Supply Department Research Articles

Fractional exhaled nitric oxide and respiratory symptoms in central sterile supply department workers exposed to different ventilation systems

ABSTRACT Objective: To verify the association between different types of ambient ventilation in Central Sterile Supply Department (CSSD), fractional exhaled nitric oxide (FeNO) values, and respiratory symptoms of workers . Methods: CSSD workers from five hospitals were evaluated in three different ventilation systems: negative air pressure, air conditioning, and natural ventilation. The prevalence of respiratory symptoms was evaluated by The European Community Respiratory Health Survey. The respiratory inflammatory response was evaluated utilizing FeNO level measurements. Results: There was a general prevalence of respiratory symptoms in 5% of the workers investigated; there was no association between respiratory symptoms and ventilation systems (p = 0.170). Of the total workers investigated, 22% had FeNO levels ≥ 25 parts per billion (ppb), considered above the normal range, and there was a statistically significant difference between ventilation systems (p = 0.009) favoring natural ventilation. Conclusion: Exposure to the natural ventilation system reduced the chance of developing FeNO levels ≥ 25 by 94.3%.

Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders in Central Sterile Supply Technicians, Nakhon Si Thammarat Province, Thailand

Objective: The study aimed to examine the prevalence of work-related musculoskeletal disorders among central sterile supply technicians (CSSTs) in Nakhon Si Thammarat Province, Thailand, and investigate the risk factors associated with these disorders.Material and Methods: A cross-sectional study was conducted among CSSTs regarding work-related musculoskeletal disorders (WMSDs). Technicians were asked about the presence and severity of disorders throughout the whole body during the sterilization procedure. The survey was distributed to the CSSTs at the central sterilization supply departments (CSSDs) of 32 hospitals in Nakhon Si Thammarat province, Thailand.Results: The prevalence rate of WMSDs in various bodily regions was assessed among technicians at the time of questioning (88.3%), after one week (65.4%), and after one year (59.2%). Various body parts were reported to have developed Musculoskeletal problems, with the lower back being the most frequently reported (88.8%), followed by the upper back (84.9%), and the ankles/feet (38.5%). These MSDs were influenced by age over 30 years (odds ratio [OR] 3.32, 95% confidence interval [CI] 1.59-6.93), work schedule (OR 2.58, 95% CI 1.02-4.96) and the handling of heavy-load equipment (OR 2.56, 95% CI 1.47-10.37) or carts, which significantly increased the risk of developing such illnesses.Conclusion: Many CSSTs from the CSSDs reported WMSDs in various locations on their bodies. Lower back pain was the most common complaint.

MARKETING PERFORMANCE INCREASING WHILE INVOLVING APPLICANTS TO ADMISSION TO THE UNIVERSITY

The professional orientation of applicants is an integral part of the marketing strategy of the universities and the state as a whole to train high-quality specialists for the national economy. The schools and colleges graduates are potential university bachelor's degree applicants. The article presents the experience of involving graduates of schools and colleges for admission to the bachelor's degree at the power supply department of the Igor Sikorsky Kyiv Polytechnic Institute, specialty 141 "Electrical power engineering, electrical engineering and electromechanics" branch of knowledge 14 "Electrical engineering". References 3.

Creating a repository of archival of documents on the sanitary and epidemiological situation in Kaluga region contaminated with radionuclides as a result of the Chernobyl accident (1987-1994)

