Purchasing
Content
• Advantages, sources, procedures and methods involved in purchasing
• Importance of central sterile supply department
Objective
After completion of this lecture, student will be able to:
• Explain purchasing of drugs
• Describe Central Sterile supply Department
Purchasing
Definition
“The service, with in the hospital, catering for the sterile supplies to all departments, both to specialized units as well as general wards and OPDs”
Aim
• Centralizing the activities of receipt, cleaning, assembly, sterilization, storage and distribution of sterilized materials from a central department
• Safe sterilization is done under controlled conditions with adequate managerial and technical supervision at an optimum cost
• To provide an efficient, economic, continuous and quality supply of sterilized material to various areas of the hospital to deliver quality and infection free patient care
• Contributes to reduction in hospital infection rate
Functions & Activities
Advantages
Planning of CSSD
The CSSD can broadly be classified into two parts
Central unit - Responsible for receiving dirty Utilities cleaning, processing, Sterilization, storage and supply
Peripheral unit - Mainly responsible for distribution to various areas of hospital.
- TSSU (Theater Sterile Supply Unit)
Planning a Department
Lay Out Designing Principle
• There is no back tracking of sterile goods
• One way movement from receiving counter to issue counter
• Sterile area should be prior to sterile storage and issue
• The receiving counter must be away from the issue counter
• Separate receiving and issuing counter
There should minimum six basic division in CSSD
Structural Designing
• The Central Unit comprises of three zones, separated by two distinct barriers
• One collection window
• one supply window on the other end
Equipment
Cleaning area:
• High capacity pass through washer disinfector at 800C to 900 C having various shapes and sizes
• Cold and hot water streams
• Detergent Solution
• Steam when available
• Hot air ovens for drying instruments
• Wall fixtures for drying
Sterilization area
• Autoclaves using dry heat, moist heat
• Ethylene oxide sterilizers
• Testing material to check effectiveness of sterilization
Storage and Distribution
• Cup boards, selves, tables, chairs, racks
• Trolleys, instrument trays, wire baskets and containers
Other Equipment
• Cleaning and decontamination devices
• Hot air Oven for drying & heat sterilization
• Glove processing unit for surgical gloves
• Instrument sharper e.g.. Needle sharper
• Testing apparatus for emergency sterilization
• Others :- trolleys, work surface, telephones
• Maintenance and repair of equipment's
• Material : chemicals for washing and cleaning
• Steam Boiler
Articles to be sterilized
Staffing
Staffing should be planned based on following factors:-
1. Three shift working
2. Messenger service
3. Maintenance service
4. Staff for 6 areas
Leave and off duty
• Average 02 technicians for 100 beds and one technical supervisors
• One clerk for keeping records, accounting and supply/ shift
• Average 04 attendants per 100 beds in all shifts
• Adequate number of cleaning attendants and transporters
• One technician and two attendants should be stationed at each zone
Organogram
CSSD
Sterilization
• It is a process of freeing an article from all living organisms including bacteria ,fungal spores and viruses
• A material is pronounced sterile if it achieves 99.99% kill of bacterial spores
METHODS OF STERILIZATION
Types of Autoclaving Machines
• Downward Displacement
• Vacuum Assisted.
• Pulsed Steam Dilution
Storage
• After sterilization the sterilized items are kept in different racks as per labeling
• Supplied as per the demand of different area
• To ensure continuous availability of sterile supply five times of daily requirement should be available in storage
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