Central Sterile Supply Departments (CSSD)

Everyday practice of Health Care requires implementation of significant volume of sterilization measures, use of modern methods and modes of sterilization, arrangement and development of its rational forms and efficiency control.

But is it so easy and simple to achieve results desired which will meet all necessary norms and requirements of a medical institution and the state?

Looking back at the historical development and formation of medicine in this field, we can refer the first clean rooms to 1860, when famous Scotland surgeon Joseph Lister created his theory of purity. According to this theory removal of bacteries from the hospitals and especially from operating rooms will prevent occurrence of infections. Owing to this theory Lister achieved a significant reduction of infectious complications in operating rooms. The conception he proposed of reduction of risk of infection at Surgical penetration was basically antiseptic method, since it was based on use of disinfection means on instruments, materials, hands of a surgeon and the environment. The further development of clean rooms is based on aseptic method that is prevention of penetration of bacteria into a working zone.

Clean rooms of that time became a significant step forward, however they still lacked an important element of modern technology of cleanliness - ventilation, with filtration of induced air. Today Centralized sterilizing departments are an inseparable part of every hospital, since it's here where the instruments from all the hospital departments come for cleaning, disinfection and sterilization, and it's from here where the process of rendering necessary help to patients start from.

By today in Kazakhstan several forms of sterilization arrangement emerged:

Decentralized, centralized (implemented in centralized sterilization departments) and mixed.

Decentralized organization has several significant drawbacks, which affect its efficiency. Preliminary sterilization processing of tools is implemented manually in adapted rooms and working places not equipped for this purpose. At that the quality of preliminary sterilization cleaning, of course, appears to be low.

Sterilization of tools is carried out in different branches of the hospital and is implemented, as a rule, by non-trained staff. Often the technology of implementation of sterilization rules of packaging and tool loading is not observed. Frequently the cases of use of malfunctioning equipment occur, since the control of efficiency of its work in conditions of decentralized sterilization is hindered.

Centralized sterilization lacks these drawbacks. It is proved by the data on bacteriological control of sterilization efficiency that the number of cases of unsatisfactory sterilization in hospitals where CSSD are arranged is approximately 3 times as less as in medical and preventive treatment facilities without centralized sterilization. Reduction by several times in number of post surgical purulent complications after CSD arrangement is noted. Moreover, CSSD improves and facilitates the work of doctors and medium medical staff of other departments.

It is possible to highlight major advantages of centralized sterilization:

• Efficient preliminary sterilization cleaning and sterilization of tools of medical purpose by highly qualified staff is provided;
• The quality and reliability of sterilization is increased;
• Efficient expensive technological equipment is used most rationally;
• Control over sterilization is carried out most efficiently;
• Significant part of staff in medical departments engaged in sterilization at decentralized system is released;
• Arrangement is simplified, and quality of rendering Services of technological equipment increases;
• Maintenance expenditure is reduced, processes of replacement of equipment is simplified, consequently, investment spent pays off quicker (material expenses on implementation of sterilization at centralized system decrease by approximately 2.8 times compared to the decentralized one);
• Owing to interchangeability of the staff absence of the employees dismissed suddenly is compensated easily;
• The opportunities of introduction modern methods of sterilization which prolong terms of use of medical and diagnostic equipment, especially temperature sensitive, occur;
• Making up applications and requirements of batches of expendable materials and their rational use is simplified which also leads to decrease of investments.

 The major tasks of CSSD are:

• Providing medical departments (institutions) with sterile medical tools;
• Search, assessment and introduction into practice of modern effective methods of preliminary sterilization processing and sterilization;
• Arrangement of the system of constant control of efficiency of sterilization;
• Control over the use of sterile tools in clinical departments;
• Training of staff by specialty;
• Rendering practical, consultation and organizational and methodical help to other departments (institutions) on sterilization issues;

All tools that are at CSSD go through several stages of technological chain: receipt and dismantling, preliminary sterilization processing at different types of equipment, or manually, control of processing quality, sorting and packaging, direct sterilization and issuing (shipment) to clinical departments.

CSSD planning must provide sufficient sets of production rooms for implementing all technological operations.

According to the present regulatory and methodical documents CSSD must have set of rooms that are divided into three zones: non-sterile (dirty), clean and sterile. Dirty Zone are rooms where used instruments and materials are located. The zone must be presented by the room for receipt of materials in containers from departments and by two washing rooms- one for instruments and materials, and the other for transport carts on which transportation of containers through Medical Institution is carried out. The dirty zone is connected with clean one only through automatic washers of transfer type and through closing pass box for passing instruments, washed, disinfected and dried manually. It is rational to include wardrobe for out clothes and toilets of public use into dirty zones. Clean Zone are rooms located directly behind the washers. The instruments and materials which are clean, but not sterile yet, are there. Rooms of packaging and preparation for sterilization of tools, preparation and packaging of textile, producing bandaging materials, various warehouses and rooms for the personnel dressed in special uniforms (robes, headgears, special shoes) belong to these premises. Entrance to a clean Zone is implemented through sanitary passing. Sterile zone is mainly warehouse of sterilized materials. It is separated from clean Zone by passing sterilizers. It's a room of special cleanliness entry to which is allowed only through sanitary passing, strictly limited staff, in special uniform, say, obligatory in masks. The service rooms isolated from functional rooms are also provided. These are corridors, the registry, staff room, not dressed in uniform, room for preparation of water and other necessary rooms.

 

The premises should be planned so that the flows of dirty, clean and sterile materials and tools would not be crossed.

Company Surgicare Kazakhstan along with the producers of disinfecting and sterilizing equipment of the world level, companies Belimed, Renosem, PMS Medikal, is happy to offer you its services on projecting Centralized sterilizing departments, creation of individual turn-key projects, and also equipment of available CSSD. Owing to highly technological equipment of a new generation you will be able to forget about inconveniences during the working process, low productivity and stagnation of equipment because of its mal function and unsuitability.

We look forward to work both with state and private institutions of municipal and regional level and will be waiting for new clients who need our help.