Study of Quality Control in Central Sterile Supply Department of a Tertiary Care Teaching Hospital

The Swab Samples for culture of sterilized sets/materials processed in Autoclave and Plasma sterilizer were taken on weekly basis for a period of Three months w.e.f 1st January 2019 to 31st March 2019 and sent to microbiology department for investigation. The data regarding the sample and results were entered on predesigned Proforma.

Ethical approval: The study was approved by Institutional Ethical Committee (IEC) SKIMS.

The data was received from the answered questionnaires and was plotted on excel 2013. The data was analyzed statistically with the help of statistical software SPSS v19. All the continuous variables of the study were represented by the descriptive statistics and all the categorical variables in the term of frequency and percentage.

The Central Sterile Supply Department is the service responsible for receiving, storing, processing, distributing and controlling the professional supplies and equipment’s (both sterile and non-sterile) for all user unit of hospital for the care and safety of patient under strict quality control. Hospital acquired infection or “nosocomial infection” adversely affects both patients and hospitals. Impact of nosocomial infections ranges from increased length of hospital stay, emotional stress, disability, death of the patients as well as increased hospital cost for the patients and providers. Studies in India have reported nosocomial infection rates from 8% to 58%. To combat these infections, hospital needs effective methods of disinfection and sterilization which has nowadays been centralized into a single department called Central Sterile Supply Department.
In 1928, the American college of surgeons-initiated centralization of all surgical supplies and dressings in one unit for supply to all departments of the hospital. Thus, the concept of Central sterile supplies department began in the hospitals. During the Second World War, the British Army established a Central sterile supplies department in Cairo for supply of sterile items to mobile units. In India, one of the earliest Central sterile supplies departments was established by Safdarjung hospital, Delhi and Christian medical college, Vellore during 1957-1960. Central sterile supplies department in SKIMS is centralized service and was commissioned along with the 1st phase of the hospital in December 1982. Central sterile supplies department is located on the ground floor (in services core area of the hospital).

The ultimate end result of any service is to deliver the desired process in the shape of finished product or service. In order to study the quality service provided by Central sterile supply department of the following quality dimensions were studied.

User end satisfaction

The ultimate outcome of the services rendered in a hospital is judged by the level to which it satisfies its user. In our study 100 personnel working in various department of the hospital directly linked with the patient care were randomly selected and studied. The category of staff studied included doctors, nurses and other staff. In the study It was found that on an average 70% staff was satisfied with the services provided by Central Sterile Supplies Department of SKIMS. This is in accordance with the study conducted by Amel et al. [4].

Microbial count

In our study it was found that 89% of items are sterile whereas 11% samples shows growth of three different organisms. Study shows that out of unsterile items Dressing set 33% of sample were cultures positive for Acinetobacter Baumannii, 33% suture sets were positive for Coagulase negative Staphylococci., 33% of Y-connector were positive for Klebsilla Pneumonia., 33% of O2 mask were positive for Coagulase negative Staphylococci. A study carried out by Dara Singh et al. [5] on Utilization & quality control in linen and laundry services at a tertiary care hospital, SKIMS, Srinagar showed that frequency distribution of 87% culture reports of various samples from linen and laundry of tertiary care hospital were sterile. In another study done by Mufarrih et al. [6] in 2019 shows that all 14 preoperative samples did not culture any microorganisms. Out of the 12 postoperative samples, four (33.3%) were contaminated. Those that were contaminated had a colony count between one and two colony-forming units. Coagulasenegative Staphylococcus was the only organism isolated.

In our study Outcome was measures by two parameters:
1. User Satisfaction
2. Microbial count It was found that in user satisfaction 70% of user end staff are satisfied with the services provided to them.
In microbial count of different items sterilized showed that 89 % samples are sterile whereas 11% samples show growth of three different organisms e.g., Coagulase-negative staphylococci, Klebsilla and Act. Baumannii.

1. Banu A, Subhas GT (2013) Central sterile supply department-need of the hour. J Pub Health Med Res 1(2): 58-62.
2. Collee JG, Fraser AG, Marmion BP, Simmons A (2006) Mackie & Mccartney practical medical microbiology. (14^th edn), Sterilization. pp. 111-134.
3. http://www.urmc.rochester.edu/sterile/basics.html
4. Ahmad A, Senousy TE, Gomaa N, Rahman AA (2017) Quality improvement in central sterile supply department: Educational interventions. JOSR-JNHS 6(2): 6-16.
5. Singh D, Qadri GJ, Kotwal M, Syed A, Jan F (2009) Quality control in linen and laundry service at a tertiary care teaching hospital in India. Int J Health Sci (Qassim) 3(1): 33-44.
6. Mufarrih SH, Qureshi NQ, Rashid RH, Ahmed B, Irfan S (2019) Microbial colonization of pneumatic tourniquets in the orthopedic operating room. Cureus 11(8): e5308.