CSSD (Central Sterile Supply Department) 

By Team 2
Importance of CSSD
 The CSSD plays a critical role in
ensuring that costly medical
equipment is sterilized and
delivered to various users in the
hospital in a quality control
environment .
 The physical infrastructure of the
CSSD consists of several work
areas including decontamination
rooms, packaging rooms and a
sterile storing area.
 Breakdown in the sterility may
lead to transmission of bacterial
and viral pathogens.
 CSSD Objective
 The Central Sterile Supply Department (CSSD) is a service unit of
the hospital responsible for providing complete sterile equipment's /
instruments to all the departments of the hospital for immediate use
in patients care. A step towards the prevention of hospital acquired
infections (HAI).
 Objectives:
1. To provide supplies of sterile linen packs, basins, instruments, and
other sterile items.
2.  To maintain proper record of cleaning disinfection and sterilization
process. 
3. To monitor and enforce controls necessary to prevent cross infection
according to infection control policy. 
4. To maintain regular supply equipment's.
 5. To stay updated regarding developments in the fields in the interest
of efficiency, economy, accuracy and provision of better patient care. 
6. To provide a safe environment for the patients and staff.
Design and
Layout 
  CSSD Layout designed for a unidirectional flow, CSSD
has been divided into 3 zones 
 1. Protective zone includes: 
1. Protective
 i) Receiving window Zone
 ii) Cleaning area
 2. Clean Zone
 (includes decontamination
CSSD Layout:  and drying)  3. Sterile Zone 
  iii) Assembling and
packaging area
 2. Clean zone includes: i) Autoclaving area 
 3.Sterile zone includes: i) Sterile storage room ii)
Issuing window
 1. Location
 CSSD should be located as near main user areas as possible like
Operation Theatres, intensive care areas etc. 

2. Area required for CSSD Department:- functional zone

DESIGN OF
THE CSSD
3. Size and location of CSSD varies 7 to 10 square feet per
bed  recommended.
 It should be located close to operation theaters,
accidents  and  emergency department and wards.
 The CSSD layout should be designed for a unidirectional flow.
  STEAM STERILIZED (AUTOCLAVE)
 WASHING AND DECONTAMINATION SYSTEM(washers, disinfectors,ultrasonic cleaners,
hospital cart washers)
 LOW TEMPERATURE STERILIZATION(for the terminal sterilization of reusable metal and non
metal medical devices)
ESSENTIAL  STERILANT,STERILITY ASSURANCE&ACCESSORIES(sterilant, biological indicator and

EQUIPMENTS
chemical indicator for VaproxHC sterilizers manage to give us sterility assurance, minimize
human errors)
 SURGICAL INSTRUNMENT CLEANING CHEMISTERIES(cleaning of surgical instruments  using
chemistry solutions)
 STERILIZATION POUCHES AND TRAYS(provides packaging flexibility, makes peel packs easy
to sterilize and stores
 LIQUID CHEMICAL STERILIZATION(provides a higher standard of reprocessing
assurance,eliminates all microbial life in a 23 minutes cycles
 HOT  AIR OVENS FOR DRYING INSTRUNMENTS
 WALL FIXTURES FOR DRYING
  A sterilization process should be verified before it is put into use in
healthcare settings. All steam, ETO(ethylene oxide), and other
low-temperature sterilizers are tested with biological and
chemical indicators upon installation, when the sterilizer is
relocated, redesigned, after major repair and after a sterilization
Essential failure has occurred to ensure they are functioning prior to placing
equipment
them into routine use

Setup
 Physical facilities :The central processing area(s) ideally should be
divided into at least three areas: decontamination, packaging, and
sterilization and storage.
• Monitoring: The sterilization procedure should be monitored
routinely by using a combination of mechanical, chemical, and
biological indicators
Documentation  Entry of all the items is made in CSSD receipt register including
date, time, type of instruments in the pack, name of department,
name and signature of person receiving the items. 
 Record of all the indicator tests and culture reports are kept. 
 Record-keeping requirements for high temperature sterilization
 Record-keeping requirements for low temperature sterilization
 Record retention requirements
 Record-keeping requirements for washer-decontaminators
 Also all the procedures done and the Person in charge.
  In case of highly poisonous gas used as a sterilizing agent in
ethylene oxide sterilizer there may be a requirement for some
specific documentations like sterilization time, aeration time
because such toxicity may be recurred after long days of
procedure specially for children due to sensitivity 
Review  During audit, auditor wants to verify the previous sterilization
records (log book) for justification. The main scrutiny areas are
daily or yearly equipment validation or calibration report,
preventive maintenance report, sterilizer registers for load
configuration, specific procedure (surgery) to sterilization ratio.
Previous related issues like; wet pack, improperly expose of internal chemical indicators and instruments
misplaced are outdated (expired) and therefore no chance of claiming from internal customer (ex: doctor, staff
nurse) ​.

•As per infection control audit report maximum Surgical infections reoccur within this period of time and if any
claim registered, then CSSD can show their supportive documents immediately according to need or demand ​
.

•For surgery related to prosthetic implants and instruments, these sterilization records are important even
after a prolonged period from date of surgery where the chances of infection can be aggravated​.

•Sometimes special care or treatment of instruments is required for decontaminating the instruments which

are infected with any organisms like HBV, HCV, HIV. The record is essential for CSSD personnel who clean and
disinfect such surgical instruments (to track incident like sharp injury) and the following patient for
next surgery ​
 https://rmlh.nic.in/WriteReadData/LINKS/Structure%20of%20CSS
D%20for%20website1f75176e-a514-4f48-a988-d7525d0390f1.pdf
 https://www.cambridge.org/core/journals/infection-control-and-h
ospital-epidemiology/article/importance-of-the-central-sterile-su
pply-department-in-infection-prevention-and-control/2F136B0BB
A34CFF75AE7A17B8A535865
 https://www.sciencedirect.com/science/article/pii/S1876034117300
357#:~:text=Record%20keeping%20in%20a%20Central,the%20pr
ocess%20of%20sterilizing%20items.
 https://www.cdc.gov/infectioncontrol/guidelines/disinfection/steri
lization/sterilizing-practices.html
 https://www.slideshare.net/zulfiquer732/central-sterile-supply-de
partment-cssd-94243201
Thank you