Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Module 1
FUNDAMENTALS IN NURSING SKILLS/LAB

MODULE DESCRIPTION

This module presents the concepts and principles of infection control with explanation
of the causes of infection, mode of transmission and defenses against infection. The module
additionally describes the specific precautions that must be taken during invasive procedures, in
particular aseptic technique.

COURSE LEARNING OUTCOMES

Given actual clinical setting with supervision the Level I students will:
1. Able to explain the relationship between the infection chain and transmission of
infection.
2. Give example of preventing infection for each element of the infection chain.
3. Identify the normal defenses of the body against infection.
4. Discuss the events in the inflammatory response.
5. Identify patients most at risk for infection.
6. Describe the signs/symptoms of a localized infection and those of a systemic infection.
7. Explains the difference between medical and surgical asepsis.
8. Perform proper procedures for hand hygiene.

PRE-TEST

Enumerate 5-10 common practices of aseptic technique at home.

 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Topic 1. Asepsis

 Asepsis is the state of being free from disease causing micro-organism.

 Aseptic technique refers to the practices/procedures that help reduce the risk of
infection.


Types of aseptic technique

1. Medical Asepsis
2. Surgical Asepsis

Medical Asepsis

 Basic medical aseptic technique breaks the chain of infection. Use these techniques
for all patients, even when no infection is diagnosed. Aggressive, preventive
measures are highly effective in reducing HAI’s. examples of medical asepsis are:
1. Hand hygiene
2. Barrier techniques and,
3. Routine environmental cleanings

Surgical Asepsis

 Surgical asepsis or sterile technique prevents contamination of an open wound,

serves to isolate an operative area from the unsterile environment, and maintains
sterile field for surgery. It demands the highest level of aseptic technique and
requires that all areas be kept free of infectious microorganisms.
Use surgical asepsis in the following situations:
1. During procedures that require intentional perforation of the patient’s skin,
such as insertion of peripheral IV catheters or a central intravenous line
2. When the integrity of the skin is broken as a result of trauma, surgical
incision, or burns
3. During procedures that involve invasive procedures such as insertion of a
urinary catheter or surgical instruments into sterile body cavities such as
insertion of wound drain

Principles of Surgical Asepsis Technique

 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

1. A sterile object remains sterile only when touched by another sterile object.
This principle guides a nurse in placement of sterile objects and how to handle
them.
a. Sterile touching sterile remains sterile
b. Sterile touching clean becomes contaminated
c. Sterile touching contaminated becomes contaminated
d. Sterile state is questionable. Discard it regardless of whether the object
itself appears untouched.
2. Only sterile objects may be placed on a sterile field.
3. A sterile object or field out of the range of vision or an object held below a
person’s waist is contaminated.
4. A sterile object or field becomes contaminated by prolonged exposure to air.
5. When sterile surface comes in contact with a wet, contaminated surface, the
sterile object or field becomes contaminated by capillary action
6. Fluids flow in the direction of gravity.
7. The edges of a sterile field or container are considered to be contaminated.

Topic 2. Infection Control

Nature of Infection
- An infection is the invasion of a susceptible host by pathogens or microorganisms,
resulting in disease. It is important to know the difference between an infection
and colonization. Colonization is the presence and growth of microorganisms
within a host but without tissue invasion or damage.

Signs of Localized Infection

 Localized swelling

 Localized redness
 Pain or tenderness with palpation or movement
 Palpable heat in the infected area
 Loss of function of the body part affected, depending on the site and extent of
involvement
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Signs of Systemic Infection

 Fever
 Increased pulse and respiratory rate if the fever high
 Malaise and loss of energy
 Anorexia and, in some situations, nausea and vomiting
 Enlargement and tenderness of lymph nodes that drain the area of infection

Chain of infection
- The presence of pathogen does not mean that an infection will occur. Infection
occurs in a cycle that depends on the presence of all of the following elements:
 An infectious agent or pathogen
 Reservoir or source for pathogen
 A port of exit from the reservoir
 A mode of transmission
 A port of entry to the host
 A susceptible host

Infectious Agent

Microorganism includes:

Bacteria
Viruses
Fungi and,
Protozoa
Infection can develop if this chain remains uninterrupted.
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Reservior
A place where microorganisms survive
1. Food
2. Water
3. Temperature
4. PH
5. Light

Portal of Exit
1. Skin and mucous membranes
2. Respiratory tract
3. Urinary tract
4. Gastrointestinal tract
5. Reproductive tract
6. Blood
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Mode of transmission
Each disease has a specific mode of transmission.
Contact
1. Direct
2. Indirect
3. Droplet
4. Airborne
5. Vehicles
6. Vector

