CSSD Module 9: Inspection, Assembly, and Packaging (IAP)

Study Notes

Assembly area is a clean area in the CSSD where surgical instruments are inspected for intactness, cleanliness, and functionality.
The area must be designated and controlled to optimize the effect of the sterilization process and minimize the risk of contamination of the RMD sets.
Ventilation in the inspection, assembly, and packing room meets clean room standards according to ISO 14644-1: 1999 Class 8 or other internationally accepted equivalent standard.
The room must be maintained under positive pressure to ensure that the air flows outward instead of into the work area.
The room must be maintained at a comfortable working temperature of 20–23°C and a relative humidity within the range 30–60%.
All furniture in the area must be made of smooth non-porous, easy-to-clean materials.
Environmental cleaning must follow policies and procedures approved by the hospital's infection control committee.

Rigid containers are almost indestructible, providing sterility and customer reassurance if handled and maintained according to the manufacturer's instructions.
Containers must be:
- Easily disassembled for cleaning, drying, and storage
- Suitable for the method of sterilization being used
- Compatible with the cleaning method and cleaning agent being used
- Suitable for the storage configuration
- Lockable, tamperproof, and non-resealable
- Packed in a manner that allows for penetration of the sterilizing agent
Containers have filter and/or valve systems that are secure and must be in proper working order before sterilization.
Filter plates must be examined for integrity before and after the sterilization process.

Create ergonomics challenge to those who lift them due to heaviness
Require additional space to store them as they are larger than wrapped trays
Longer cycle time may be required to avoid issues associated with excessively wet packs
Entail extra effort since the containers must be cleaned between uses
Potential risk of filter dislodge leading to instruments contamination

Peel-apart pouches with a see-through front and paper backing are often used for single devices or small loads.
Pouches come in reels of various sizes where both ends need to be sealed or as single forms of various sizes for self-seal.
Peal pouches are used to pack small lightweight single instruments.

All surgical devices unloaded from the washer-disinfector must be inspected for cleanliness, stains, corrosion, cracks, breakage, and stiffness of movable parts before being placed in device sets.
Devices should be checked under magnification because small pieces of bioburden or debris can otherwise be difficult to see.
Each RMD from a set should be inspected separately.
Critically inspect all areas of the devices, including box joints, serrations, and crevices, for cleanliness.

Peal pouches are used to pack small lightweight single instruments.
Sealing peel-apart pouches is essential to ensure that the product remains sterile after autoclaving.
Self-sealing pouches have an adhesive manufactured into the open end of the bag or plain top and either a heat sealing machine or autoclave tape is then required to create a seal.
Recommended sealing temperatures and pressures, and other technical advice should be followed carefully.
Identification of packed devices is easy because of the transparent plastic film.