Sterilizing surgical and patient care equipment in the hospital is undoubtedly very important. Sterilization means the destruction of all living organisms and is an inevitable procedure for performing surgeries and aggressive diagnostic and therapeutic measures in a completely hygienic and germ-free environment. In teaching aseptic techniques, it is emphasized that it is a device or sterile, and this means that sterilization is absolute, that is, an almost sterile device has no meaning in the field of sterilization. In almost all hospitals, there is a section for sterilizing medical devices and equipment. This part of the hospital is known as the Central Sterilization Unit or CSR or CSSD. If this unit can not be called the heart of the hospital, it can undoubtedly be considered as a vital artery of all hospital activities and services. CSSD or Sterile Center is the place where all the necessary equipment of the wards and operating rooms of the hospital are disinfected, sterilized and stored.
Physical characteristics of the CSSD part:
1 . The best place to place the CSSD is near the operating room so that when transporting equipment to sterilize problems such as wasting time and energy and damage to devices and equipment, etc., and the device is delivered to the operating room in a timely manner.
2 . It is necessary for the warehouse of dirty and sterilized items to be completely separate and distinct, so the use of signs and labels is mandatory.
3 . The clean and dirty part of the sterile part should be completely separate and the movement in them should be completely controlled.
4 . The entrance door of the CSSD section should be large enough (approximately 2.20 m) to allow the trolley and stretcher to pass through easily.
5 . In order to protect the privacy of the sterile part, the rules for crossing the red line must be clearly defined in the CSSD entry area, and the necessary warnings must be observed by installing the sign.
6 . At the entrance to the CSSD section, there should be a locker room for changing shoes and wearing guns. This place should also take up the necessary space according to the volume of CSSD activity and the location of shoes and slippers (clean / dirty) should be installed in it.
7 . In the sterile center, a door should be provided for the entry and exit of employees and the movement of various people should be limited and completely controlled. Delivery or replacement of equipment should be done through the window dedicated to this work.
8 . The sterile storage area must be separate from the CSSD enclosure, and this separation must be in front of the sterile delivery door.
9 . The CSSD ventilation system is very important and should work well. The temperature in this section is generally high due to the operation of autoclaves. Therefore, with proper ventilation, it should be possible to keep it in the range of 27 to 38 degrees Celsius.
10. If gas autoclaves such as ethylene oxide are installed, a separate ventilation system should be provided for this hospital autoclave to be independent of the central ventilation system.
11. Washing places and sinks dedicated to this must be complete.
Instructions for observing safety tips in the central CSR unit for hospital sterilization:
CSR staff should be vaccinated against hepatitis B and have an antibody titer three months after the last injection.
People working in CSR must comply with the requirements of each section in the following order:
1 . Washing: When washing, it is necessary to use goggles, guns, plastic caps, latex gloves and hats, masks and shoes. If there is a discharge in the eyes of people while washing the dishes, it is enough to use eye bas and ordinary water.
2 . packing: In this unit, the use of hats, masks and shoes is mandatory.
3 . Sterile: In this unit, the use of hats, guns, masks and caps is mandatory.
Tip! If personnel have wounds or skin secretions, they should use gloves and replace them if they are punctured or wet.
Tip! Send staff clothes to the lanyard twice a week for washing.
Tip! Personnel must wash their hands with soapy liquid before working in each unit, and re-scrub after work.
Instructions for washing surfaces, floors, walls in CSR:
In CSR, the floor should be washed daily with water and ordinary detergent powders for heavy traffic, and at the end of the day with 0.1% Javelin water solution or Deconex 50 AF.
Dusts, sinks and appliances should be dusted daily and surfaces should be disinfected with Deconex 50 AF.
Wash the walls of the sterile part one day a week and the walls of the non-sterile part one day a week with 0.01% bleach or Deconex 50 AF.
Instructions for working with autoclaves in Central CSR:
The autoclave operates according to the standard definition at 5 minutes at 134 ° C (or 15 minutes at 121 ° C) consisting of three steps (vacuum filling, sterile, vacuum) and a total sterilization step for 25 minutes. he is doing it.
Print machine: Displays time, pressure and temperature in each cycle.
The stage of arranging the equipment in autoclave baskets is important because the air and steam flow must be done properly during sterilization and vacuuming.
• The equipment should be placed at distances of 5 cm in different classes from large and small.
• Accessories packed with vepac paper should have their paper parts stacked on top of each other.
Inside the autoclave, it is tested once a week by biological and chemical tests, and the test results are archived by the head nurse.
The print of each cycle is also archived as a test and control definition of the device.
Completion of a standard sterilization cycle includes: The color change of the chemical indicator is class D, class A for vepac papers, the definition of machine printing and the dryness of the equipment.
Instructions for moving equipment between departments, operating room and central CSR:
Delivery of equipment:
1 . Items must be clean, dry, safe and free of debris upon delivery.
2 . The equipment must be free of any cracks, decay or breakage.
3 . Staff use disposable gloves or latex.
4 . Personnel should be careful not to injure or scratch their hands when delivering sharp and winning tools.
Delivery of equipment:
1 . After making sure that the work with the autoclave is completed, it will leave the machine due to the change in the color of the indicators and the dryness of the equipment on the sterile side.
2 . Items are placed separately on the relevant shelves: The equipment of the operating room is sent there and the equipment of the wards is delivered after the visit of their personnel.
3 . When storing and delivering the equipment, care should be taken that the packages and pegs are not torn, open and perforated, and if these items are observed, the equipment will be referred again for sterilization.