Sterile Service Department Process Mapsterile Service Department Process Map Report (Assessment)

Acquisition

The used and contaminated equipments and instruments are collected and transported to the Sterile Service Department or SSD of the hospitals in carefully sealed containers and this is a very important aspect of any healthcare system. The SSD is an area or room, which has access to a washroom and is completely isolated. The reception area where the equipments and instruments are received should be guarded against unauthorized admission. They are then sorted and sent for cleaning. (NHS, 2004)

Cleaning and disinfecting

Cleaning removes all dirt from the instruments and disinfecting them minimizes infection risks faced by the staff. The equipments are then dried. The complete process is generally automated. However, we can use a combination of mechanical cleaning, ultrasonic cleaning and manual cleaning. Items that are delicate to be cleaned by the machines are washed manually. Equipments with long tubes or surfaces that are difficult to clean manually are put in an Irrigating Ultrasonic Cleaner which forces down enzymatic cleaner inside the instruments to loosen up the debris. Then they are placed in any of the three Washer Disinfectors that cleans the equipments by a pre-wash, then at a 90^o centigrade and is rinsed at 110^o centigrade and then dried. This is the disinfecting cycle and takes around 40 minutes to finish. The disinfected, clean and dry instruments should not be exposed to the atmosphere of the washroom. (Simmers, 2003)

Inspection, assembly and packaging (IAP)

The equipments are then sent to the IAP room along with materials brought from material transfer room. They are then inspected for damage, cleanliness and function. In case of failure they are brought out of the room and either re-cleaned or repaired. The equipments are then labeled using a tracer label so that the set and the packer can be identified. They are then assembled into different trays and packs and are prepared for sterilization. (Poultsides, 2008)

Sterilization

Decontamination is actually the combination of the cleaning, the disinfecting and the sterilization processes and this combination makes the surgical equipments safe for future use. The equipments are mostly sterilized using steam at 134 ^o centigrade. For heat sensitive items, specialized processes are used. Mainly single door sterilizers are used in hospitals. The sterilizers are massive machines, which created a vacuum removing all the air inside and around the equipments. Steam, which is kept under pressure, is pumped to entirely fill up the vacuum. This is done so that all the surfaces are equally heated to 134 ^o centigrade. This temperature is maintained for about 3.5 minutes after which pressure is released out and the equipments are properly dried. The whole procedure takes about 45 minutes. The equipments are then checked and labeled with a Batch No., Autoclave No., and Date. “Sterilized” is stamped on the tracer label declaring it sterilized. (Bland, 2001)

Storage, distribution and use

After the items are sterilized, they either are put in the sterile store or are distributed to the appropriately designated departments for further use. Due to the complexity and volume of the labor that goes in the decontamination processes it can take almost five hours to sterilize the equipments before using them again. (Brouqui, 2006)

Bibliography

Bland, Lee A. Martin S. Favero, Matthew J. Arduino; 2001; Should Hemodialysis Fluid Be Sterile?; Seminars in Dialysis; 6, 1, 34-36; Hospital Infections Program, National Center for Infectious Diseases, Centers For Disease Control, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia.

Brouqui, Philippe & Didier Raoult; 2006; New insight into the diagnosis of fastidious bacterial endocarditis; FEMS Immunology & Medical Microbiology; 47, 1, 1-13; CHU Nord AP-HM & Unit des rickettsies, Facult de Mdecine, Universit de la Mditrrane, Marseilles, France.

NHS; 2004; Sterile Services Department: Health Building Note 13; NHS Estates Staff, Dept. of Health, NHS Estates, NHS Estates, NHS Estates Staff, Great Britain; The Stationery Office.

Poultsides, Lazaros A. & Konstantinos N. Malizos; 2008; Novel model for studying hematogenous infection in an experimental setting of implant-related infection by a community-acquired methicillin-resistant; Journal of Orthopaedic Research; 26, 10, 1355-1362; Orthopaedic Research Society; Department of Orthopaedic Surgery & Musculoskeletal Trauma.

Simmers, Louise; 2003; Diversified Health Occupations; Edition: 6, Cengage Learning.