{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:26:58Z","timestamp":1786602418386,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Central Sterile Supply Department (CSSD) plays a crucial role in preventing healthcare-associated infections through proper instrument reprocessing. However, critical control points in the reprocessing workflow and their direct association with surgical site infection (SSI) remain inadequately characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify key control points in CSSD instrument reprocessing and analyze their association with surgical site infection (SSI) rates, defined according to Centers for Disease Control and Prevention (CDC) criteria through a comprehensive retrospective analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted from January 2020 to December 2023 at a tertiary care hospital. We analyzed 15,847 surgical procedures and corresponding CSSD reprocessing records. Key control points were identified through process mapping, failure mode analysis, and statistical correlation with infection outcomes. Multivariate logistic regression was used to determine independent risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven critical control points were identified: pre-cleaning verification (OR: 2.34, 95% CI: 1.78\u20133.09), cleaning efficacy validation (OR: 3.12, 95% CI: 2.45\u20133.98), sterilization parameter monitoring (OR: 4.67, 95% CI: 3.89\u20135.61), sterile integrity maintenance (OR: 2.89, 95% CI: 2.21\u20133.78), staff competency verification (OR: 2.56, 95% CI: 1.99\u20133.29), equipment maintenance compliance (OR: 3.45, 95% CI: 2.67\u20134.46), and quality documentation completeness (OR: 1.98, 95% CI: 1.54\u20132.54). Overall SSI rate was 2.4% (380\/15,847 procedures). Inadequate control at identified points increased infection risk by 180\u2013367%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Seven key control points are significantly associated with SSI rates. Implementation of enhanced monitoring and control measures at these points may be associated with SSI and improve patient safety outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1844524","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:31:48Z","timestamp":1786599108000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Identification of key control points in instrument reprocessing of hospital central sterile supply department and its association analysis with surgical site infection"],"prefix":"10.3389","volume":"14","author":[{"given":"Xia","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Central Sterile Supply, The People's Hospital of Liyang City","place":["Liyang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hospital Infection Management, The People's Hospital of Liyang City","place":["Liyang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1056\/NEJMoa1801550","article-title":"Changes in prevalence of health care-associated infections in U.S. hospitals","volume":"379","author":"Magill","year":"2018","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1001\/jamasurg.2017.0904","article-title":"Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017","volume":"152","author":"Berr\u00edos-Torres","year":"2017","journal-title":"JAMA Surg"},{"key":"ref3","volume-title":"Comprehensive guide to Steam Sterilization and Sterility Assurance in Health care Facilities","year":"2017"},{"key":"ref4","volume-title":"Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008","author":"Rutala","year":"2019"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"526","DOI":"10.5946\/ce.2020.238","article-title":"Does the reprocessing of endoscopes have to take place immediately after pre-cleaning? 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