• DESIGN FOR INFECTION CONTROL

• • The design of a CSSD plays an essential role in addressing infection control

issues to minimise the risk of infection transmission.

• • Planning and design features to support infection control includes the following:
• Restricted/controlled access

• • Unidirectional work flow, progressing from dirty to clean to sterile areas

• • Controlled air flow with positive air pressure from clean to dirty areas

• • Containment of steam and moisture, preventing potential contamination of

stored sterile articles.

• • Building and layout details that would facilitate easy cleaning

• • Selection of suitable building materials and finishes

• • Selection of fixtures, fittings and equipment with suitable detail, materials and
finishes for easy cleaning, and prevention of build-up of harmful organisms

• • Adequate facilities for cleaning and waste management

• • Access to the area should be limited and controlled. This should prevent any
unauthorised person from entering the area without permission

• • Staff/visitors should have access to hand-washing facilities, separate from

those used for cleaning devices, before entering or leaving the areas.

• • The flow of both staff and equipment must allow no cross-over of soiled and
clean materials

• Design for Occupational, Health and Safety Planning and design features to
support occupational health and safety includes

• • Selection of floor finishes with a non-slip finish

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 • • Selection of fixtures, fittings and equipment with suitable detail, materials and
finishes to prevent personal injury through accidents or misuse

• • Provision of suitable and adequate facilities to support and encourage a high

level of personal hygiene, with special reference to hand hygiene

• • Provision of adequate dispensing points for the appropriate personal protection

items (PPE) for the specific area to enable strict enforcement of PPE
requirements in the protection of workers from HIV

• • Top-loading, worktop equipment should be accessible to staff members of all

heights

• • Ill-considered dimensions and layouts of fixtures and fittings could have a

significant negative effect on occupational health and safety of staff.

AREA REQUIREMENTS

AREA DISTRIBUTION

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Water

Water must be clean, odourless and possess a low Total Dissolved Solids level (TDS).

• TDS Range: 0-20ppm.

• Water pressure 4-5 kg/cm²

• Both normal and hot water supply must be readily available.

• A TDS meter must be available to monitor and record the daily readings.

Temperature: 20 - 22°C

• Humidity: Less than 60% (Ideally 55-60%)

• Pressure:

• In Cleaning, decontamination and toilet, a negative pressure is maintained using a

separate ventilation facility

• Packaging area has a normal pressure maintained.

• The sterile storage area has a positive pressure maintained.

• There must be a protocol to document the readings in routine.

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Electricity

An uninterrupted electricity supply with nil fluctuation is a must for the CSSD unit.

• A power back up supply must be available to provide continuous power supply to the
equipment.

• The working areas must have good lighting facilities along with a backup power supply
for at least one light.

Equipment

• Understanding the need and the requirement of the facility, equipment must be selecte

d• Eg. Steam, EO & H202 Sterilizer, Ultrasonic Machine, Washer Disinfector, Dryer, etc.

• Some of the few criteria to look out before selecting are

Approved ratings from agencies like

FDA Physical Space Requirement

Required Raw Material and the inputs

Source and availability of the consumables

Warranty/ Guarantee/AMC Training Needed

Operator Manuals and Technician Manuals

Compressed Air

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• A non-interrupted compressed air supply with a pressure range of 7-10 kg/cm² along
with a pressure gauge, filter and pressure regulating mechanism.

The compressor unit must be centrally located or placed in allocation where round the
clock monitoring is possible.

Workflow Management-

Main focus is to reduce the wastes and the errors at various stages of the CSSD
process.

• For the same process, different workforce should not be employed

• The workflow should always be unidirectional.

• There must be clear separation of tasks and work areas.

• There must be strictly no crisscross between the sterile and unsterile areas.

Personnel Training and Assessment

The human resources within CSSD will comprise all cadres, right from illiterate to
literate and highly skilled technicians.

• This improper mixture has to be balanced appropriately.

• Periodical trainings, certifications, skill development and assessment criteria must be

provided for the CSSD professionals.

• There is a need to identify the key strategies for the state certification of CSSD
professional.

• Apt allocation of tasks amongst the resources must be ensured.

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Health & Safety of CSSD Staff

Definitions of Hazards

• Any substance with a potential risk to compromise safety is called hazardous material.

• The impact that such hazardous materials have on human bodies are called as the
health hazard.

• If such health hazards take place during the workplace activity, it is called as an
occupational health hazard.

• To combat such situations the Occupational Safety and Health Act of 1970 was
formulated by NIOSH (The National Institute for Occupational Safety and Health) &
OSHA (The Occupational Safety & Health Administration)

• Vaccinations appropriate vaccinations (Hepatitis B and any other relevant) should be

administered to the CSSD Staff.

• Focus on Hand hygiene practices & appropriate PPES for personnel safety

• Material Safety Data Sheet (MSDS) is an in depth document prepared by the

manufacturers in order to guide it's users on how to use a product, the various
parameter settings. It also gives in detail the various health related issues associated
with it and provides suggestion on how to tackle such situations. It should be referred to
while handling any product.