1 / 35

CSSD Central Sterile Supply Department

CSSD Central Sterile Supply Department. “ No Stronger Condemnation of any hospital or ward could be pronounced than the simple fact that ZYMOTIC DISEASE has originated in it or that such disease attack other patients than those brought-in with ” - FLORENCE NIGHTINGALE.

elga
Download Presentation

CSSD Central Sterile Supply Department

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CSSDCentral Sterile Supply Department

  2. “ No Stronger Condemnation of any hospital or ward could be pronounced than the simple fact that ZYMOTIC DISEASE has originated in it or that such disease attack other patients than those brought-in with ” - FLORENCE NIGHTINGALE

  3. BHATTA CHARJEE DEFINES – CSSD 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. 1928 – American College Of Surgeons – CSSD. 1942 – World War II .Cairo, British SDS Unit . 1955 – Cambridge Military Hospital – Regular CSSD in UK. 1965 – First CSSD in India – SafadarajanHosptial

  5. AIMS To provide sterilized material from a central department where sterilizing process is carried out under properly controlled conditions To alleviate the burden of work of the nursing personnel, there by enabling them to devote more of their time to patient care .

  6. ADVANTAGES ; 1.Bacteriological safe sterilization. 2. Less expensive. 3. Elimination of unsound practices & establishment of standard procedures. 4. Assurance of adequate supply of sterile products immediately and constantly available for sometime as well as emergency use.

  7. 5. Conservation of trained staff. 6. Better quality control 7. Better good of material flow 8. Prolonged life by proper care of equipment

  8. ITEMS COMMONLY HANDLED BY CSSD STORES

  9. 1. Syringes 2. Procedure Sets Lumbar puncture ; sternal puncture ; venesection ; paracentesis ; aspiration ; catheterization ; tracheotomy ; suturing ; dressing ; biopsy ; incision & drainage ; aortography ; cardiac resuscitation ; etc 3. Needles 4. Gloves

  10. 5. I.V.Fluids. 6. Treatment Trays. 7. O.T Instruments. 8. O.T. Linen 9. Infusion Fluids for Renal Dialysis. 10. At times LINEN. (other than O.T) NB: Diet , drugs , bedpans & urinals are not included by convention .

  11. PLANNING A DEPT ; (COPP) 1. Physical Planning. 2. Functional Planning. 3. Personnel Planning. 4. Equipment Planning. 5. Financial Planning. 6.Quality Control. 7.Preventive Maintenance.

  12. PHYSICAL PLNG 1. Location & Grouping . 2. Lay Out & Space Reqts. 3. Fixturtes & Furniture .

  13. RULE OF THE THUMB ROUGHLY – 10 SQFT / BED - MCGIBONY

  14. EQPT IN CSSD 1.Jet water cleaning gadgets. 2.Ultrasonic Washers 3.Glove sharpener 4.Needle sharpener. 5.Gas, Chemical or steam autoclaves. 6.Testing apparatus for efficiency of sterilization

  15. OTHERS 1.Maint & Repair EQPT 2.Adequate number of cabins & Furniture 3.Telephone or intercom. 4.Adequate no of syringes & procedure sets.

  16. NUMBER OF SETS/SYRINGES Total: 4.5 to 5 times of the daily requirement

  17. Methods Of Sterilization / Disinfection Natural Chemical Physical Sun Light (UV) Air (Desiccation) Solids Lime, Bleeching Powder, KMNO4 Liquids Formalin, Phenol , Alcohol , Glutaraldehyde Gases Formaldehyde, Ethylene Oxide Dry Heat Burning or Dry Air (160°C for 60 Min) Moist Heat Boiling Steam Radiation Ionising Radiation U V Rays

  18. CHEMICAL CIDEX – A Glutaraldehyde derivative is most effective as it destroys spores too. ETHYLENE OXIDE (ETO) ; • Quite effective against spores too. • Useful for delicate instruments and item which can’t be immersed in liquids - Low Boiling Point (10 degree C) - Prolonged Aeration - Highly Expensive / Explosive / Toxic

