Central sterile supply services

NITHIN MANOHAR R
M.Pharm,(PhD),MSc Psychology,
Assoc. Professor
Dept Of Pharmacy Practice
Pushpagiri College Of Pharmacy
 WHAT IS CENTRAL STERILE
SUPPLY DEPARTMENT ??
• The central sterile services department
(CSSD), also called sterile processing
department (SPD), central supply
department (CSD), is an integrated
place in hospitals and other health
care facilities that performs
sterilization and other actions on
medical devices, equipment and
consumables.
• CSSD has a great role in reducing
Hospital Acquired Infection (HAI).
• The most common method
for sterilization of medical
instruments worldwide is
steam sterilization.
• They provides professional
supplies & equipments to all
specialised departments.
• The specialized departments which are served includes all
nursing departments, clinicians, certain specialized labs
such as cardiac lab (catherisation) and operating rooms.
• Single use of items such as syringes, tubes, urine collection
sets, I.V administration sets, needles, gloves, blood bags,
are dispensed by central sterile supply room.
• The CSSD should have the following
zones –
 The unclean and washing area
 The assembly and packing area
 The sterilization area
 Objectives of CSSD
The main objectives of central service includes the
following:
• 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 monitor and enforce controls necessary to prevent
cross infection according to infection control policies.
• To establish and maintain sterile processing and
distribution standards.
 Functions of CSSD
CSSD has dual functions:
• Cleaning, packaging, sterilization and distribution of
medical equipments and supplies which is the
responsibility of the nurse.
• Manufacturing of sterile fluids which is the
responsibility of pharmacist. 
 WORK FLOW

•  Major activities in a CSSD includes:

Receiving the used items from user departments

Cleaning
Packing
Sterilizing

Storing (Temporary)
Distributing To User Departments
 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 Hypochlorite
solution in the user department itself before sending to
CSSD.
• The Receiving area of CSSD should have access to outside
through a window with a counter.
• 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.
 CLEANING AREA
• Here the instruments are washed either manually or in
machines.
• For manual washing, sinks with water supply and working
counters are organized. Detergents and brushes of various
sizes and shapes are required in this area.
• Machines- ultrasonic washer is a machine used for cleaning
surgical instruments. Tunnel washer is highly sophisticated
and expensive machine.
• After the instruments are washed, they are dried in oven
dryer and shifted to packing area.
 PACKING AREA
• Clean and dry instruments are packed before
sterilization, so that they are not contaminated while
handling after they are sterilized.
• Most of the instruments are packed in trays (tray
assembly) that are wrapped with double layer of cotton
cloth. Paper envelopes are also available for packing the
instruments. Sealing machine is used for the sealing the
plastic bags in which instruments are packed.
• After packing and sealing, the instruments are shifted
for sterilization
 STERILIZATION AREA
Sterilization is done by either of the two methods in CSSD:
1. Steam sterilization by autoclaves - Refer
2. Gas sterilization by ETO (ethylene oxide) machines -
Refer

 
 STORE
• The items are temporarily stored in a clean store (on
racks) from where they are distributed to user
departments.

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
 PHARMACISTS ROLE IN CSSD
 A pharmacist with his thorough training in microbiology
and sterilization procedures can be employed in CSSD to
supervise the activities in this department.
 The pharmacist has to design the department facilities
and infrastructure.
• A pharmacist under the sterile supply service is responsible
for storing, receiving, processing, controlling and
distributing the medicines, equipments to the hospital care
unit.
• Prepare a mixture of chemicals in dry state which when
dissolved in the specified volume of distilled water results
in a desired product which is then packed and sterilized by
CSSR panel members.
• Prepare and package the solutions for sterilization by
CSSR
• They store the medicines and equipments under
controlled conditions of safety and sterilization.
• Pharmacists have a great role to prevent the hospital
acquired infections.
• Participate in the teaching programmes in hospital.
 UNIVERSITY QUESTIONS

1. Role of pharmacist in Central Sterile Supply Services (5)

2. Central Sterile Supply Services (5)