Commonly seen issues for Central Sterile Supply Departments
Ensuring that the water produced by CSSD ROs complies with the current healthcare standards and ensuring that hospitals and clinics have a reliable source of water for their sterilisation departments is not as simple as designing an isolated water treatment system. There are additional site specific factors that require consideration during the design phase which centre around the installation site and the planned operation of the CSSD RO.
Central Sterile Supply Departments (CSSDs) are responsible for supplying hospitals and health care centres with sterilised medical equipment. CSSDs will use steam sterilisers, washer disinfectors and manual cleaning to ensure medical equipment is safe for use. CSSDs face a number of challenges, including:
• Staff training and retention – Staff training on sterilisers and disinfectors is very important for a number of reasons such as ensuring that sterilisers aren’t overloaded and that steam can contact with all of the packages, using the correct chemical in disinfectors and not reinfecting sterile equipment. Care also needs to be taken not to damage the packaging used during sterilisation as damage to the packaging can stop the sterilisation from being effective. Due to the level of competence required, the retention of trained staff is also important as well as continuing professional development of CSSD staff as the standards are frequently being updated.
• Overly large surgical sets – Audits of common sets of surgical equipment have revealed that 20% of equipment can be redundant leading to additional sterile processing work which could be avoided.
• Surgical equipment instrument condition – Surgical equipment can frequently be damaged during use and can also be damaged during sterile processing (e.g. surface corrosion). Visual inspection of equipment and processes for equipment replacement are essential to maintaining a sterile equipment supply.
• Insufficient inventory of surgical equipment – With loads failing due to overcrowding and instruments being lost to damage, additional inventory of surgical equipment needs to be kept on hand to ensure there is sufficient supply for the healthcare setting. Maintaining a significant inventory can be problematic due to the high cost of medical equipment.
However, all of these issues assume the washer disinfector or steam steriliser is well maintained and regularly tested and serviced. These issues also assume that the feedwater to a CSSD washer disinfector of steam steriliser is consistently AS4187 compliant. Without clean water feeding the sterilisers or disinfectors, the results will be sub-standard or the machines can be damaged. It is very difficult to achieve consistent AS4187 compliance, particularly from a biological standpoint and constant testing and monitoring is required. Moerk Water has significant experience in the design of CSSD compliant water supplies and the monitoring and sampling requirements these treatment systems require to ensure a consistent supply to CSSDs.
You can learn more about what poor quality feedwater can do to your washer disinfector or steam steriliser here. Contact Moerk Water to ensure your CSSD RO is appropriately designed for your location.