CSSD Central Sterile Supply Department

Presentation Transcript

CSSD Central Sterile Supply Department

" No Stronger Condemnation of any healing center or ward could be maintained than the straightforward certainty that ZYMOTIC DISEASE has begun in it or that such ailment assault different patients than those got with " - FLORENCE NIGHTINGALE

BHATTA CHARJEE DEFINES – CSSD as that administration, with in the clinic, providing food for the sterile supplies to all divisions , both to particular units and general wards and OPDs.

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 – Safadarajan Hosptial

AIMS To give cleaned material from a focal division where sanitizing procedure is completed under legitimately controlled conditions To ease the weight of work of the nursing staff, there by empowering them to dedicate a greater amount of their opportunity to patient care .

ADVANTAGES ; 1. Bacteriological safe sanitization. 2. Less costly. 3. Disposal of unsound practices & foundation of standard techniques. 4. Confirmation of satisfactory supply of sterile items promptly and continually accessible for at some point and in addition crisis utilize.

5. Preservation of prepared staff. 6. Better quality control 7. Better great of material stream 8. Drawn out life by appropriate care of gear

ITEMS COMMONLY HANDLED BY CSSD STORES

1. Syringes 2. Methodology Sets Lumbar cut ; sternal cut ; phlebotomy ; paracentesis ; goal ; catheterization ; tracheotomy ; suturing ; dressing ; biopsy ; entry point & seepage ; aortography ; cardiovascular revival ; and so on 3. Needles 4. Gloves

5. I.V.Fluids . 6. Treatment Trays. 7. O.T Instruments. 8. O.T. Material 9. Implantation Fluids for Renal Dialysis. 10. Now and again LINEN. (other than O.T) NB: Diet , drugs , bedpans & urinals are excluded by tradition .

PLANNING A DEPT ; (COPP) 1. Physical Planning. 2. Practical Planning. 3. Faculty Planning. 4. Hardware Planning. 5. Monetary Planning. 6.Quality Control. 7.Preventive Maintenance.

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

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

EQPT IN CSSD 1.Jet water cleaning contraptions. 2.Ultrasonic Washers 3.Glove sharpener 4.Needle sharpener. 5.Gas, Chemical or steam autoclaves. 6.Testing mechanical assembly for proficiency of cleansing

OTHERS 1.Maint & Repair EQPT 2.Adequate number of lodges & Furniture 3.Telephone or radio. 4.Adequate no of syringes & methodology sets.

NUMBER OF SETS/SYRINGES Total: 4.5 to 5 times of the every day prerequisite

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

CHEMICAL CIDEX – A Glutaraldehyde subordinate is best as it wrecks spores as well. ETHYLENE OXIDE (ETO) ; Quite powerful against spores as well. Helpful for fragile instruments and thing which can't be inundated in fluids - Low Boiling Point (10 degree C) - Prolonged Aeration - Highly Expensive/Explosive/Toxic

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

Sterilization . It is a procedure of liberating an article from every single living being including microbes ,contagious spores and infections. A material is proclaimed sterile on the off chance that it achieves 99.99% slaughter of bacterial spores.

STEAM STERILATION - Water ��  Saturated ��  Wet vapor ��  Dry immersed Vapor ��  Super Heated Vapor/Steam - Steam with <0.95 Dryness Factor is not valuable for Sterilization. - Superheated Steam acts like Dry Hot Air just . ( Strength Of Steam is its Latent Heat)

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

TYPES OF AUTO CLAVING MACHINES 1. Descending Displacement 2. Vacuum Assisted. 3. Beat Steam Dilution

TESTS FOR EFFICENCY OF Sterilization 1 . Exceptionally treated paper strip. 2. Weight delicate tape to be altered to the last crease 3. Cocoa pointer tubes - (extremely costly) 4. Organic. Green strip containing microscopic organisms (Color must change to dark)

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

ADVANTAGES OF STEAM Sterilization 1 . Fast warming & entrance of burdens. 2. Pulverization of all types of microbial life 3. No leftover poisonous quality.

4. No harm to provisions being disinfected . 5. Simple Quality Control 6 . Prudent & Reliable This strategy is inadmissible for warmth touchy and non-porous material

RADIATION Sterilization ; " ISO MED " at "BARC" Trombay ; measurement - 2.5 Mega Rhontgen ; Source – Cobalt-60/Caesium – 137/Electron Beam (produced by direct quickening agent) Reliable, can infiltrate a wide range of pressing. Huge & different molded articles can be cleaned . No remaining radio action at 2.5 mega rhontgens . Glass gets to be dim, cotton looses elastic property, sustenance gets undesirable flavor. Not practicable in doctor's facilities

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

DISTRIBUTION SYSTEMS : 1. Standard issue of one day's necessity. 2. Clean for grimy trade. 3. Drain round framework (besting up foreordained stock level) 4. As on required premise. (Staple framework)

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

A SUGGESTED LAYOUTOF CSSD AUTOCLAVE ROOM ASSEMBLY (PARKING ) STERILE STORAGE CLEANING& WASHING GLASS PARTITION Supervisors office dismantling Clean stockpiling Verandah STERILE ISSUE Dirty gathering ° 0 ° clean gathering RAMP INTRA MURAL COMMUNICATION LINE

Thank You

Thermal Death Time (TDT) TDT is the time required to kill a known populace of microorganisms in a particular suspension at a specific temperature Increasing temperature diminishes TDT Lowering the temperature builds TDT

Thermal Death Time ( cont.) Acidic or fundamental pHs diminish TDT Fats and oils moderate entrance and increment TDT