Central sterile services department

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The central sterile services department (CSSD), also known as the sterile processing department (SPD) or central supply, is a hospital area that cleans, disinfects, and sterilizes reusable medical equipment before it is used again in the operating room or other patient-care areas. Its job is to make sure instruments and supplies are safe and ready for aseptic procedures like surgery, catheterization, wound care, and dressings.

Reusable medical equipment (RME) includes items from stainless steel surgical tools to IV pumps and crash carts. RMEs are grouped by how clean they must be:
- Non-critical items (like IV poles) need intermediate to high-level disinfection.
- Critical items (instruments entering the bloodstream or sterile areas) require sterilization.

Sterilization is the main task of the CSSD. After decontamination, items are cleaned, inspected, and packaged for sterilization. Common methods are:
- Steam sterilization: the most affordable and widely used, using high-temperature steam.
- Ethylene oxide (ETO): used for heat-sensitive items but slower and more hazardous to workers.
- Hydrogen peroxide plasma: a low-temperature option with fast cycles and minimal worker risk.

Sterilization storage can follow either:
- Time-related policy: packages have an expiration date.
- Event-related policy: sterility remains until a seal is broken, package damaged, or conditions compromise it.

Decontamination starts at the point of use and follows the manufacturer’s instructions. Proper cleaning, including adequate detergent dilution and cleaning of lumens with appropriate brushes, is essential; if cleaning is poor, sterilization won’t work. SPD staff must be competent with processing equipment, receive ongoing training, and ensure equipment is tested and working correctly.

In many facilities, the CSSD is divided into four areas: decontamination, assembly/sterile processing, sterile storage, and distribution. A sterile processing technician cleans and sterilizes used instruments so they can be safely reused.