The work that is done in the Central Sterile department (CSD) is critical to help prevent surgical site infections (SSIs), along with other factors like compliance with a robust infection prevention program. The physical environment in CSD arguably contains some of the most contaminated (Decontamination) and the most hygienically clean (Prep and Pack) areas of the hospital. Environmental hygiene in this department is critical to ensure that reprocessed surgical instruments are free from contamination that could impact patient outcomes.
As such, daily terminal cleaning and disinfection of all horizontal surfaces and floors in CSD is recommended by the Association for the Advancement of Medical Instrumentation (AAMI), the Association for PeriOperative Registered Nurses (AORN) and the Association for the Healthcare Environment (AHE).
When to Clean
Terminal cleaning should occur when personnel are not actively decontaminating instruments. Cleaning should proceed from cleanest areas to dirtiest areas to prevent cross contamination. Prep and pack and sterile storage should be cleaned before the decontamination work areas. A multidisciplinary team (e.g. CS, EVS, IP) should determine how often and the extent of cleaning needed when the department is not occupied (e.g. weekends) or rooms are unused. For instance, the team may decide that terminal cleaning is not required if personnel have not been in closed areas. Similarly, a multidisciplinary team should determine the frequency of cleaning of areas such as dumb waiters, ventilation ducts, sterilizers, walls and ceilings if they are not included in terminal cleaning.
What to Clean
Horizontal surfaces on this high-touch object wall card should be terminally cleaned daily when the area is in use. This card is part of the Ecolab Central Sterile Program and has been awarded the AORN Seal of Recognition.*
How to Clean
Here are some tips working with chemicals and best cleaning practices to ensure optimal cleaning and disinfection.
Working with Chemicals
Cleaning Best Practices
How to Monitor and Document Cleaning Effectiveness
Both AORN and AHE recommend a comprehensive assessment of the cleaning practices in the Central Sterile Department. This includes monitoring and providing feedback on the thoroughness of cleaning. In addition to visual inspection, an objective measure of cleaning thoroughness should be performed, and the results provided to the Environmental Services and Central Sterile Department staff. Programs that incorporate monitoring such as DAZO® Fluorescent Marking Gel are clinically proven to improve thoroughness of cleaning in hospitals.