Is Your CSSD Terminally Clean?
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Environmental terminal cleaning in Central Sterile Supply Department (CSSD) areas is critical for reducing the risk of disease transmission from reservoirs of blood borne pathogens and microorganisms in the decontamination environment.
Terminal Cleaning
Terminal cleaning and disinfection of areas within the CSSD should be performed daily if the area has been used, but should not be done during the cleaning or sterilizing of any instruments. Furthermore, to reduce the possibility of contaminating clean areas, the cleaning workflow should start in sterile storage, then move to prep and pack, and end with decontamination.
To reduce cross contamination, it is also recommended to always work through the clean areas first, leaving the dirtiest areas for last to prevent spreading contaminants. Additionally, you should work from top to bottom to avoid the risk of debris, dust, and contaminants falling onto clean areas from above. You can even use a clockwise or counter clockwise method to prevent accidently missing any areas. Keep in mind that your clockwise or counterclockwise method should never replace your clean to dirty or top to bottom pattern but merely work in conjunction with them, if possible.
Terminal Cleaning Supplies
Equipment and supplies needed to clean the CSSD include:
- Detergents and disinfectants
- Low-linting clothes
- Mop
- Single-use disposable wipes
When choosing your cleaning supplies, remember that it is considered best practice to utilize separate cleaning supplies whenever possible to avoid transferring contaminates from dirty to clean areas.
Terminal Cleaning Tasks
Terminal cleaning includes the following tasks, which can be shared cleaning responsibilities between the CSSD and Environmental Services:
- Counter tops
- Furniture
- Shelving
- Sinks and wash basins, including eye wash stations
- Computer Accessories (touch screen monitors, keyboards, mouse)
- Light switches
- Telephones and mobile communication devices
- Trash and linen receptacles
- Empty trash when full or, at minimum, once daily
- Cleaning floors
- Utilize a wet vacuum or single-use mop
- When cleaning floors, make sure to progress from the cleanest to the dirtiest areas of the floor
Scheduled Cleaning
Scheduled cleaning is a cleaning schedule that defines areas and equipment that should be cleaned on a regular basis (weekly, monthly) or according to the manufacturers’ instructions. Consider the following equipment when planning your scheduled cleaning:
- Sterilizers and sterilizer loading carts
- Air intake and ventilation ducts
- Lighting fixtures
- Stained ceiling tiles
- Walls and Storage shelves
- Sterilizer service access rooms
Regulatory Compliance
When it comes to cleaning and staying on a schedule, try to utilize checklists to prevent human error or missed cleaning of items. Keeping up with environmental terminal cleaning is important not just for the safety of your patients but also for your facility to stay in good standing with the regulatory agencies like The Joint Commission. Tweet this.
The Joint Commission will focus on:
- Daily cleaning versus deep cleaning
- Behind closed doors and under racks
- Hidden corners and high level flat spaces
- Behind and around automatic cleaning equipment
- Sterilizer service access room, including to tops of the sterilizers
If you don’t already have a system or process in place to stay on top of environmental terminal cleaning in your CSSD, consider adopting a system today. Put checkpoints in place so that you know whether or not the steps are being followed correctly. At the end of the day, it is the CSSD’s responsibility to stay clean in order to process and sterilize assets correctly and guarantee patient safety.

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