Central sterile supply department (CSSD) management quality sensitive index constructed by management mode under the guidance of key point control theory and its effect on CSSD management quality: a retrospective study.

BACKGROUND: The central sterile supply department (CSSD) ensures the quality of medical care and controls infection. The professional, standardized, and scientific management of the CSSD is prerequisite if a hospital is to realize sustainable development. Based on the management mode and under the guidance of key point control theory, this study developed the CSSD management quality sensitive index to analyze its effects on the management quality of the CSSD. METHODS: We conducted a retrospective analysis of 282 medical devices processed from January 2020 to June 2020 (the control group), and 280 medical devices sterilized from July 2020 to December 2020 (the observation group). The devices in the control group were cleaned and disinfected according to the conventional operation process, while the observation group used a management quality sensitive index that had been developed according to the management mode, as guided by the key point control theory, and managed by the CSSD. The sensitive indexes of the two groups before and after the intervention were recorded to evaluate the work quality of CSSD medical staff. RESULTS: After the intervention, the process indexes, such as the qualified rate of cleaning quality, qualified rate of assembly, qualified rate of labeling, and correct rate of sterilization, the qualification rate of the sterilization results, the rate of intact packaging, and the rate of intact instruments, the environmental status, packaging quality, cleaning quality, and equipment management scores of the observation group were significantly higher than those of the control group (P<0.05). The incidence of wet packaging in the observation group was significantly lower than that in the control group (P<0.05). The service quality indexes, such as the replenishment time, retrieval time and preparation time of goods, of the observation group were significantly shorter than those of the control group (P<0.05). CONCLUSIONS: The quality sensitive index constructed under the guidance of the key point control theory can be used to guide the quality management of the CSSD, improve the processing results of key points in key control processes, and improve the work quality and service quality of the medical staff.

Application of the defect management improvement mode under Joint Commission International standard to improve the instrument cleaning and disinfection effect and management quality in the central sterile supply department: a randomized trial.

Background: Professional, standardized, and scientific management of the disinfection supply room is the prerequisite to ensure medical quality and improve the comprehensive strength of the hospital. This study aimed to evaluate the application of the defect management improvement mode of the Joint Commission International (JCI) standard in improving the cleaning and disinfection effect as well as the management quality of instruments in the central sterile supply department (CSSD). Methods: From January 2020 to December 2020, 32 medical staff in the hospital CSSD were divided into control and observation groups according to the random number table method, with 16 staff members in each group. The control group adopted the standardized management mode and the observation group adopted the defect management improvement mode based on the JCI standard. During the management period, we compared the disinfection effect and incidence of adverse events of the instruments and articles in the CSSD of the two groups, and evaluated the work and satisfaction of both groups of subjects. Linear correlation analysis and multiple linear regression analysis were used to determine the influencing factors of satisfaction. Results: During the standardized management, the instruments and articles were used 611 times in the control group and 602 times in the observation group. The cleaning qualified rate, infection awareness rate, standard implementation rate, hand hygiene implementation rate, theoretical knowledge score, and practical operation ability of the observation group were significantly higher than those of the control group (P<0.05). The incidence of adverse events in the observation group was significantly lower compared to the control group (P<0.05), and the satisfaction scores of the observation group were significantly higher than those of the control group (P<0.05). The total satisfaction score is independently related to the training method, educational background, and professional title. Conclusions: Adopting the defect management improvement mode under the JCI standard for CSSD is conducive to improving the cleaning effect of instruments, enhancing the work situation and job satisfaction of medical staff, and reducing the incidence of adverse events. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100053068.

Importance and results of sterility testing of various products in a microbiology laboratory of eastern India.

Components of blood products from Blood bank, stem cells products from Haemotapoietic Stem Cell Transplant unit, CSSD (Central Sterile Supply Department) items, and pharrrmaceutical products, were sterility tested by liquid culture. 2.91% of the total 3122 samples sent for sterility testing from various departments were positive (i.e. showing contamination). CSSD products showed no contamination (0/37); products from blood bank and bone marrow transplant unit showed a contamination rate of 2.03% (47/2307) and 4.64% (31/667) respectively. The average cost of sterility test was Rs. 302 (INR). Sterility test requires stringent aseptic precautions which is resource intensive.