The study is relevant due to the need to preserve unique experience of the emergency response to the Chernobyl accident and ensure radiation safety of the population living in radioactively contaminated areas. The study of the impact of consequences of the Chernobyl accident on the health of people living in the areas of radioactive contamination aims to assess the effectiveness of measures to protect the inhabitants of the areas contaminated with radionuclides. The study uses archival information on the elimination of the consequences of the Chernobyl accident which is available on electronic resources. The study aims to create an electronic archive of documents on the sanitary and epidemiological condition in Kaluga region radioactively contaminated as a result of the Chernobyl accident. Information collected from scientific publications is presented. The documents on medical consequences of the Chernobyl accident for the population of Kaluga region derived from the State Archive of Kaluga region are studied. Results. The study analyzed documents from the State Archive of Kaluga region (GAKO): R-2275 “Federal State healthcare institution “Center for hygiene and epidemiology of Kaluga region”; R-3237 “Department of health and drug supply of Kaluga region”. A repository of archival documents containing information on the sanitary and epidemiological situation in the territories of the Kaluga region radioactively contaminated as a result of the Chernobyl accident (for the period of 1987-1994) has been created. Conclusion. Relying on the documents from the R-2275 and R-3237 funds, a repository containing data on the medical consequences for the population of Kaluga region living in radioactively contaminated areas was created (1987-1994). The repository contains the following information: laboratory data from food laboratory studies (including data on the maximum levels of cesium-137 contamination in food); information on the medical examination of the child population and women; data on specialized medical and dosimetric examinations of children and adolescents of the districts of Kaluga region most affected by the Chernobyl accident. The collected information may be used in the analysis of the key trends in the natural movement of the population and the dynamics of morbidity in the districts of Kaluga region most affected by the Chernobyl accident, in order to identify possible changes associated with radioactive contamination of the territories.

Analysis of Infection Prevention Control Management of Central Sterile Supply Department (CSSD) Staff

Background: The Central Sterilization Supply Department’s (CSSD) main function is to clean, disinfect and provide sterile items for subsequent use by healthcare professionals in various hospital departments, including the ambulance. Materials and Methods: A survey of infection prevention control (IPC) knowledge, practice, and infrastructure adherence was conducted in a selected government super-speciality hospital's central sterilisation supply department (CSSD). The data were analysed, and a report with recommendations was presented to the institution's head. Results: The overall response showed good knowledge and practices with hospital environmental adherence to infection prevention control protocol with few infrastructure modifications facilitating the unidirectional flow pattern. Conclusion: This study was able to bring insights into the staff knowledge and practice towards IPC adherence

Psychological Effects of Noise Exposure on Personnel in Central Sterile Supply Department in China.

This study aimed to investigate whether noise exposure in hospital sterile supply centers exacerbated the psychological burden on staff, potentially mediated by concerns about physiological health. Between July 5 and August 4, 2023, 308 staffs from central sterile supply departments in 30hospitals in Hainan were chosen by convenient sampling method. They completed self-administered questionnaires to assess noise exposure status and used the Self-Reporting Inventory-90 to quantify the psychological state of staff across three dimensions: somatization, anxiety, and sleep and diet. Binary logistic regression analysis was used to assess the influencing factors of their psychological symptoms, while a mediation model was used to analyze the pathway of noise affecting psychology. (1) Predominantly, respondents reported air gun sounds (76.3%) and pressure steam sterilizer noises (78.2%) within central sterile supply departments to be the most troublesome. (2) Approximately 25.33% of participants expressed that their sleep was significantly impacted by noise, while 32.14% expressed concerns about the potential serious effects on their health. (3) Logistic regression analysis revealed that age (OR,1.06, 95% CI, [1.01, 1.11]), educational background (OR, 0.65, 95% CI, [0.49, 0.85]), perceived noise exposure (OR,1.57, 95% CI, [1.04, 2.48]), health concerns (OR, 1.91, 95% CI, [1.06, 3.52]), and hearing loss (OR, 1.46,95% CI [1.02, 2.10]) emerged as significant influencing factors of psychological symptoms. (4) Mediation effect model analysis demonstrated that health concerns (mediation effect value=0.11, 95% CI [0.08, 0.16], Effect ratio=53.83%) mediated the impact of noise affecting psychological state. Noise exposure represents a concealed risk factor for service quality within hospital central sterile supply departments, with health concerns serving as a mediating factor in the relationship between noise exposure and psychological well-being.

