Guidelines for infection control in operations

• Contaminated instruments from various hospital or clinic departments should be collected and transported to the CSSD for proper cleaning, disinfection, and sterilization.
• After processing, sterilized instruments should be returned to their respective departments for reuse.

                                                             Figure 28

Workflow Diagram for Instrument Reprocessing

Collection and Transportation of Contaminated Instruments:

• Contaminated reusable instruments from hospital departments should be collected in a sealed container filled with water and liquid detergent, labeled with a detailed tag specifying its contents.
• Instruments must be safely transported to the Central Sterile Services Department (CSSD).
• Cleaning contaminated instruments in hospital departments is strictly prohibited.

Handling of Instruments in the CSSD:

• Place contaminated instruments in the designated area within the CSSD.
• Clean all instruments using water and liquid detergent or an enzymatic solution, either manually or using automated systems, while ensuring proper personal protective equipment (PPE) is worn.
• Thoroughly dry all instruments.
• Inspect all equipment to verify cleanliness and detect any damage.
• Send damaged instruments to the maintenance department after high-level disinfection or sterilization.
• Pack clean critical instruments properly before sterilization.
• Sterilize or disinfect instruments as required.
• Verify sterilization effectiveness by checking biological and chemical indicators.
• After reprocessing, return sterilized instruments to hospital departments or store them in a clean, well-ventilated area.
• Strict separation between contaminated and sterile instruments must be maintained within the CSSD.
• Dedicated carts or containers must be used for transporting contaminated instruments—they must not be mixed with those used for sterile instruments.

Design of the Central Sterile Services Department (CSSD):

• Physical barriers (easy to clean and disinfect) must separate clean and contaminated areas in the CSSD.
• Airflow direction must move from clean areas to contaminated areas.
• The workflow must be structured to prevent cross-contamination between dirty, clean, disinfected, or sterilized instruments.
• Doors should remain closed to prevent contamination from dust, airborne particles, and insects, while ensuring proper ventilation.
• Adequate hand hygiene facilities must be available.
• A dedicated staff team should be assigned to each processing area.
• If this is not feasible, strict adherence to standard precautions must be maintained for each work zone.
• Separate supplies and storage areas must be allocated for each processing stage.

Important Note:

• All CSSD staff must be vaccinated against Hepatitis B.
• Refer to the Occupational Health and Safety section for further details.

Operations Department General Plan