CSSD Department

THE LETTER C.S.S.D STANDS FOR: CENTRAL STERILIZING SUPPLY/SERVICE DEPARTMENT. W.C.H C.S.S.D. ALSO HAS A SUB SECTION – M.E.P.D. THE MEDICAL EQUIPMENT PASTEURIZING DEPARTMENT.

WHAT IS C.S.S.D?

This is the area in the hospital in which the sterile packs for the wards, departments and theatres are prepared, packed and sterilized. The M.E.P.D. is responsible for disinfection of all anaesthetic, ventilation, suction and other equipment that may be re-used and only needs to be surgically clean, not 100% sterile.

Good communication must be built up between the CSSD and nursing and medical staff who are the chief users of the service in order to:

  • Reduce costs by re-sterilizing items
  • Preparing and controlling of instrument trays and specialized packs for specific treatment procedures
  • Standardizing packs to assist users and generally enable CSSD to provide a more efficient service.
  • Reduce the workload in the wards, theatres and departments
  • Simplify stock control by having a central store
  • Cut down on infection in hospitals by proper and controlled sterilization

TYPE OF SERVICE RENDERED AND TO WHOM

  1. This department does steam sterilization (autoclaving) for the two hospitals, W.C.H., Katutura and 7 clinics in the Windhoek District. Okahandja and Gobabis Hospitals also bring their sterilization items here when their autoclaves are broken as they only have one autoclave each.
  2. Ethylene oxide gas sterilization for all government health facilities in Namibia. We also do some ethylene oxide sterilization for N.I.P. This service is at present being done at the Roman Catholic Hospital as our gas sterilizers cannot work properly due to incorrect compressed air from main service area.
  3. Chemical disinfection in the M.E.P.D. section.
  4. Procurement and issuing of pre-packed sterile packs from the industry.
  5. Arranging specialized instrument sets from the different firms
  6. Procurement, processing, issuing and arranging payment of all items handled by C.S.S.D.

 

WHAT C.S.S.D. EXPECTS FROM THE THEATRE USERS:

  1. Telephonic daily orders of all the items needed by the theatre to be placed between 07h00 and 09h00. The order to be placed only after checking the sterile stocks in theatre. Orders are place daily from Monday to Friday so it should not be necessary for “hoarding” or over ordering to take place.
  2. Orders for items usually kept in theatre, not normally coming to CSSD, can be placed on a requisition form sent to the department as the need arises. Please do not wait until the last item is used before placing an order. The ordering process is lengthy and it may take weeks/months before an item is obtained. The hospital budget has been cut and at certain times the system does not allow the printing of orders which can also cause delays.
  3. Only the person working in CSSD is theatre trained. If orders are placed please use the correct names, catalogue numbers, specifications and any other information available to ensure that you receive the right items in the correct amounts. This also applies to motivations for new items.
  4. Working conditions/work flow must be so organized that the theatres are prepared the afternoon before with all the requirements for the operations in that specific theatre for the next days’ list. NO RUNNING AROUND LOOKING FOR INSTRUMENTS WHEN THE PATIENT IS ALREADY ON THE TABLE.
  5. CSSD works for the whole Windhoek complex not only the theatres. A work routine has been worked out to accommodate all users. Deviations will disrupt the service to another section. Transport section send 2 workers who deliver the clean items and collect the dirty items at certain times throughout the day throughout the hospital. If one of the men is off sick, or on leave it is difficult to get a replacement. The replacement is usually assigned to another area of work e.g. the truck collecting the refuse and will therefore not be available for CSSD for the whole day. Please ensure that the used items get taken to the collection area as they are used.
  6. Report to CSSD should your items not be collected or delivered.
  7. Please remember that if no dirty instruments are received from the theatres, CSSD will not be able to prepare them in time. The same applies to the linen used. If the laundry receives no linen, they will not be able to supply CSSD, who will in turn no be able to supply the theatres.
  8. There is only a certain amount of each type of instrument sets available. Theatres to co-ordinate the theatre bookings to prevent delays e.g. you cannot have 20 T’s & A’s booked for the morning list of 2 theatres if you only have 10 instrument sets. Both surgeons may be able to do a tonsillectomy in 10 minutes but the cleaning process in between cases takes a long time. C.S.S.D. can re-sterilize the used instrument sets as they are used but keep in mind that the dirty instruments must first be collected, cleaned and put into the autoclaves. A process which all takes time. The autoclaves may not all be functional or may already be in use for other items from another department. The transport people may also not be available to collect the dirty sets as they are used.
  9. Theatre sisters to arrange for instrument sets not in the theatre at 14h00 in order for CSSD to prepare the packs for the next day. CSSD only works till 16h00. A sister is on call for emergency packs after hours. If the packs had been used during the day the sister to please see that the same are returned to CSSD by sending porter down if the transport person has already collected the dirty instruments.
  10. Scrub sisters to check instruments before commencement of the operation and also once the operation is completed. Any shortages to be reported immediately to CSSD. Instruments to be wiped during operation and returned on the same trays that they came from. Instrument forms to be signed and usage form of e.g. screws and plates also to be completed with patients’ particulars, state or private and exactly what was used.
  11. CSSD does not expect the theatres to wash instruments but we do not want to receive instruments coated in blood and full of debris of any sort. It is very difficult to clean the instruments once the blood has dried on them and if put into the machine it will only fix the dirt even more tightly onto the instrument. Rinse the instruments in water or wipe of the blood before putting back on the tray.
  12. Please rinse suction tubing through during procedures.
  13. Any blunt, broken, damaged instrument to be marked with a sticker and placed back onto the set it was taken from.
  14. Do not open instrument sets unnecessarily for one or two instruments. Please ask CSSD if it is not possible to have the instrument packed as an extra instrument.
  15. If any changes are to be made to an instrument set please ask that it can be discussed with all skate holders. You may not want to use a certain item but the next person may still want to use that item. The sets are standardized to accommodate everyone.
  16. Please route packs. We should not have to re-sterilize instrument packs due to expired dates. Very few packs are not in constant circulation.
  17. Human errors will occur from both sides. Please inform CSSD if any problems are experienced. We can only make changes if we know what is expected.

CONCLUSION:

Good communication must be built up between the CSSD and the theatre users. If everyone is courteous, honest, and responsible and shows patience with someone who is new or does not understand what is being asked for, it will go a long way in rendering a quality, infection free service to our patients. It must be remembered that everyone plays a vital role in the whole set up, from the cleaner to the surgeon.

 

EVERYONE MUST WORK TOGETHER AS A TEAM!