Hospitals rely on the central sterile supply department to ensure that all equipments, instruments, tools, cathethers and rubber products or any such items used in treatment of patients or in surgical processes are entirely sterile and remain free from contamination until the point of use.
Common responsibilities of a CSSD in any large hospital would comprise of the following:
- Clean and sterilize all instrument sets, equipments and devices using appropriate and relevant dry or wet steam or chemical or physical methods and processes.
- Ensure the highest levels of quality standards in cleaning, disinfection and sterilization processes
- Carry out checks and maintain documentation for each process
- Maintain inventories
- Ensure suitable set of controls and monitoring proceses are rigorously implemented to prevent any cross contamination
- Track developments in the field
- Source suitable supplies of medical packaging that will keep all instruments, equipments and devices sterile until the time they are opened and used in sterile environments thus guaranteeing absolute sterility and safety of patients and doctors
- Train nurses and other stafff in appropriate processes
A modern hospital would have an ERP in place and the CSSD is likely to use custom software as well as employ trained professionals to handle the crucial process of sterilization and packaging following a well defined set of quality control processes. Even then there are various indicators that serve as quality indicators of the CSSD:
- Presence of trained staff with a commitment to their job: Sterilization is a crucial process and there can be no let up or compromise at any time for any item or for any process. Only qualified nurses, and not mere labour staff, are in charge of the processes.
- Organizing sets of instruments and checking the set for completeness
- Use of only appropriate processes as may be required such as moist high temperature steam autoclaving for certain equipments; ethylene oxide process for reusable plastic products sensitive to heat and dry plasma sterilization process.
- Visual control and check for completeness of various sets prior to packing into sterile medical packaging sourced from the most trusted supplier.
- Packaging into highly reliable and totally secure, absolutely sterile medical packaging to ensure contained equipments remain free of the risk of contamination during storage and transport to various departments.
- Maintain paper and computerized records of each process and transaction for each device and set.
While the importance of processes and equipments cannot be minimized, the final step is medical packaging. Packaging must be sourced only from a reliable and certified manufacturer. Apart from maintaining class 8 clean rooms, automated equipments and the entire line up of manufacturing as well as sterilizing equipments in-house, the manufacturer must also be capable of supplying various types of medical packaging to meet requirements of the CSSD. The CSSD must rely on the supplier and his certified claim that the packaging is absolutely sterile. Importantly, the packaging must have a closure system that ensures contents remain fully protected against any intrusion by bacteria or pathogens while in storage and transit.