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Disinfection and
Sterilisation
Practical Aspects
Disinfection and Sterilisation
CSSD : Central Sterile Supply Department
TSSU : Theatre Sterile Supply Unit
HSSU : Hospital Sterile Supply Unit
The idea of SSU was conceived in the late 1940’s and it began
to catch on in the 1950’s in the UK. After a slow start in
Ireland there is now a professional body and specialist
courses are available.
Disinfection and Sterilisation
Functions of SSU:
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Rinsing
Cleaning
Drying
Inspection and assembly
Packaging
Labelling
Sterilisation
Storage
Distribution
Disinfection and Sterilisation
Main objectives of SSU:
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To provide medical and surgical equipment that is safe to
use.
To maintain records of processes used and instruments
processed.
To relieve the Nursing staff of these duties.
To avoid duplication of expensive hospital equipment.
To maintain an inventory of supplies and equipment.
To provide a safe environment for patients and staff
To keep up to date with developments and advances.
Disinfection and Sterilisation
The SSU should:
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assume total responsibility for processing hospital items.
Maintain an educational programme in relation to certain
aspects of infection control.
Maintain a cost effective programme of instrument
management.
Disinfection and Sterilisation
Management Structure of the SSU:
Head of Facility
CSSD Manager
Shift Supervisors
CSSD Personnel
Disinfection and Sterilisation
Other options:
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Single use items.
Purchased sterile packs.
Contracted service.
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Central facilities supplying many hospitals.
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Disinfection
Byline: A. Das, P. Ray, M. Sharma
Dear Editor,
Endoscopy is a very frequently performed diagnostic and therapeutic
interventional modality. Recently, it has been reported that up to 270,000
infections (in 2.7% of procedures) are transmitted annually by flexible
endoscopes in the USA. There have been > 500 reports of infections due to
use of contaminated endoscopes, commonly by Pseudomonas aeruginosa ,
Salmonella spp., Mycobacterium tuberculosis and atypical mycobacteria.
Recommendations for reprocessing of endoscopes have been established
worldwide, but lack of compliance is rampant in 20-70% of centres in Europe,
Australia and Asia. Compliance is also very poor in Japan, India (only 1/3 of
133 centres practised minimum disinfection), Western Europe (inadequate
disinfection in ≥30% centres) and USA (inadequate disinfection of 23.9% of
endoscopes).
International recommendations for endoscope reprocessing is a stepwise
process; pre-cleaning …
Disinfection
Endoscopy:
There are many kinds of endoscope:
Some of these require and can withstand sterilisation eg rigid
arthroscopes.
Others which are flexible and may have a number of lumens, such as
bronchoscopes, colonoscopes, gastroscopes, duodenoscopes, and
sigmoidoscopes require a high level of disinfection but cannot
withstand sterilisation..
This involves thorough cleaning and exposure to a suitable chemical.
At present this is usually peracetic acid. (Used to be
glutaraldehyde. Newer agents include chlorine dioxide.)
Disinfection
Specialised endoscope washer/disinfectors.
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Are enclosed to reduce noxious vapours.
Can accommodate any scopes.
Can flush out the different channels.
Ensure sufficient contact time with disinfectant.
Rinse with water.
Should record both cycle and scope.
Disinfection
Endoscope Dryer/storage cabinets:
Once the endoscope has been disinfected it requires to be
stored in a way so as to avoid contamination. Firstly, this
means drying the scope and then storing it so that no
microbes can reach it. Modern cabinets are designed to store
scopes safely for up to 72 hours. Otherwise the scopes
require retreatment
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