Improvement and exploration of a water conservation system in the Central Sterile Supply Department

Improvement and exploration of a water conservation system in the Central Sterile Supply Department

A novel hybrid fuzzy analytical hierarchy process–game theory model for prioritizing factors affecting the deterioration of water pipelines

Water pipes face significant aging and degradation problems due to several pipe-related, soil-related, operational, and environmental factors. Hence, the paramount objective of this research paper is to prioritize the criticality of the factors affecting the deterioration of water pipes in Hong Kong. The framework of the developed model is envisioned based on two main modules, namely weight computation and weight aggregation. The first module incorporates identifying and categorizing water deterioration factors. Then, the relative importance priorities of water deterioration factors are scrutinized using seven weight computation methods. These methods encompass analytical hierarchy process (AHP), Monte Carlo AHP, fuzzy AHP, magnitude-based fuzzy AHP, total difference-based fuzzy AHP, spherical fuzzy AHP and Pythagorean fuzzy AHP. In this regard, fuzzy-based and Monte Carlo-based methods are leveraged to circumvent the critical shortcomings of classical AHP. The performances of weight computation methods are analyzed using statistical evaluation indicators of satisfactory index (SAT) and distance between weights (WD). The second module is a hybrid meta-heuristic-based game theory model designated for compiling the importance weights of deterioration factors obtained from the first module. In this context, a set of widely acclaimed meta-heuristics are exploited and examined for optimizing the significance of deterioration factors. Analytical results exemplified that soil-related factors implicate the deterioration process more than pipe-related, operational-related, and environmental-related factors. It was also inferred that water pressure (6.64%) is the most significant factor influencing water pipe deterioration followed by internal corrosion and protection method (6.11%), and then soil corrosivity (6.05%). On the other hand, length (1.93%), rain deficit (1.97%), and street block length (2.33%) constitute the least influencers on water pipe deterioration. Results also demonstrated that spherical FAHP outperformed other variants of AHP accomplishing SAT and WD of 0.065 and 0.057, respectively. Comparative analysis revealed that particle swarm optimization-based game theory is a better mechanism than the remainder of meta-heuristic-based game theory models in obtaining a more accurate compromised-based weighting vector to the experts’ judgments. It is envisaged that this research can assist the water supplies department in identifying, assessing, and prioritizing the impairment causes of water pipelines in Hong Kong. It can also aid in establishing more accurate deterioration models and more cost-effective maintenance intervention programs.

A two-stage hybrid flow-shop formulation for sterilization processes in hospitals

Sterile processing is a critical secondary process and a major cost factor in the processing, acquisition, and storage of costly medical devices. This article aims to improve the performance of sterile processing by developing, implementing, and evaluating a dispatching rule-based algorithm to reduce the time medical devices spend in the central sterile supply department using a two-stage hybrid flow-shop formulation. The algorithm combines dispatching rules with stage decomposition and compatibility conditions. A genetic algorithm is designed to benchmark the performance in addition to an analytic bound. Real-world data from a large German hospital were used to test the effectiveness of the heuristics. The case study demonstrated the practical implications of the approach, leading to a reduction in the time medical devices spend in the system and improved utilization of washer-disinfector machines and sterilizers. It also highlighted the importance of aligning machine capacity with demand and the potential trade-offs associated with batch processing decisions. Our approach can contribute to substantial operational cost savings and efficiency gains, offering significant benefits to decision makers at both the operational and tactical levels.

Evaluating Boil Water Advisory Policies and Practices: Health Outcomes in Hong Kong

Boiling water (BW) is a common global practice, especially in Asia, for ensuring safe drinking water, though it does not remove chemical contaminants. The World Health Organisation recommends BW as an emergency measure against microbial contamination. In Hong Kong, the Water Supplies Department ensures water quality through strict regulations and extensive monitoring. Comparisons with Norway and Canada reveal effective practices such as water safety planning and risk-based advisories. Norway mandates water safety planning and uses messaging notifications for water advisories, ensuring high compliance, while Canada issues site-specific BW advisories based on risk assessments. Hong Kong faces unique challenges, such as a warm climate and complex building infrastructure, which impact water quality. Many buildings lack proper maintenance, leading to potential health risks and necessitating regular maintenance. Health management, public health education and expert guidance are essential for promoting efficient practices and ensuring safe drinking water.

