Central sterile services department
The central sterile services department (CSSD), also called sterile processing department (SPD), sterile processing, central supply department (CSD), or central supply, is an integrated place in hospitals and other health care facilities that performs sterilization and other actions on medical devices, equipment and consumables; for subsequent use by health workers in the operating theatre of the hospital and also for other aseptic procedures, e.g. catheterization, wound stitching and bandaging in a medical, surgical, maternity or paediatric ward.
The operations usually consist of the reprocessing, that is cleaning, disinfecting, and sterilizing of reusable medical equipment. Reusable medical equipment or RME can consist of any medical equipment from stainless steel surgical instrumention, to IV pumps and crash carts. RME is usually by standards separated into three classes, non-critical, semi-critical, and critical. Each class requires at a minimal a certain level of reprocessing. Also manufacturer's instructions or directions for use usually contain the required steps to properly reprocess their equipment. The three classes of RME are non critical, semi critical, and critical. Non critical items are items that do not have direct contact with a patient. This would be items like your IV poles, IV pumps, carts, suction machines etc. Semi critical items are items that are expected to have contact with what is usually a intact mucus membrane. These items usually consist of your endoscopes like those used in colonoscopies. Critical items areally items that will be introduced into a patient blood stream, or in a normally sterile area of the body. Non-critical items require at a minimal intermediate disinfection which can be accomplished with most hospital disinfectants like a bleach spray or wipes. Semi Critical requires high level disinfectants like Glutaraldehyde solution, paraceitic acid, or hydrogen peroxide plasma. High Leven Disinfectants (HLD) kill all organisms besides spores when done correctly. Critical items require sterilization, these would be all of what is usually considered surgical instruments used in various procedures. To achieve sterilization there are a different methods reliant on the part of the world you live in. This is due to different governing bodies havin different standards. In the US one of the cheapest and easiest is steam. You can also achieve sterilization through gas (ETO) and low temp like hydrogen peroxide plasma.
Depending on the healthcare facility's policy, there will be either an event related or time related sterile storage policy. If the policy is time related, an expiration date is placed on the sterile package, before being supplied to the end-user as a sterile product. If along the supply route, the sealed package got damaged or opened by a health worker, it needs to be returned to the CSSD for re-sterilization. If the healthcare facility's policy is event related, the package is considered sterile until an event occurs to compromise it's sterility (e.g. opened, dropped package, high humidity conditions, torn muslin wrap, etc.)
A sterile processing technician is someone who cleans and sterilizes used surgical instruments and other medical supplies so that they can be safely redistributed and reused on additional patients. This work is usually centralized in a special department of the medical facility.
Job titles
Job titles include the following:
- Sterile processing and distribution technician (SPD tech or CPD tech)
- Central sterile supply technician (CSS tech)
- Central processing technician (CPT)
- Central service technician (CST)
Sterile processing departments are typically divided into four major areas to accomplish the functions of decontamination, assembly and sterile processing, sterile storage, and distribution.
Decontamination
- Decontaminating used surgical instruments and other medical devices
- Operating and maintaining special decontamination equipment like automatic washers
- Inspecting decontaminated items to make sure they are clean
- Assembly
- Organizing clean items and packaging them into appropriate instrument trays and sets
Sterilization and storage
- Sterilizing assembled trays of instruments
- Precisely operating and monitoring special sterilization equipment like autoclaves
- Keeping detailed records of items that have been cleaned, sterilized, and stored
Distribution
- Stocking crash carts
- Organizing sterilized medical supplies
- Ensuring that sterile supplies don’t become outdated / preventing event related sterility issues
- Delivering sterile supplies where they are needed and picking up dirty ones
How to become a sterile processing technician
Many of the job openings in competitive regions will require proof that you are certified as one of the following:
Certification Board for Sterile Processing and Distribution (CBSPD)
- Certified Sterile Processing and Distribution Technician (CSPDT)
- Certified Ambulatory Surgery Sterile Processing Technician (CASSPT)
- Certified Surgical Instrument Specialist (CSIS)
- Certified Flexible Endoscope Reprocessor (CFER)
- Certified Sterile Processing Manager (CSPM)
International Association of Healthcare Central Service and Materiel Management (IAHCSMM)
- Certified Registered Central Service Technician (CRCST)
- Certified Instrument Specialist (CIS)
- Certified Healthcare Leader (CHL)
- Certified Central Service Vendor Program (CCSVP)
To obtain certification, a written examination must be passed and CEU credits will be required to maintain certification.
Certification
As to government regulations, certification is currently required in 3 states: New Jersey, New York and Connecticut. However, legislation that would require sterile processing technicians to be certified is now pending in Pennsylvania.
In all other states, certification is strictly voluntary. But many hospitals and surgical centers prefer to hire certified sterile processing technicians, even at a higher rate of pay.
The two main certifying organizations are the IAHCSMM and the CBSPD. Both require you to pass an examination. Once certified, you must accrue continuing education points in order to renew your certification at regular intervals.