Maintaining water quality inside Central Sterile Supply Department

1
Maintaining water quality inside Central Sterile
Supply Department

• Created by Debabrata Basu
• Associate Scientific Officer
• Central Sterile Supply Department
• Tata Medical Center, Kolkata, India

2
Construction

• CENTRAL STERILE SUPPLY DEPARTMENT

3
Plumbing system

• Avoid GI pipe line for low mineral content water
  that may collect inner rust from the GI pipe
  line.
• Use PVC pipes for clean and rust free water.
• Diameter of pipe line should be adequate as per
  water supply requirement.
• For better water pressure booster pump can be
  used.
• Pipe lines should be straight enough (not curved)
  for good water pressure also.
• Geyser or solar system can be used where
  basically hot or lukewarm water is required

4
How to get treated water in CSSDwww.ncbi.nlm.nih.
gov/pubmed/25118738
Supply to CSSD
Water reservoir for storage
Filtration by electro de-ionization processes (EDI)
Water chlorinated by sodium hypochlorite
Water pH maintained by soda ash check conductivity
Filtration by reverse osmosis processes (1to 5 filters)
Addition of anti- scaling agents
De- chlorination of water
Sand filter
Chlorination of water
Water softener
Iron remover
Raw water (Municipal or bore well water)
5
Area wise daily water requirement inside TMC-CSSD
Water source Essential water quality Total water requirement per day
Instrument wash basin R-O water (10-100ppm) Not measured
Disinfection tank R-O water (TDS-10-100ppm) 90 liters per day
Ultra-sonic cleaner EDI water (TDS-0-10ppm) 50 liters
Rinser in US tank EDI water (TDS-0-10ppm) Not measured
Washer disinfector EDI water (TDS-0-10ppm) 1500 liters per day
Trolley wash Normal water Not measured
Autoclave (vacuum pump) R-O water (10-100ppm) 5000 liters per day
Autoclave (steam generator) R-O water (TDS-0-10ppm) 100 liters per day
Hand wash Housekeeping purpose Normal water Not measured
6
Monitoring water quality

• CENTRAL STERILE SUPPLY DEPARTMENT

7
Tools for water quality monitoring
Water TDS- total dissolved salt- Conductivity
meter CSSD targetlt10 mg/L Source Aesculap
Water chlorine level- Colorimeter O-toluidine/
Electronic Target 0.2-0.5 ppm Ref WHO
Water microbiology Membrane filtration Target Col
iforms- 0/100 ml Pseudomonas- 0/100 mL Ref WHO,
HPA (UK)
8
Monitoring water quality in TMC-CSSD
www.ijpmonline.org/article.asp?issn0377-4929yea
r2014

• Water pressure 4Kg/cm2
• Residual chlorine --------- 0.05 ppm
• TDS------------------------------ 10 ppm
• Microbiology test Every month
• Appearance Colorless, clean, without sediment
• Changing filters every 3 months (mandatory)

9
Monthly water quality monitoring (Chemical and
Microbiological report)https//www.health.qld.gov
.au/chrisp/sterilising/OH_section5_SOP.pdf
Sr. No. Location TDS of water Chlorine content in water (ppm) Test result Day 1 Test result Day 2 Test result Day 3 Staining result Gram stain




10
International recommendation for maximum
acceptable contaminants levels for Autoclave
steam generator (According to EN 2852006)
Name of the contaminants Acceptable limit to Steam Generator
Evaporate residue 10 mg/l
Silicate 1 mg/l
Iron 0.2 mg/l
Cadmium 0.005 mg/l
Lead 0.05 mg/l
Rest of heavy metals 0.1 mg/l
Chloride 2 mg/l
Phosphate 0.5 mg/l
Conductivity 5 um/cm
pH value 6.5 to 8
Hardness 0.02 mmol/l
Total dissolve solids 10 ppm
Appeararance Colorless, clean, without sediment
11
(No Transcript)