Central sterile services department

General Planning Considerations

Sterilisation department in a hospital The sterilisation department in a hospital is known by many acronyms, e.g.: CSD Central Sterilisation Department CPD Central Processing Area SSD Sterile Service Department TSSD Theatre Sterile Service Department TSSU Theatre Sterile Service Unit CSSD Central Sterile Service Department (the most widely used term in the South African context)

Location and functional relationship Functional relationships to other departments See Figure 1. The CSSD should be centrally located with ready access to all related service areas, such as the ICU, in-patient units and emergency unit. The department should also have direct access, either horizontally or vertically, to the operating theatres.

Deliveries and transportation routes Trolleys are used as mode of transport for both receivables and deliveries. In order to cater for the high volume of trolleys to and from the CSSD receiving and dispatch areas, the entry/exit points should ideally be separated to create a uni-directional traffic flow and also to avoid cross-contamination through the division of the clean and dirty material.

Access for plant and equipment maintenance Plant and equipment in service areas would need access from outside the CSSD, in order not to compromise the desired level of cleanliness in the unit. In some situations direct access between the plant area and the steriliser is required in order to allow access for maintenance staff to the equipment controls in the CSSD area side.

Figure 1: Departmental relationships (IUSS:GNS Adult Inpatient Services)

Primary function of a CSSD The primary function of a CSSD is to provide an efficient, economic, continuous and quality supply of sterilised items, when needed, to all patient-care service points in the hospital, and to receive returned contaminated items for cleaning. This process is generally referred to as the “decontamination life cycle” (see Figure 2).

Figure 2: Decontamination life cycle

Activities in a CSSD can functionally be sorted under the following primary zones: • Dirty Decontamination Zone • Clean IAP (Inspection and Packing Zone) • Sterile Clean Zone

In addition to the above primary zones, supporting activities are accommodated in the CSSD.

Support zone In order to identify the functional relationship between the various spaces, the convention is used throughout this guide to indicate the respective zones in the following colours:

DIRTY : DECONTAMINATION ZONE    CLEAN : IAP (INSPECTION and PACKING ZONE)    STERILE : CLEAN ZONE    SUPPORT ZONE 
In order to create a work space for maintaining a clean environment suitable for handling sterile articles, access to the red, blue and green zones is restricted and subjected to “red-line” principle. In addition to the above, the red area (decontamination zone) is divided with a hard barrier from the IAP area, in order to prevent contaminated particles from freely entering the relatively cleaner IAP area. This barrier could be a solid brick wall, or glass wall. Activities comprising the decontamination cycle should allow a progressive work-flow pattern that commences with a “dirty” entry and receiving area, proceeds to a cleaning, decontamination and drying area, into a sorting and packing area, through to sterilisation and cooling area, to finish with sterile storage, distribution and exit areas.