Portal of entry
The means of a pathogen entering a host: the means of entry can be the same
as one that is the portal of exit (gastrointestinal, respiratory, genitourinary
tract).
Susceptible Host
Susceptible host describes a host (human or animal) not possessing enough
resistance against a particular pathogen to prevent disease or infection from
occurring when exposed to the pathogen; in humans this may occur if the
person’s resistance is low because of poor nutrition, lack of exercise of a
coexisting illness that weakens the host.
Breaking chain of infection
Infectious agent

 Correctly cleaning, disinfecting or sterilizing articles before use

 Educating clients and support persons about appropriate methods to clean,
disinfect, and sterilize article
 Reservoir (source)
 Changing dressings and bandages when soiled or wet
 Appropriate skin and oral hygiene
 Disposing of damp, soiled linens appropriately
 Disposing of feces and urine in appropriate receptacles
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

 Ensuring that all fluid containers are covered or capped

 Emptying suction and drainage bottles at end of each shift or before full or
according to agency policy

Portal of exit

 Avoiding talking, coughing, or sneezing over open wounds or sterile fields

 Covering the mouth and nose when coughing or sneezing

Method of transmission

 Proper hand hygiene

 Instructing clients and support persons to perform hand hygiene before
handling food, eating, after eliminating and after touching infectious material
 Wearing gloves when handling secretions and excretions
 Wearing gowns if there is danger of soiling clothing with body substances
 Placing discarded soiled materials in moisture-proof refuse bags
 Holding used bedpans steadily to prevent spillage
 Disposing of urine and feces in appropriate receptacles
 Initiating and implementing aseptic precautions for all clients
 Wearing masks and eye protection when in close contact with clients who
have infections transmitted by droplets from the respiratory tract
 Wearing masks and eye protection when sprays of body fluid are possible

Portal of entry

 Using sterile technique for invasive procedures, when exposing open wounds
or handling dressings
 Placing used disposable needles and syringes in puncture-resistant containers
for disposal
 Providing all clients with own personal care items

Susceptible host

 Maintaining the integrity of the client’s skin and mucous membranes

 Ensuring that the client receives a balanced diet
 Educating the public about the importance of immunizations
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Modes of Transmission

1. Direct contact: describes the way in which microorganisms are transferred from person
to person through biting, touching, kissing, or sexual intercourse; droplet spread is also a form
of direct contact but can occur only if the source and the host are within 3 feet from each
other; transmission by droplet can occur when a person coughs, sneezes, spits, or talks.

2. Indirect contact: can occur through fomites (inanimate objects or materials) or through

vectors (animal or insect, flying or crawling); the fomites or vectors act as vehicle for
transmission

3. Air: airborne transmission involves droplets or dust; droplet nuclei can remain in the air
for long periods and dust particles containing infectious agents can become airborne infecting
a susceptible host generally through the respiratory tract

Defenses Against Infection

1. Normal Floras – the body normally contains microorganisms that reside on the
surface and deep layers of skin, in the saliva and oral mucosa, and in the GI and
GU tracts.
2. Body System Defense – a number of body organ system unique for infection.
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

3. Inflammation – is a protective vascular reaction that delivers fluid, blood

products, and nutrients to an area of injury.
Signs:
1) Swelling
2) Redness
3) Heat
4) Pain or tenderness, and
5) Loss of function in the affected body parts
Systemic:
1) Fever
2) Increased white blood cells
3) Malaise
4) Anorexia
5) Nausea
6) Vomiting
7) lymph node enlargement
8) organ failure
Inflammatory responses:
1) Vascular and cellular response
2) Inflammatory exudate
3) Tissue repair
Health Care – Associated Infection (HAI’s)
Results from the delivery of health services in a health care facility. They occur as the
result of invasive procedures, antibiotic administration, the presence of multidrug-resistant
organisms (MDROs), and breaks in infection prevention and control activities.

Factors Influencing Infection Prevention and Control

1. Age
2. Nutritional status
3. Stress
4. Disease Process
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

Medical Asepsis
- Control or Elimination of Infectious Agent
1. Cleaning
2. Disinfecting and sterilization
- Protection of the susceptible host
- Control or elimination of reservoirs of infection
- Control of portals of exit/entry
- Control of transmission
1. Standard precaution
Hand hygiene
- The most effective basic technique in preventing and controlling the
transmission of infection is hand hygiene (Mathur, 2011; WHO, 2009). Hand
hygiene is a general term that applies to four technique:
 Handwashing
 Anti-septic hand wash
 Anti-septic hand rub
 Or surgical hand antisepsis
 Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

POST TEST

A link will be sent by your Instructor

REFERENCE

Potter, Patricia A., Stockert, Patricia A., Perry, Anne G., Hall, Amy M. (2017) Fundamentals of
Nursing. Ninth Edition Vol.1. Elsevier Inc. Singapore
https://www.rnpedia.com/nursing-notes/fundamentals-in-nursing-notes/asepsis-and-
infection-control/

REFLECTION

The instructor will give separate instructions for your reflection.