage, and distribution.
The objectives of central service include the following:

 To provide inventoried supplies and equipment to customer areas.

 To promote better patient care by providing prompt and accurate service.
 To provide supplies of sterile linen packs, basins, instruments, and other sterile
items.
 To maintain an accurate record of the effectiveness of the cleaning, disinfecting,
and sterilizing processes.
 To strive for uniformity and simplicity in the trays and sets that the department
provides.
 To maintain an adequate inventory of supplies and equipment.
 To monitor and enforce controls necessary to prevent cross infection according
to infection control policies.
 To establish and maintain sterile processing and distribution standards.
 To operate efficiently to reduce overhead expense.
 To stay abreast of developments in the field and to implement changes as needed
to stay current with new regulations and recommended practices.
 To review current practice for possible improvements in quality or services
provided.
 To provide consulting services to other departments in all areas of sterile
processing and distribution, including in- service education programs, review
policies and procedures, and implementation of new processes.