THE RELEVANCE OF NURSE TRAINING FOR PERFORMANCE IN THE CENTRAL SUPPLY AND STERILIZATION DEPARTMENT: A narrative review

The present study aimed to highlight the importance of nurse training to ensure the good performance of the team in the Central Supply and Sterilization Department (CSSD). A narrative theoretical review was conducted, with searches in the BVS (Virtual Health Library) and Scielo (Scientific Electronic Library Online) databases. In addition to articles published in the last ten years, current documents and publications from national health organizations that guide the procedures for sterilizing medical-hospital materials were also considered. The flow of health product processing was described; subsequently, the responsibilities and expected skills of the nurse in the department were specified; finally, important aspects of the professional nurse's training for the role in the CSSD were discussed. The consulted works confirmed the relevance of training and continuous education for nurses as a means of ensuring the effectiveness of health product processing and, consequently, patient safety.

Establishing Nursing-Sensitive Quality Indicators for the Central Sterile Supply Department: A Modified Delphi Study.

Previous studies have shown that improving quality management in the central sterile supply department (CSSD) is an effective measure to control and decrease hospital-acquired infections. This study aimed to establish nursing-sensitive quality indicators for CSSD nursing in China. We drafted nursing-sensitive quality indicators on the basis of the Structure-Process-Outcome model, and then conducted 2 rounds of consultation with experts using a modified Delphi method to determine the indicators and scientific methods of measurement. We identified five CSSD nursing-sensitive quality indicators. Recovery rates of the 2 rounds of valid questionnaires were 100%. Expert authority coefficients were 0.810 and 0.902, respectively. Kendall's coefficients of concordance were 0.168 and 0.210, respectively ( P < .05). Evidence-based nursing-sensitive quality indicators for the CSSD were established.

Optimising Surgical Instrument Trays for Sustainability and Patient Safety by Combining Actual Instrument Usage and Expert Recommendations

Annually, over 300 million surgeries occur globally, requiring numerous surgical instruments. However, many instruments on the tray are returned to the central sterile supply department (CSSD) unused, creating an unsustainable pattern of unnecessary consumption. To address this, we developed a method for optimising surgical instrument trays (SITs) that is straightforward to implement in other hospitals. This optimisation aims to enhance patient safety and sustainability and to improve working conditions and reduce costs. We identified actual instrument usage (IU) in the operating room (OR) and obtained expert recommendations (ERs). Data from both methods were combined in a computer model (CM) to adjust the SITs. The performance of the adjusted SITs was assessed over a year. IU of three different SITs was collected during 16 procedures (mean = 28.4%, SD = 6.4%). Combining IU and ERs resulted in a 36.7% reduction in instruments and a 31.3% weight reduction. These measures contribute to reducing the carbon footprint and enhancing sustainability. During the evaluation of the new SIT contents (n = 7 procedures), mean IU increased from 28.4% (SD = 6.4%) to 46.5% (SD = 11.0%), with no missing instruments during surgery. A one-year follow-up showed no need for further alterations. Combining both methods yields better results than using them individually, efficiently reducing unnecessary items in SITs without compromising patient safety.

Characterization of leakage signatures in buried water pipes by ground penetrating radar(GPR) and instantaneous frequency analysis

The aging and complexity of underground water pipes pose significant challenges to modern society, necessitating long-term monitoring and maintenance to prevent the socioeconomic costs. So, effective nondestructive and geophysical methods are needed to localize the possible leakage areas before any rational opening up is conducted. In this study, we propose a workflow to generate instantaneous frequency slices (IFS) from raw ground penetrating radar (GPR) data. Characterizing the horizontal and vertical patterns of water leakage using IFS revealed two key mechanisms—reflections due to the dry and wet interface and absorption due to water distributed in soil—that significantly influence instantaneous frequency. A well-designed real site (Q-Leak), in collaboration with the Water Supplies Department (WSD) of the government, was conducted to replicate typical leakage scenarios, validating the effectiveness of our IFS-based approach. The results of proposed method demonstrate that IFS is a reliable approach for characterizing leakages in buried water pipes, effectively addressing several challenges associated with amplitude slice analysis. Our proposed methodology enriches the toolkit available for large-scale, future-oriented water leakage detection.

