Objectives & functions

1. To provide sterile materials to user departments.

2. To provide sterilized material from a central department where
sterilizing practice is conducted under conditions, which are
controlled, thereby contributing to a reduction in the incidence of
hospital infection.
3. To avoid duplication of costly equipment's, which may be infrequently
used.
4. To maintain record of effectiveness of cleaning, disinfection and
sterilization process.
5. To monitor and enforce controls necessary to prevent cross infection
according to infection control policy.
6. To maintain an inventory of supplies and equipment.
7. To stay updated regarding developments in the field in the interest of
efficiency, economy, accuracy and provision of better patient care.
8. To provide a safe environment for the patients and staff.

General Designing & Planning

1. The CSSD should be located in a delineated area where there is less
or no external traffic movement.
2. Location of CSSD should be either close to OT or should be
connected to OT with safe & quick transfer mechanism, like
dumbwaiters.
3. The CSSD layout should have well demarcated zones in
unidirectional movement of staff and supplies, which includes
Dirty zone - Receiving & Decontamination area
Clean zone - Assemble and packing area
Sterile zone - Sterile store, dispatch / issuing sterile goods to
users.
4. There should be physical barrier between clean and dirt area.
5. Space requirement 7-10 sq.ft./ bed is recommended.
Major areas - Receiving / Decontaminated area (20-25%),
Packing area (30-40%), Sterile area (10-15%)
6. The floor should be smooth, impervious, non skid and robust. Tiles
should be large with minimum joint and joints should be filled with
PVC.
7. For sterile are epoxy flooring is recommended.
8. Relative humidity should be maintained at 45+ 5% and temperature
20-24°C
9. The clean area should be maintain at positive pressure.
10. Sterile area should have a higher air pressure to prevent outside air to
enter in this area.
11. Air exchange 6-10/hr
12. Emergency exit route should be identified and displayed.
13. Easy access to fire fighting measures like extinguisher should be
placed outside the department and inside the ETO room.
14. CSSD needs RO water of 15 PPM for steam generation, Washer
disinfectant, Ultrasonic Cleaner and Wash station.
 15. CPVC pipeline for water supply is required.
16. Drain line of Cast steel for hot water drain and PVC pipe for normal
water drain is used.
17. Autoclave should have steam exhaust system through covered
canopy.
18. Covered drainage line should be provided for Wash area and
Autoclaves and Plasma/ETO
19. Equipment: CSSD should have required sterilization and cleaning
equipment in well-functioning condition. Although, not explicitly
specified in standards but it is expected that CSSD must have
technologically sound equipment. Also, equipment should be relevant
to the type of materials required to be sterilized. For eg., if rubber and
plastic items have to be sterilized ETO should be available. Horizontal
autoclave with two doors is preferable than vertical single door type.

The Layout
1. Entrance lobby
2. Receiving & Decontamination area
3. Assembly and packing area
4. Sterilization area
5. Sterile area
6. Linen area
7. ETO room
8. Office
9. Unsterile Storage room (if dressing material is stocked up in CSSD).
But suggested, DM should be indented by user department as
required and given to CSSD for sterilization process.
10. Staff changing room
11. Wash room

Workflow in the CSSD

Receiving & Decontamination area

Items used in user department and unsterile items should be received at

receiving area.
After segregating instruments they are cleaned and disinfected according to
the cleaning protocol.
Negative air pressure should be maintain in this area

Requirement in Decontamination area,

Receiving counter / receiving trolley
Instrument cleaning counter with 3 sink and movable, flexible tap
Air jet
Water jet
Hot / Cold water provision
Cleaning agent (enzyme, anti rust, lubricant)
Eye wash station
Janitor
S. S. shelf to store solution, PPE
Pass box between decontamination area and assembly area

Equipments- Washer disinfectant, ultrasonic cleaner

Assembly / Packing area

After items are safe for handling without protective attire, they are transferred
to this area
Workstations are set up to facilitate the next steps in processing cycle.
Each Instruments is carefully inspected for Integrity, cleanliness, functioning
and possible defects/damage.
Instruments, utensils, and other devices are assembled into sets, are then
packaged and labeled in preparation for sterilization.
EOT items are also packed in this area.
Different types of packaging material like linen, Non woven sheets,
Polypropylene pouches, Tyvek reels, paper envelopes available with us.
Expiry date is depend on type of wrapping material and sterilization method
selected

Requirement
Min. 2 packing station to assemble and pack sets/instruments
1 packing station for ETO items
Open Shelf and Cabinet to store packing material, indicators, record and
documents
Rotating back rest stool
Stand to keep non woven packing material
System and Printer for staff
Steam sterilizer
Heat Sealing machine
Temperature & humidity gauge
ETO room adjacent to sterile area
ETO sterilizer

Linen Area
Light table
Open S.S. shelf
2 Different color linen

Sterile Area
Sterilized items are stored in sterile storage area until dispatch to user
department.
Environment and sanitation is maintained as in OT.
Microbial Surveillance is carried out once in a month.
Issuing/Dispatch area is part of this area
Issuing station / pass box

Requirement
S.S. perforated racks
Wire mesh baskets
Issuing station / pass box

Office
System & desk
Instrument storage cupboard
Shelf / cabinet for records & document

CSSD Expectation from user

Check for the content while sending and receiving the materials from
CSSD.
If any shortage immediately call for help
Use different baskets for transportation of contaminated and sterilized
materials and should be labeled for it.
Before using check for the sterility indicator on the material.
Store sterilized material on clean and dry surface and Use as per the
FIFO (First In First Out).
Return expired material to CSSD one day prior expiry.
Keep track of CSSD instruments inventory on daily basis.
Wash used instruments immediately after used.
Instruments used for positive patients to be disinfected (after cleaning)
before sending to CSSD and should be labeled.
Never use Saline (NaCl) to clean and Sodium Hypochlorite (NaOCl) to
disinfect the instruments they cause corrosion on instruments
Any damage / missing should be informed with the reason in person and
same should be mentioned in record.
Requirement should be given 2hrs prior

Staff in patient care areas who receives CSSD goods must know
 About the labels on sterile packs, specially expiry date
Storage condition that should be maintained
Condition under which sterile packs must not be used
What to do in case a sterile pack has been recalled
How to send soiled/used items

Supporting Departments
User departments OT / ICU / Wards
Biomedical
Maintenance
Housekeeping

Staffing

Staff should be planned on following factors

1. Three shift working
2. Leave and off duty
3. Staff for minimum 3 areas
For 100 bedded hospital 2 technician, 3 attendant and 1 head are
recommended

Advantage
Efficacy, Efficiency, safety, surety and overall economy.

The problem of standardization, uniformity and co- ordination of materials

and procedures are easily controlled.

It avoids duplication of costly surgical instruments and equipments.

The life of the materials is prolonged due to efficient handling and standard
method and procedures.