Iriflophenone-3-C-ß-d Glucopyranoside from Dryopteris ramosa (Hope) C. Chr. with Promising Future as Natural Antibiotic for Gastrointestinal Tract Infections.

Ethnopharmacological approaches provide clues for the search of bioactive compounds. Dryopteris ramosa (Hope) C. Chr. (plant family: Dryopteridaceae) is an ethnomedicinal plant of the Galliyat region of Pakistan. The aqueous fraction (AqF) of D. ramosa is being used by inhabitants of the Galliyat region of Pakistan to treat their gastrointestinal tract ailments, especially those caused by bacteria. The aims of the present study were as follows: (i) to justify the ethnomedicinal uses of the AqF of D. ramosa; (ii) to isolate a bioactive compound from the AqF of D. ramosa; and (iii) to evaluate the antibacterial and cytotoxic potential of the isolated compound. Column chromatography (CC) techniques were used for the isolation studies. Spectroscopic techniques (UV-Vis, MS, 1&2D NMR) were used for structural elucidation. The agar-well diffusion method was used to evaluate the antibacterial potential of "i3CßDGP" against five bacterial strains, and compare it with the known antibiotic "Cefixime". The brine shrimp lethality test (BSLT) was used for cytotoxic studies. The AqF of D. ramosa afforded "iriflophenone-3-C-ß-D glucopyranoside (i3CßDGP)" when subjected to LH20 Sephadex, followed by MPLC silica gel60, and purified by preparative TLC. The "i3CßDGP" showed a strong potential (MIC = 31.1 ± 7.2, 62.5 ± 7.2, and 62.5 ± 7.2 µg/mL) against Klebsiella pneumoniae, Staphylococcus aureus, and Escherichia coli, respectively. On the other hand, the least antibacterial potential was shown by "i3CßDGP" (MIC = 125 ± 7.2 µg/mL), against Bacillus subtilis, in comparison to Cefixime (MIC = 62.5 ± 7.2 µg/mL). The cytotoxicity of "i3CßDGP" was significantly low (LD50 = 10.037 ± 2.8 µg/mL) against Artemia salina nauplii. This study not only justified the ethnomedicinal use of D. ramosa, but also highlighted the importance of ethnomedicinal knowledge. Further studies on AqF and other fractions of D. ramosa are in progress.

The impact of a sterile processing program in Northwest Tanzania: a mixed-methods study.

Background: Inadequate training of health care workers responsible for the sterilization of surgical instruments in low- and middle-income countries compromises the safety of workers and patients alike. Methods: A mixed methods research study was initiated in the Lake Zone areas of Northwestern Tanzania in the summer of 2018. The goal was to identify the impact of education and training on sterile processing practices at ten hospitals. Quantitative data analyzed included hospital assessments of sterile processing practices prior to and 4 months after training, as well as participant test scores collected at the beginning of training, after 5 days of classes, and 4 months after mentorship was completed. Thematic analysis of interviews with participants 4 months post-training was completed to identify associated impact of training. Results: Improvement in test scores were found to be directly related to sterile processing training. The greatest sterile processing practice changes identified through hospital assessments involved how instruments were cleaned, both at point of use and during the cleaning process, resulting in rusted and discoloured instruments appearing as new again. Themes identified in participant interviews included: changes in practice, challenges in implementing practice changes, resource constraints, personal and professional growth, and increased motivation, confidence and responsibility. Conclusions: Providing education and follow up support for workers in sterile processing resulted in increased knowledge of best practices, application of knowledge in practice settings, and awareness of issues that need to be overcome to decrease risks for patients and health care workers alike. Further research is needed to identify the impact of mentorship on hospital sterile processing practices in order to provide clear direction for future spending on training courses.

Analysis of processes and costs of alternative packaging options of sterile goods in hospitals - a case study in two German hospitals.