PREEMPTIVE AND NON-PREEMPTIVE GOAL PROGRAMMING APPROACH TO INVENTORY OPTIMIZATION OF THE CENTRAL STERILE SUPPLY DEPARTMENT, UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

This research applied a multi-criteria optimization technique to analyse the inventory system of a Central Sterile Supply Department (CSSD) through preemptive and non-preemptive goal programming. Data on six raw materials and four finished products were collected, in addition to their costs, demand rates, shelf lives, and available capital. The developed objective function of the non-preemptive model combined four goals: inventory cost optimization (highest priority), inventory turnover, service level, and delivery lead time. The implemented model guaranteed zero stock-outs, reduced wait times between productions, timely product sales, and the elimination of unnecessary overall costs.

Emergency preparedness in the central sterile supply department: a multicenter cross-sectional survey

ObjectiveTo investigate the current situation of emergency preparation and emergency drill in the CSSD, and analyze its influence on the nurses’ emergency attitude and ability.MethodsThis study employed a multicenter stratified sampling method, conducted from January to June 2023 using the online survey, participants completed the general data, emergency preparedness and drill questionnaire, public health emergency response questionnaire and emergency capacity scale. An independent samples t test or Kruskal-Wallis test was used to analyse differences in nurses’ emergency capacity and attitudes.ResultsThe data from 15 provinces 55 hospitals in China. Overall, 77.58% of participants’ institutions set up emergency management teams, 85.45% have an emergency plan and revise it regularly. 92.12% store emergency supplies. All survey staff participated in the emergency drill, which predominantly consisted of individual drills (51.52%), with 90.30% being real combat drills, 49.09% of participants engaging in drills every quarter, and 91.52% of the drill’s participants exceeding 50%. The respondents’ emergency attitude score was (29.346 ± 6.029), their emergency ability score was (63.594 ± 10.413), and those with rescue experience showed a more positive attitude (Z = -2.316, P = 0.021). Different titles, education levels, rescue experience and the frequency of emergency drill affected the emergency rescue ability of the respondents (P < 0.05).ConclusionsMost medical institutions establish emergency management systems and plans, yet the content lacks geographical specificity.The duration and participation of emergency drills are high, but the effectiveness of the drills needs to be further improved, and the response capacity and attitudes of CSSD nurses are low. It is recommended that agencies develop comprehensive and targeted contingency plans to strengthen the inspection and evaluation of team strength, equipment and safeguards against the contingency plans, so as to ensure that the measures mandated by the contingency plans can be implemented promptly after the emergency response is initiated.

Status of Professional Identity, Self-Directed Learning Competence, and Self-Efficacy Among Central Sterile Supply Department Nurses.

BACKGROUND Previous studies on professional identity, self-directed learning competence, and self-efficacy among central sterile supply department (CSSD) nurses are rare. We investigated the status of these 3 characteristics among CSSD nurses and offered suggestions, to provide a reference for CSSD talent development. MATERIAL AND METHODS CSSD nurses working in 45 hospitals in southwest China were invited to participate in a questionnaire survey in August 2021. The survey comprised a general information questionnaire, a self-directed learning competence rating scale, a professional identity scale, and a general self-efficacy scale. RESULTS The CSSD nurses' scores for professional identity, self-directed learning competence, and self-efficacy were 109.92±17.161, 125.77±21.316, and 26.92±6.633, respectively. For professional identity, statistically significant differences were identified (P≤0.05) for 3 factors: monthly income, reason for studying nursing, and reason for working in the CSSD. For self-directed learning competence, statistically significant differences (P≤0.05) were identified for 5 factors: age, hospital grade, type of employee, monthly income, and reason for working in the CSSD. For self-efficacy, statistically significant differences were identified (P≤0.05) for 3 factors: age, reason for studying nursing and working in the CSSD, and whether the CSSD nurses wished their children to become nurses. CONCLUSIONS The professional identity, self-directed learning competence, and self-efficacy of the CSSD nurses in this study were at the medium level. More attention should be paid to career planning of young nurses and improvement of their professional identity and self-directed learning competence.

