Healthcare Infection Control through Cleaning & Sterilization
It is now being widely accepted that efficient pre-washing / cleaning is essential in the sterilization process. Moreover, with the current technologies in the CSSD, the demanding thermo disinfection processes are possible to assure high levels of disinfection in perfectly dry materials, deeply reducing the time factor.
Mishandling and improper sterilization of the instruments can be fatal. Safe and effective disinfection and sterilization can be guaranteed with clean medical products. CSSD provides tangible tools for securing high quality infection control because it is equipped with disinfectors and sterilization facilities.
Muralikrishnan Nair concedes, “CSSD breaks the chain of infection in the hospital and the maintenance department helps achieve it.” Experts emphasize that the rise in incidence of nosocomial infection with corresponding increase in mortality, length of stay and cost can be brought down by establishing a good CSSD set-up. CSSD was generally looked upon as an essential part for supporting the OT, Cathlab & ICU as the use of sterile supplies in a hospital is more applicable in these areas. However, it is considered today, integral to the function of Out Patient Department (OPDs), wards and other patient care areas, wherever any surgical or invasive procedure takes place.
The Central Sterile Supply Department (CSSD) plays a key role in providing the items required to deliver quality patient care. CSSD within a hospital receives, cleans, packs, sterilizes, stores and distributes the material to make reliably sterilized articles available at the right place and at the right time to all departments. Identifying and completing the many tasks performed in CSSD require development of effective policies and SOPs that are supported by industry standards and guidelines. Training CSSD team members to follow these policies and procedures will ensure a consistent and high-quality product and enhance service level. This in turn will support quality patient care.
Any compromise in terms of cleanliness and hygiene could lead to nosocomial infection. Asian Heart has various processes in place to achieve cleanliness & hygiene, but the challenge lies in the form of competency and expertise of staff, says Nair. “Their training and orientation therefore is a continual process,” he adds.
Today, there is no need for nurses to divert their attention to other mundane activities and they can focus more of their time in their primary responsibility of patient care.
Towards achieving quality
AHIRC has today achieved the distinction of the lowest infection rate by virtue of the stringent protocols and training of the cleaning and the CSSD staff.
The administration department of AHIRC has outsourced competent building service contractors (BSCs) to attain desired hygiene levels and to ensure consistent infection control practices. The contractor is selected on the basis of certification, documentation, competence, customer satisfaction and their credibility in the market.
For effective management and administration purpose, the current practice prevailing in AHI is that they have a well orchestrated and integrated system of staff comprising of CSSD and Maintenance Personnel to achieve the same.
The service provided by the BSCs is expected to be patient centric and aligned as per the goal and expectations of the hospital. To achieve this, ownership is inculcated among these contractors so that they do the job in a desired way. Rare Hospitality is providing services at Asian Heart presently.
The cleaning support staff in CSSD is also called Patient Care Assistants. They help the technical staff in CSSD and are also involved in activities like lifting, laying and transporting instruments from one machine to other and from one area to the other.
In the wash area, they can help in the cleaning and collection of material. “The people required during the cleaning process are trained under the supervisor of the maintenance department. There is a mandatory minimum of nine hours training in a month.”
They need to follow proper protocols while changing positions in the CSSD area. For example, when they are finished with their job in the washing area, they have to remove their gloves, attire and wash their hands. They have to remove their plastic aprons and ensure that they wear specific attire for better identification, so that contamination is prevented.
“Cleaning of instruments, transport of dirty instruments, receiving at the user area and distribution are done in a seamless fashion by the support staff and the outsourced cleaning staff. CSSD department has a team of 12 people, which comprises the following staff – Manager, Deputy Manager, Team Leader and Technicians.
“We have a dedicated manpower which works 24 x 7 in three shifts. We refrain from using detergents in the sterilizers for cleaning them. Microfibre wet wipe is specially designed for the sterilizers for manual cleaning once a week. These wipes are of very good strength and can last up to three months,” says Nair.