BACKGROUND: Hospitals should monitor the costs of all direct and indirect processes in order to achieve efficiency and safeguard financial sustainability. One neglected process with significant costs is the processing of reusable medical devices and their packaging performed in the central sterilisation supply department and the operating room. The objective of this research is to analyse and compare processes and costs of four different packing alternatives, i.e. non-woven sterilisation wrap with two sheets, one-step wrap, sterilisation container with inner wrap and sterilisation container without inner wrap. METHODS: We defined sub-processes that are directly related to the packaging options and measured them through a comprehensive time study. For all sub-processes and the total processes a distribution fitting and a Monte-Carlo-Simulation were performed. We calculated the costs for all sub-processes, i.e., costs for personnel, variable costs and the respective share of fixed and jump-fixed costs (e.g. depreciation of containers) associated with each packaging option. All results are discussed through various scenarios to evaluate the advantageousness of all packaging options. RESULTS: The four packaging options are associated with different costs. "Sterile container without inner wrap" causes 2.05€ per use. The options "sterile container with inner wrap" (3.24€), "one-step sterilisation wrap" (3.44€) and "two sheets sterilisation wrap" (3.87€) cause higher costs. With regard to personnel costs the option "sterile container without inner wrap" clearly causes the lowest costs. In addition, variable costs are lower in case of sterile container. Sterile container only cause higher costs in the aspect of fixed and jump-fixed costs per packaging. CONCLUSIONS: The analysis shows that even under a broad set of scenarios the "sterile container without inner wrap" is the most cost-effective alternative. The evaluation of the options "sterile container with inner wrap" and "one-step sterilisation wrap" remains particularly interesting as they often yield comparable results. Both options cause approximately the same personnel costs, so the decision appears to be more dependent on the material prices for wrap or the frequency and duration of use for container. It turns out that the personnel time and consequently the personnel costs significantly influence the rational choice of the packaging options.

The importance of paper records and their preservation period in a Central Sterile Supply Department: An experience from a oncology center in eastern India.

Everywhere recordkeeping is very essential for future need. This may be required for any audit purposes, legal issues and forgetting any incident. Record keeping is a specialized area in every hospital that is handled by specialized medical records officer for proper management of all important documents for long time preservation purposes. In this article there are various important healthcare sterilization related paper records have been discussed for documentation and preservation purposes. Though several articles on 'retention of medical records' have already been published worldwide but exclusively sterilization related records and their cause of preservation have not been discussed as such. The purpose of the article is to highlight only the essential CSSD paper records and their preservation policy so that this certainly guides to every CSSD in-charge and hospital authority for making a standard guideline of retaining sterilization records in their institution.

Sports Nutrition Knowledge, Perceptions, Resources, and Advice Given by Certified CrossFit Trainers.

BACKGROUND: CrossFit is a large, growing force in the fitness community. Currently, Level 1 and 2 CrossFit certification classes do not include nutrition education. The purpose of this study was to identify sports nutrition knowledge, perceptions, resources, and advice given by Certified CrossFit Trainers. METHODS: An online questionnaire that measured these four constructs was placed on a private Facebook community, open only to certified CrossFit trainers, for 10 days. RESULTS: Complete surveys were obtained from 289 CrossFit trainers. The mean Sport Nutrition Knowledge (SNK) score was 11.1 ± 2.1, equivalent to 65.3% ± 12.4% correct. The trainers perceived nutrition to be extremely important to athletic performance (9.4 ± 0.9 on a 10 point scale). Overall, the trainers graded their SNK higher than that of their CrossFit peers. The internet and CrossFit peers were the most frequently reported sources for nutrition information; Registered Dietitians were the least reported source. The Paleo and Zone diets were the most common dietary regimens recommended by CrossFit trainers. Results indicated a positive correlation between a CrossFit trainer's self-reported hours of nutrition education and their SNK score (r = 0.17; p < 0.01). CONCLUSION: Nutrition education modules for Level 1 and 2 CrossFit trainers, developed with input from Board Certified Specialists in Sports Dietetics, are recommended.

Design improvement and application of transfer trolley for collection and distribution in central sterile supply department / 医疗卫生装备

Objective To modify the existed transfer trolley for collection and distribution so as to enhance cleaning and disinfection.Methods The existed transfer trolley was added with an intake pipe,a spray nozzle,a drilled divider,a drainage pipe and etc for perfusion rinse,and equipped with auxiliary mechanisms such as a protective support and preserver.Omnidirectional cleaning and disinfection of the trolley were executed by the intake pipe,nozzle and high-pressure irrigation machine.Results The trolley prevented the disinfection solution from spitting,ensured the safety of the staff and environment,and had the qualified rate of disinfection being 100％.Conclusion The modified transfer trolley gains advantages in environmental protection,energy saving and practicability,and thus is worthy promoting clinically.

