Section 1: General Information
The CSSD staff member should fill out the following basic details to log the day's activities:
Field Information Required
Date Date of the shift (e.g., April 1, 2025)
Shift Time Start and end time of the shift (e.g., 7:00 AM - 3:00 PM)
Staff Member Name Name of the CSSD staff member responsible for logging data
Sterilizer Equipment List the sterilization equipment used that day (e.g., autoclaves,
Used washers, etc.)
Section 2: Sterilization and Infection Control Data
1. HAIs and Instruments/Devices Data
o Total Number of HAIs: The CSSD staff might not have direct access to patient
data, but you can request them to get this data from the infection control team or
from the hospital's infection surveillance system.
o HAIs Due to Instruments/Devices: Again, this may require input from infection
control or clinical staff, but CSSD staff should note the specific instruments or
devices involved in any infection incident if known.
Metric Data Collection Method
Collect this from the infection control department or hospital
Total Number of HAIs
records.
HAIs Due to Infection control team provides feedback on which
Instruments/Devices instruments caused infections.
% of HAI Due to Formula calculation by infection control (Staff may need to
Instruments/Devices fill in after calculation).
2. Sterilization Failures
o Number of Sterilization Failures: CSSD staff should track instances when
sterilization cycles fail. This could include mechanical failures, operator errors, or
equipment malfunctions.
Metric Data Collection Method
Sterilization Record the failure instances (e.g., autoclave cycle not completed). If known,
Failures categorize failure (e.g., time, temperature, equipment).
Staff must note the specific cause of failure (e.g., incorrect settings, equipment
Failure Cause
breakdown, human error).
3. Re-Sterilization Data
o Number of Items Re-Sterilized Due to Improper Storage: CSSD staff should
record instances where items must be re-sterilized due to improper storage
conditions (e.g., contamination after storage, improper packaging).
Metric Data Collection Method
Number of Items Re-Sterilized Track instances of re-sterilization due to improper storage
Due to Improper Storage (e.g., packaging errors, storage conditions).
Total Number of Items Sterilized Track the total number of items sterilized in the shift or day.
4. Sterilization Non-Compliance
o Number of Non-Compliant Sterilization Instances: CSSD staff should track
any non-compliance with sterilization protocols. This can include things like
improper loading of sterilizers, not following sterilization time/temperature
standards, or failure to record results.
Metric Data Collection Method
Track and record when sterilization protocols are not followed.
Non-Compliant
Document the reason for non-compliance (e.g., improper load
Sterilization Instances
configuration, faulty equipment).
Total Number of
Record the total sterilization cycles performed during the shift or day.
Sterilization Instances
Section 3: Daily Summary and Remarks
Sterilization Equipment Maintenance: Was any maintenance or calibration required on
sterilization equipment? Record details.
Staff Training/Issues: Were there any issues with staff training or procedural
knowledge? If so, note down actions required.
Comments/Notes: Additional observations or notes related to sterilization activities.
Field Data/Comments
Sterilizer Maintenance Yes/No (If yes, details of the maintenance done or required)
Staff Training/Issues Yes/No (If yes, what actions need to be taken)
Additional Remarks Any other important observations
Daily Data Collection Example (for CSSD Staff)
Date April 1, 2025
Shift Time 7:00 AM - 3:00 PM
Date April 1, 2025
Staff Member John Doe
Sterilizers Used Autoclave #1, Washer #2
Metric Data
Total Number of HAIs 5
HAIs Due to Instruments/Devices 2
% of HAI Due to Instruments/Devices 40%
Number of Sterilization Failures 1
Failure Cause Autoclave Cycle Time Error
Number of Items Re-Sterilized Due to Improper Storage 3
Total Number of Items Sterilized 100
% Re-Sterilization Due to Improper Storage 3%
Number of Non-Compliant Sterilization Instances 2
Total Number of Sterilization Instances 25
% Non-Compliance to Sterilization Practices 8%
Tracking and Reporting:
Digital or Paper Forms: You can either provide the staff with a digital form (e.g.,
Google Sheets or Excel), or paper-based logs they can fill out during their shifts.
Data Submission: Set up a system for daily data submission, where CSSD staff either
submit the forms at the end of each shift (via email or direct upload) or place paper forms
in a designated location for collection.
Daily Review: A supervisor or designated person should review the collected data daily,
ensuring completeness and addressing any issues or discrepancies promptly.
Automating the Process:
To streamline the process, consider using a digital reporting system like Google Sheets or
Excel, where the CSSD staff can directly input data into a shared sheet. This makes it easier to
track performance and generate reports for analysis. You can also use apps or software designed
for inventory management or sterilization monitoring that may have built-in features for data
entry and tracking.
Would you like help setting up a digital version of this tracker? I can guide you in creating a
Google Sheets or Excel template for this!
