The CSSD or Sterile Processing Department is considered a backbone of modern medical practice.

Its primary aim is to centralize all sterilization activities in the hospital, along with the timely redistribution of the sterilized instruments.

The CSSD Technician or Sterile Processing Technician is in charge of ensuring that all medical instruments and apparatus are free from bacterial contamination, therefore allowing the doctors, nurses, and other medical practitioners to work without fear of infection.

The sterilization technician may be delegated to one of the two primary units of the CSSD:

• the central unit
• the peripheral unit (also called the Theater Sterile Supply Unit)

The former contains the segments responsible for taking in the used utilities, disinfecting and processing them for sterilization and storage.

Once decontaminated, the items are passed on to the peripheral unit which then takes charge of distributing the clean instruments to other parts of the hospital.

The peripheral unit also tasks the CSSD technician to ensure that there is no back-flow of contaminated items.

What to consider in setting up the hospital’s Sterile Processing Department or CSSD

• For one, it needs to be in an accessible location, as near as possible to all the other hospital wards and departments.
• The CSSD equipment and staffing also has to be looked into — these two are highly dependent on the size of the healthcare constituent being served, as well as to the different operations being performed within.
• There should also be a consistent water and steam supply, for CSSD sterilization of instruments and apparatus.

CSSD Layout

• The layout of the CSSD should be that it encourages a one-way flow of items from the receiving to the issue counter.
• There should be a sterile area prior to access to the storage and issuing counter.
• The receiving counter and issuing counter should also be located on opposite ends of each other.
• A barrier should be located between the collection area and the cleaning area, as well as between the cleaning area and the CSSD sterilization area.

CSSD Staff

• As for manpower, the Central Sterile Services Department is commonly staffed with three working shifts to cover 24 hours of the day.
• There is a messenger service between the department and the other areas of the hospital, to allow the CSSD technician to efficiently collect soiled items and redistribute them after undergoing CSSD sterilization.
• This messenger system can be automated, through an intercom or phone service.

CSSD Maintenance

There should also be a maintenance service working to ensure that all CSSD sterilization equipment are working properly.

There should be staff at all times for all the major areas of the CSSD, from the receiving area, to the cleaning, assembly and storage, sterilization, and redistribution.

This includes taking into account those on leave and are off-duty.

• The rule of thumb is that there should be a CSSD technician for every 50 hospital beds, and one technical supervisor every 100 beds.

CSSD Clerk

There should also be a clerk on hand per shift for keeping records, as well as for accounting supply concerns.

There are also attendants below the CSSD technician to assist with the more mundane aspects of the CSS department.

• The rule of thumb is an average of 4 attendants per 100 beds across all three shifts.
• Usually, the distribution is two attendants per CSSD technician.

CSSD Cleaning Attendants and Transporters

• Depending on the duties of the hospital, there should also be dedicated cleaning attendants.
• Transporters are also hired, taking charge of actually delivering the items when the department asks for it through the messenger system.

CSSD Supervisor

• Over the CSSD technician, there should be a supervisor overseeing all processes in the Sterile processing department and taking care of the quality assurance and administration tasks.
• The supervisor is also in charge of measuring the level and efficiency of CSSD sterilization, through the use of mechanical, chemical, and biological indicators.
• They are also tasked with the enforcement of corrective procedures should these indicators show that there are inefficiencies or errors in the completion of the CSSD sterilization tasks.

Overall, the Central Sterile Services Department is a well-oiled and complicated machine, upon which the hospital rests.

Without it, the sterilization process will be distributed, inefficiently duplicating efforts and foregoing any unified quality monitoring.

CSSD staff are trained carefully for their tasks ensuring that patients will remain safe and free from any debilitating infection caused by the hospital instruments.

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