Design of water supply system for disinfection of surgical instruments in tertiary hospital / 局解手术学杂志

Objective To design a set of supply water processing system for disinfecting surgical instruments in integrated tertiary hospi-tal,and improve the quality of supply water for the instrument disinfection and control the cost of water. Methods Since October 2012,Wa-ter Disinfection Device for instrument in tertiary hospital CSSD was studied. And a system of integrated production and supply the softened wa-ter,level-one reverse osmosis purified water,secondary reverse osmosis pure water was designed,which can realize a steady supply of disinfec-tion water all the day. The equipment cleaning and instrument sterilization equipment running used softened water,final rinse and disinfection of equipment used level-one reverse osmosis water purification,the instrument sterilization with steam pressure for production used secondary reverse osmosis water purification. Results According to the design scheme,the equipment to supply and product water for integrated surgi-cal instruments disinfection was confirmed by processing water with specification,high efficiency and low cost for nearly three years,which sig-nificantly improved the quality of disinfection supply processing of the surgical instrument. Conclusion Only Focus on supply water for sur-gical instruments disinfection in the tertiary hospital,and improve the quality of the equipment disinfection supplies, which could provide se-curity for clinical medical treatment of sterile equipment.

Protective Measures to Occupational Risk Factors of Working Staffs in Central Sterile Supply Department:A Discussion / 中华医院感染学杂志

OBJECTIVE To investigate the occupational risks factors and protective measures for the working staff in the central sterile supply department(CSSD).METHODS Looking back the latest 5 year study,the occupational risks factors were analyzed complehensively and safety measures were proposed.RESULTS Occupational risks factors to the staff in hospital CSSD included accidental injury,chemical disinfectant,ethylene oxide,electronic radiation,noise disturbance,flocci and dust,environment temperature and humidity,and lacking of safety knowledge and consciousness.CONCLUSIONS Strengthening occupational protective consciousness and skill education,standardizing operational process,perfecting preventive regulation,controlling the whole process,improving environment condition,stressing monitoring,and building protective barrier are important to protect working staff in CSSD and will be vital evidence for management.

RFID Information Management Technology Applying in CSSD / 中华医院感染学杂志

OBJECTIVE To build up an integrated,flexible,real-time backward management system for recycling medical appliance.METHODS The radiofrequency identification technique(RFID) information management technology was adopted.RESULTS Exertion of RFID information management technology in Central Sterile Supply Department(CSSD) not only promoted its work more effectively,correctly and feasibly,but also guaranteed the quality of recycling medical appliance.CONCLUSIONS The RFID information management technology applying in CSSD,could control the whole process of managing recycling medical appliance backward completely,and gain the legal witness and humanity management.

Installation, Construction Design and Infection Control of CSSD Equipment / 医疗卫生装备

Objective To study installation, construction design and infection control of CSSD (central sterile supply department)equipment. Methods The merits of advanced CSSD building layout was studied as reference. International advanced disinfection & sterilization equipment was used. The laminar flows of the air in sterile room were purified. All apparatus and articles were controlled by computers. The third zone was equipped with full-automatic cleaning disinfection & sterilization apparatus. Results The quality and index all meet the requirement in construction design and infection control. Conclusion The design meets modern disinfection standards and can control the infection effectively.

Potential Occupational Risk Factors onto CSSD Staff and Corresponding Protective Measures / 中华医院感染学杂志

OBJECTIVE To analyze occupational risk factors onto Central Sterile Supply Department(CSSD) staff caused by actual working conditions and provide correspondingly protective measures.METHODS Take actions,such as circulating the air inside working site,eliminating contamination which brought into by biological and chemical methods,and avoiding physical fatigue etc,which summarized by practical study and analysis on the(various) factors during daily work routine,e.g.physical factor,chemical factor,biological factor and psychological factor.RESULTS All methods mentioned in this article could improve self-protection awareness of CSSD staff and(enhance) the physical condition of staff as well as reduce pollution on environment.CONCLUSIONS For preventing the threats of occupational risk factors,it′s critical to reduce or eliminate the negative factors in CSSD.