Maintaining air quality inside Central Sterile Supply Department

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Maintaining Air QualityinsideCentral Sterile
Supply Department

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

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Infrastructure

• CENTRAL STERILE SUPPLY DEPARTMENT

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Constructional layout inside CSSD (Red arrow
shows the unidirectional workflow inside CSSD)
journals.cambridge.org/article_S0195941700094492
RAW MATERIAL STORE
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Traffic control system
www.ncbi.nlm.nih.gov/pubmed/25203193

• All CSSD doors should be access controlled
• Entry only for authorized personnel's.
• Wear clean dresses and PPEs while entering
  inside.
• CSSD should be far away from normal traffic area.

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Air lock room (between packaging zone and sterile
store) http//medind.nic.in/maa/t04/i1/maat04i1p6
3.pdf

• Pass through mechanism should be maintained
  properly.
• PPE's should be followed up strictly.
• Maintain hand hygiene technique before touching
  sterile products.

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Cleaning of CSSD sterile storehttp//www.scielo.b
r/scielo.php?pids0080-62342012000500025scriptsc
i_arttexttlngen

• Keep store away from dirt, dust, fluid
  moisture.
• Daily cleaning of sterile store furniture and
  floors.
• Weekly cleaning of sterile store walls ceiling.
• Monitoring air quality every 3 months.
• Temperature and humidity monitoring regularly.
• Use dehumidifier or room heater for controlling
  the moisture if any.

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Separate linen packing areahttp//www.infectionco
ntroltoday.com/articles/2002/03/taking-cover.aspx

• Linen room should be separate from normal work
  area
• Linen room must be well ventilated
• All reusable linen should be washed and laundered
  to reduce lint that accumulate dust
• During linen packing door should be closed.
• Used dedicated trolleys for transportation
• Linen room should be cleaned daily

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Personnel dress code

• CENTRAL STERILE SUPPLY DEPARTMENT

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CSSD personnel dress code
www.ncbi.nlm.nih.gov/pubmed/25203193

• Entry to the CSSD should be via the entrance
  corridor where outside footwear will be exchanged
  for inside footwear. Wearing cap is very much
  required at the time of entry in the department.
  Mask should wear mainly entry in Sterile store,
  instrument handling and linen packing time.
• Left side image shows when a outsider visit in
  C.S.S.D (except Sterile store).
• Middle image shows one C.SS.D personnel standing
  in front of packing zone wearing scrub suit and
  cap.
• Right side image shows a personnel working in the
  decontamination area should always wear proper
  PPE

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Monitoring air quality

• CENTRAL STERILE SUPPLY DEPARTMENT

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Control air flow in controlled environment
http//www.jstor.org/stable/10.1086/678072

• Work and Material Dirty to Clean

• Staff Segregate area wise

• Air Clean to Dirty

• Pressure Positive to Negative
• Air exchange 10 times/hour
• Air velocity 300 cfm

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CSSD zone wise ventilation requirement
http//info.aia.org/knowledgebase/Guidelines_for_D
esign_and_Construction_of_Hospitals_and_Health_Car
e_Facilities.htm
CSSD zone Air pressure/Air movement Total air exchange/hour
Decontamination zone Negetive / In 10
Linen packing room Negetive / In 10
Instrument packing area Positive / Out 10
ETO room Negetive / In 10
Sterile storage area Positive / Out 10
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Air microbiology in Sterile store
http//info.aia.org/knowledgebase/Guidelines_for_D
esign_and_Construction_of_Hospitals_and_Health_Car
e_Facilities.htm
Location examples At rest (cfu) Operational (cfu)
Clean support room 5 50
Air particle count in Sterile store
Filter size Filter size Filter size Filter size Filter size Filter size
0.3 um 0.5 um 1 um 3 um 5 um 10 um
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Temperature and Humidity monitoring in CSSD
sterile store http//info.aia.org/knowledgebase/G
uidelines_for_Design_and_Construction_of_Hospitals
_and_Health_Care_Facilities.htm.

• Temperature maintains 20oC to 24oC as per
  standard
• Relative humidity maintains 50-60 as per
  standard

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Tools for monitoring air quality
Air Particle Counter
Anemometer
Agar plates- settle plates
Agar Strips for MAS
Microbiological Air Sampler (MAS)
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Documentation system
CENTRAL STERILE SUPPLY DEPARTMENT

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Cleaning audit for CSSD
Main Points Area Frequency Responsible Person Status
Machine dusting Soil and Packing room Daily
Trolley washing Trolley wash zone Daily
Computer cleaning Packing/Sterile store Weekly
Furniture dusting Soil/Packing/Sterile zone Daily
Walls/Ceiling cleaning Packing/Sterile store Once a week
Door/ Pass box cleaning All area Once a week
Cleaning air flow ventilator duct grill Sterile store Alternative months
Shoe cleaning C.S.S.D Daily
Floors/ Corridor cleaning All area Daily
Remove /clean garbage Soil and Packing room Daily
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Sample copy of a swab culture formhttp//www.micr
otestlabs.com/documents/wp_sterility-testing.pdf
Details of specimen Test result
Specimen number
Sample received on
Specimen type
Specimen remarks
Department
Media used
Date of collection
Volume
Incubation type and temperature
Result after 3 days of incubation
Report
Status
Reporting date
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