February 2014

Streamlined Workflow-Key to Infection Control

ehealthAnuradha Desai, Manager “Academy, Getinge India
Central sterile supply departments (CSSD) are known by a variety of names in different facilities. Some go by central service, central processing, surgical supply and processing, or may be sterile supply and distribution. They also serve different customers like the entire hospital or just the operation theatre or even day care centres or dental clinics. While CSSDs may not have the same label, responsibilities or reporting structure, there is one thing that never changes – the fight against infection. This is the common goal of all CSSDs. The foundation towards this goal is laid by a well designed and well equipped CSSD.


East Way Around
To make the reprocessing department an efficient production plant and still meet microbiological demands, it is vital that the interior design of the department is adapted to good manufacturing practice and provides good working routines. Our design of a CSSD is generally based on three areas – for soiled, cleaned/disinfected and sterile goods respectively – with products, designed for a pass-through processing flow, serving as barriers between the areas. The first barrier, used in the fight against pathogenic microorganisms, is between the soiled reception area and the clean area where the inspection and packing take place. The physical barrier itself consists of high-capacity, pass-through washer – disinfectors. Since soiled cleaned and disinfected goods respectively are handled in entirely separate rooms by separated operators, the risk of cross-infection due to staff and the surroundings is minimized. The second barrier, between the clean area and the sterile storage area, includes passthrough sterilizers. Once again, the operators are physically separated, with one group working in the Clean Area, while the other is working in the Sterile Storage Area. An effective workflow also requires the use of standardized goods carriers by and between the various work procedures. While it is recommended to follow the above guidelines to the fullest extent possible, there may be barriers along the way. There are barriers of knowledge or rather lack of knowledge. Many barriers seem to be financial in nature – whether its not enough staff, inadequate space, too few instruments, unreliable equipment or something else. Yet, it is important and also practically possible to follow the concept underlying the designing of a CSSD from the perspective of Infection Prevention.

Quality of Utilities
While the foundation for successful reprocessing of medical devices is a well designed and equipped CSSD, it is incomplete unless proper processes are followed and quality of utilities used. The hospital has to maintain the quality of utilities such as water required for the proper functioning of the equipment, and has also maintained the equipment by regular cleaning and servicing. Records for all processes conducted are maintained which are important from the legal point of view. A CSSD that is operational 24 X 7, has to have well trained staff, and lays emphasis on quality control. Thus a CSSD designed for specific requirements, with state of the art equipment, and proper and well documented processes, is well equipped to handle the challenges that infections pose in hospitals today


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