STERILE SERVICES DEPARTMENT The hospital sterile services department(SSD) is operated by a specialised group of staff who provide an essential service by supplying the operation theatres with sterile instruments and departments with specific items required for patient care.(Department of health, National Health Services, 2009). After each use, the medical devices undergo various decontamination processes to render them safe and for reuse on patients and for staff handling. Prior to beginning the decontamination, the used medical device is first received by the sterile services department in a collection container specifically meant for this purpose and is subjected to reprocessing. At this juncture, it is essential that the SSD staff need to check the device and to notify the user if any part of the equipment is damaged or missing on receipt. This is followed by a series of interdependent decontamination procedures like cleaning, disinfection and sterilisation to ensure complete elimination of microbes and other contaminants from the reusable medical device. Cleaning is the first step in decontamination and is an essential prerequisite for the next stage namely disinfection. Cleaning is done either by mechanical means using an automated washer disinfector or an ultrasonic bath comprising warm water rinse, power wash, disinfection using a detergent and a drying phase. The choice of detergent depends on the nature of the equipment and the user follows the instructions of the manufacturer . However, for delicate or complex medical devices, manual cleaning is normally preferred. In this case a clean sink is filled with warm water and a detergent. The used medical device is dismantled and fully submerged in the detergent solution where brushing, wiping, agitation and jet-washing are carried out. On completion of the cycle, the device is reassembled and subjected to disinfection. Reusable medical devices are disinfected by using either a washer-disinfector at low temperature steam or by employing liquid disinfectant immersion . Here again the choice of the liquid depends on the type and nature of the equipment. The main purpose of disinfection is to decontaminate medical devices that are in contact with mucous membrane, blood and body fluids. However, all reusable medical devices that penetrate the skin are subjected to sterilisation using steam in which case the cleaned medical device is brought in to direct contact with pure dry saturated steam at the desired temperature and time. The medical device is completely devoid of viable pathogens as a result of sterilisation. This is followed by inspection to ensure that the device is fully functional. After thorough inspection, the device is wrapped in a suitably sized medical grade packaging material and sterilised in an autoclave. On successful sterilisation the device is cooled naturally prior to storage. Such processed equipments are stored in a clean, well ventilated and secure room. Usually the SSD maintains a record of such stored devices within the storage administrative area and any item despatched is noted down immediately. The processed device is then transported to the clinical unit in a clean, secure container to avoid any damage along with the user instruction manual and the user retains a receipt of the device. Such a reusable medical device can be tracked at any stage throughout the decontamination process by affixing a label that contains history of the device and such label has to be removed from the device and placed in the medical records of the patient owing to its use.
Web page Decontamination [Internet]. Available from http://healthcarea2z.org/stdPage.aspx/home/Decontamination/DecontaminationBackground/Safesystemsofwork/SterileServicesDepartment#sec_464 [Accessed 15 February 2009]
Web page Decontamination [Internet]. Available from http://healthcarea2z.org/stdPage.aspx/home/Decontamination/DecontaminationBackground/Decontaminationprocesses/Sterilisation#sec_441. [Accessed 15 February 2009]
Wep page Sterile Services Department Information [Internet]. Available from http://www.yeovilhospital.nhs.uk/MktMenu/Clean/SterileServicesDepartment/tabid/336/Default.aspx [Accessed 15 February 2009]