Central sterile services

Central Sterile Services
Department (CSSD)
Presented By
Prof. Jyotsna P. Khedkar
M.Pharm (Pharmacology)
P.S.G.V.P.M’S IOP Shahada
Prof. Jyotsna Khedkar, PSGVPM's IOP Shahada

• The central sterile services department also called
sterile processing department (SPD), sterile processing,
central supply department or central supply is an
integrated place in hospitals and other health care
facilities that performs sterilization and other actions on
medical devices, equipment and consumables for
subsequent/reuse by health workers in the OT also for
aseptic procedures. Non-sterile material
needed to OT is also provided.

• The modern pattern of the pharmacy services
incorporate C.S.S. concept which is accepted
by the hospital authorizes while planning with
the setup of C.S.S., nursing time is saved.

There are three different patterns for the
management of C.S.S.:
1. C.S.S. under nursing department
2. C.S.S. under pharmacist
3. C.S.S. under control of nurses as well as a
pharmacist

1. C.S.S. under nursing department: The majority
of items dispensed are used by nurses for the
patient care therefore in some hospitals this
department is under the control of a nurse.

2. C.S.S. under pharmacist:
Pharmacist prepares and distributes IV fluids,
irrigation fluids in the department of pharmacy.
In C.S.S. sterile preparation are prepared
therefore in some hospital this department is
under a pharmacist

3. C.S.S. under control of nurses as well as a
pharmacist:
In this pattern manufacturers of sterile
solutions under control of a pharmacist while
cleaning packing and distribution of medical
equipment is under a nurse.

Central services about hospital
Organisation:
• Many hospitals treat central service as a sub-
department of the pharmacy or nursing
department. In some hospital, central services do
not perform sterilization. The duty of sterilization
is put under a charge of the pharmacist.

Pharmacy and C.S.S. may have a joint
responsibility when the pharmacy department:
• Prepares solutions in bulk and transfer to C.S.S. row for bottling
and sterilization.
• Prepares and fill the solution sterilized by C.S.S. room.
• Prepares a concentrated solution which is then diluted, packed
and sterilized in the C.S.S. room.
• Prepares a dry powder which is dissolved in water-
filled and sterilized in C.S.S room.

Location:
• It should be located near the department from where it
receives materials. It should also be near to those
departments, where its supplies are Maximum distributed like
the operation theatre.
• It should be connected to the consumer department by
elevator conveyor and dumb waiter. Department must have the
capacity to expand in future. It should have good transportation
service to receive linen, surgical dressing and large
volume parenteral. It must have many work stations.

LAYOUT

Generally, the central supply department is
divided into two parts:
1.Dirty area
2.Clean area
• Both areas are separated by autoclave. Materials to be
sterilized are received in the dirty area. The materials
pass from many work stations and finally sterilized. The
sterilized material is stored in a sterile storage area. The
material is issued to the various department from
the clean area.

• At the entrance, non-sterile items like gloves, syringe and
needle, rubber gloves, surgical instruments and dressing, urine
and blood collection sets etc are received.
• The non-sterile items then pass for sorting and disassembly
purpose.
• It goes for general clean- up process for washing purpose,
powdering process for gloves and all this assembled according to
types of items. Linen material goes to the linen storage section.

• Then these items pass through partition zone to the sterile area
for sterilization in the different sterilizer.
• Finally, the sterilized items come to the sterile storage area.
• From this area, these items are issued or distributed to various
departments through the clear area.
The purpose of such layout is to minimize cross-flow of a non-
sterile item with sterile items thereby eliminating the possibility of
error of contamination.
Prof. Jyotsna Khedkar, PSGVPM's
IOP Shahada

Manpower of central sterile supply room (CSSR)
• CSSR should have adequate manpower with the knowledge of
the following areas
• Principles of sterilization.
• Methods and techniques of sterilisations like Autoclaving,
gaseous sterilisation.
• Identification of surgical instruments.
• Assembly of treatment tray.
• Cleaning the assembly equipment.
• Fundamentals of microbiology.
Prof. Jyotsna Khedkar, PSGVPM's
IOP Shahada

Advantages:
1.Bacteriological safe sterilization.
2.Less expensive.
3.Elimination of unsound practices and the
establishment of standard procedures.
4.Assurance of adequate supply of sterile
products immediately and costly available for
some time as well as emergency use.

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

Duties of a pharmacist in CSS:
• Distribution of supplies to different departments.
• Dispensing of supplies in small lots.
• Purchase of supplies, receiving and storing.
• Interaction with sales personnel.

• Meetings and discussion on problems with
medical staff.
• Implementation of standardization procedures.
• Manufacturing of bulk.
• Manufacturing of small lot of sterile and non-
sterile products.

Questions
1.Who is an outpatient?
2. Discuss various types of outpatient services for the drug distribution system in the hospital.
3. What is satellite pharmacy?
4. What is bedside pharmacy?
5. Write a note on central sterile services.
6. Give benefits of unit dose system.
7. Explain the dispensing of non-charge floor stock drugs in the hospital.
8. What is the floor stock system? Explain charge floor stock system.
9. Mention the different drug distribution system to in-patient

Central sterile services

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