  19. Types Of Sterilization Techniques 1.Dry Heat 2.Steam High Pressure Autoclaves operated by Gas, K.oil or Electricity ( Flash, Pulse) 3. Ethylene Oxide Sterilization. 4. Chemical Sterilization. 5. Radiation Sterilization. - Infra Red Radiation – Syringes - Ultra Violet Radiation – Decontamination of Air - Ionising Radiation / Gamma Radiation ISOMED at BARC

  20. STERILISATION . 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.

  21. STEAM STERILATION - Water  Saturated  Wet vapor  Dry saturated Vapor  Super Heated Vapor / Steam - Steam with <0.95 Dryness Factor is not useful for Sterilization. - Superheated Steam acts like Dry Hot Air only . ( Strength Of Steam is its Latent Heat)

  22. MODE OF ACTION. Dry Heat  Oxidation Steam  Denaturation = Coagulation of Proteins

  23. TYPES OF AUTO CLAVING MACHINES 1. Downward Displacement 2. Vacuum Assisted. 3. Pulsed Steam Dilution

  24. TESTS FOR EFFICENCY OF STERILISATION 1.Specially treated paper strip. 2. Pressure sensitive tape to be fixed to the final fold 3. Brown indicator tubes - (very expensive) 4. Biological. Green strip containing bacteria (Color must change to black)

  25. 5.Cellophane wrapped tablet containing - Lactose - 75% - Starch - 24% - Magnesium Trisilicate – 1% (Tablet turns brown during autoclaving) 6. Microbiological examination of finished products. 7. Thermo - couples .

  26. ADVANTAGES OF STEAM STERILISATION 1. Rapid heating & penetration of loads. 2. Destruction of all forms of microbial life 3. No residual toxicity.

  27. 4. No damage to supplies being sterilised. 5. Easy Quality Control 6. Economical & Reliable This method is unsuitable for heat sensitive and non- permeable material

  28. RADIATION STERILISATION ; ‘ ISO MED ‘ at ‘BARC’ Trombay; dose - 2.5 Mega Rhontgen; Source – Cobalt-60 /Caesium – 137/ Electron Beam (generated by linear accelerator) Reliable, can penetrate all types of packing. Large & diverse shaped articles can be sterilised. No residual radio activity at 2.5 mega rhontgens. Glass becomes dark, cotton looses tensile property, food gets undesirable flavor. Not practicable in hospitals

  29. STAFFING :CSSD BHATTA CHARJEE RECOMMENDS : SUPERVISORS (sister/male ward masters) 4 STAFF NURSES 5 TECHNICIANS (ORA) 6 ATTENDANTS 24 SWEEPER 4 CLERK 1 TOTAL 44 CENTRALISED SUPPLY (RULE OF THUMD 2PER 100 BEDS)

  30. DISTRIBUTION SYSTEMS : 1. Regular issue of one day’s requirement. 2. Clean for dirty exchange. 3. Milk round system (topping up predetermined stock level) 4. As on required basis. (Grocery system)

  31. FLOW PROCESS : CSSD WARDS/DEPTS BULK STORES DIRTY RECEIPT CLEAN RECEIPT COTTON & GAUGE DISASSEMBLY INSTRUMENT GLOVES RUBBERWARE WASHING AREAS ASSEMBLY INSPECTION PRE – STERILE STORAGE STERILISATION STERILESTORAGE DISTRIBUTION

  32. A SUGGESTED LAYOUTOF CSSD AUTOCLAVE ROOM ASSEMBLY (PARKING) STERILE STORAGE CLEANING& WASHING GLASS PARTITION Supervisors office disassembly Clean storage Verandah STERILE ISSUE Dirty reception ° ° ° ° 0 ° ° ° ° clean reception RAMP INTRA MURAL COMMUNICATION LINE

  33. Thank You

  34. Thermal Death Time (TDT) • TDT is the time required to kill a known population of microorganisms in a specific suspension at a particular temperature • Increasing temperature decreases TDT • Lowering the temperature increases TDT

  35. Thermal Death Time ( cont.) • Acidic or basic pHs decrease TDT • Fats and oils slow penetration and increase TDT

More Related