Steam quality monitoring as a strategy to reduce wet packs and sterilization failure

Hospital articles processed by steam are widely used in the Central Sterile Supply Department (CSSD), responsible for due sterilization. Steam sterilization is discussed worldwide, aiming to protect patients. If steam is outside the specified requirements, the sterilization process may fail, resulting in the wet packs at the end of the sterilization cycle. The present study evaluated the steam quality at Santa Catarina Hospital (São Paulo, SP, Brazil) from 2016 to 2022. Saturated steam containing noncondensable gases, excess condensate, or even superheat was characterized using the methodology indicated in the European Standard EN 285:2015. From 2016 to 2020, qualification tests showed that the saturated steam quality does not achieve standardlimit parameters. Infrastructural maintenance actions were taken to adjust the saturated steam quality. In 2021, the steam quality followed technical standards, and its adequacy was confirmed in 2022. The points developed by the hospital's maintenance department, the adoption of appropriate devices for this purpose, and the correct preventive maintenance in the autoclaves, together with the correct qualification of the equipment and proof of the steam quality, contributed to improve the safety of the hospital sterilization process and reduce the incidence of wet packages.

Модернизация резервуарного парка региональной дирекции материально-технического снабжения железнодорожного транспорта

Objective: current system of organizing material and technical supply (MTS) in the Russian Railways Holding evaluation, determining the place and role of the regional supply department (RSD) in it, and identifying the most significant aspects of its activities. Methods: methods of comparative analysis of industry methodological documents and regulations for the functioning of both the entire MTS system and its individual departments, methods for calculating coefficients assessing the condition and use of the RSD fuel tank farm, statistical analysis and data processing, were used to achieve the goal of the study. Materials from scientific works on the chosen topic and periodicals were used to carry out the research. Results: highlighted the distinctive features of the MTS system in railway transport, that are expressed in a management and financing system high degree of centralization, in a number of financial and organizational restrictions of the regional material and technical supply department activities, reducing its functions in the procurement and delivery processes to operational control. The state and efficiency of using the fuel resource storage system in the department are evaluated, some proposals are made for its modernization. Practical significance: based on the calculations and comparative analysis of the results obtained, the advantages of modernizing the existing storage system for fuel and energy resources using modular storage technologies in directions with insignificant and changing cargo flows are substantiated. Those proposals can be used to improve the efficiency of the system for providing fuel resources to railway transport organizations.

Undertaking risk assessments for Hong Kong reservoirs

The 2013 RARS (risk assessments for reservoir safety management) guidance was developed for the Environment Agency to provide a robust three-tiered framework for the risk analysis, assessment and management of reservoirs in the United Kingdom. The methods presented can be used to assess a reservoir's risk in its entirety, either at a qualitative level (tier 1) or more in-depth quantitative levels (tiers 2 and 3). Binnies undertook RARS assessments of reservoirs for Hong Kong's Water Supply Department. This paper identifies the limitations and challenges encountered when applying the guidance in Hong Kong, beyond its original intended purpose. It outlines the adjustments made to assess the Hong Kong service reservoirs at tier 1, and large embankment and gravity dams at tier 2. Some of the differences include (i) how the nature of loading and external threats differs due to geographical and locational differences; (ii) how consequences of reservoir failure differ due to topology, population densities and cultural differences in the reservoirs’ uses and (iii) how the reservoirs are atypical from ‘Pennine’ type UK embankment dams, from which most UK empirical methods are derived.