Asepsis an

Infection
Control
PAUL KENNETH R. CALISANG, MAN, MPA, RN, RM, EMT-B
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 LEARNING OBJECTIVES
By the end of this lecture you should
be able to:
1. Identify the six components of the
chain of infection.
2. Identify ways that infection may
occur.
3. Describe factors that increase
the risk of infection in various
settings.
4. Discuss the role of healthcare
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personnel and health agencies in

infection control.
 LEARNING OBJECTIVES
5. Identify ways that caregivers can
increase their protection against
infectious exposure
6. Explain ways that caregivers can
decrease the transmission of infection
to the patient.
7. Differentiate between medical and
surgical asepsis.
8. Demonstrate good hand hygiene
techniques and identify key occasions
and reasons for incorporating them
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as an integral part of the practice.

 LEARNING OBJECTIVES
9. Describe appropriate situations for
using cleaning, disinfection, and
sterilization.
10. Describe proper use of barriers
also known as personal protective
equipment (PPE).
11. Discuss the two-tier system of
isolation.
12. Identify age-related and cultural
considerations in preventing the
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transmission of infectious diseases.

 Key Terms:
1) Asepsis
2) Infectious disease
3) Multi-drug-resistant organisms
(MDROs)
4) Extended-spectrum
betalactamases (ESBLs)
5) Pathogens
6) Sepsis
7) Asepsis
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 ROLE OF MICROORGANISMS
IN INFECTION

- Pathogens
- Sepsis
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 Agents VIRUSES
Causing BACTERIA FUNGI
Infection

PARASITES
PRIONS
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 MULTI–DRUG-RESISTANT
ORGANISMS
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 Factors that have contributed to the evolution and
proliferation of resistant microbial organisms include the
following:
● Overprescribing antibiotics
● Using inappropriate antibiotics for the infecting organism
● Not taking antibiotics as prescribed
● Spreading of resistant organisms by carriers who are symptom-free
and unaware they are carriers
● Over utilizing antibiotics in farming and agriculture, thus
contaminating milk and meat with resistant strains of bacteria
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 Prevention and control of drug-resistant infections are crucial. The CDC (2018b) has
outlined four prevention strategies and seven control strategies to lessen the risk of
infection. Prevention strategies include the following:
1. Use of bundled practices for diligent care for vascular and urinary catheters and
ventilators.
2. Swift and precise diagnosis and treatment for the infectious organism
3. Appropriate selection, dose, duration, and route of antimicrobial therapies
4. Meticulous adherence to evidence-based transmission prevention strategies
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 Chain of Infection
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 Healthcare-Associated Infections
● RISK FACTORS IN THE DEVELOPMENT OF HEALTHCARE-
ASSOCIATED INFECTIONS
● Risk factors that contribute to the development of HAIs can be grouped
into three categories:
1. environment
2. therapeutic regimen, and
3. patient resistance.
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 INFECTION RISKS IN VARIOUS HEALTHCARE SETTINGS
1. Acute care settings
2. Long-term care facilities

3. Ambulatory care settings

4. Homes

5. Schools

6. Workplace
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 INFECTION CONTROL
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 ● TRANSMISSIBLE DISEASES
Because healthcare workers, including nurses, are at risk for
contracting and transmitting vaccine-preventable diseases, maintenance of
current immunization status is a good health practice
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 ASEPTIC PRACTICES
The two major categories of aseptic practice
1. Medical asepsis
2. Surgical asepsis
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 Some factors that contribute to poor compliance with
hand hygiene include the following:
● Lack of awareness of patient care activities that require hand hygiene,
such as performing routine and “clean” activities, including taking blood
pressure or shaking hands with a patient
● Common misperception that wearing gloves and gowns can substitute for
hand hygiene
● Understaffing and high workloads leading to perceived time constraints
● Inaccessibility of sinks or dispensers for soap or alcohol-based cleanser
● Skin irritation and dryness
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 The World Health Organization (2009) developed and implemented hand hygiene
guidelines. These guidelines include recommendations in nine different areas:

● Indications for handwashing and hand asepsis

● Hand hygiene technique
● Surgical hand preparation
● Selection and handling of hand hygiene agents
● Skin care
● Use of gloves
● Other aspects of hand hygiene
● Healthcare worker educational and motivational programs
● Governmental and institutional responsibilities
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 Hand Hygiene Guidelines

● Indications for washing hands with soap and water include visibly dirty
hands, hands visibly soiled with body fluids, or after using the toilet.
● Alcohol-based hand sanitizer is preferred in the following situations if
hands are not visibly soiled: before and after touching a patient; before
handling an invasive device for patient care; after contact with body fluids
or excretions, mucous membranes, nonintact skin, or wound dressings;
between contact with a contaminated body site to another site on the same
patient; after contact with inanimate surfaces and objects; and after
removing sterile or nonsterile gloves.
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 Hand Hygiene Guidelines

● Handwashing with soap and water is recommended when alcohol-based

hand sanitizer is unavailable.
● Alcohol-based hand sanitizer or soap and water can be used before
handling medication or preparing food.
● Concomitant alcohol-based hand sanitizer and soap use is not
recommended.
● Soap and water handwashing technique includes using a towel to turn off
the faucet, thorough drying of hands, and single towel use.
● Acceptable forms of soap are liquid, bar, leaf, or powdered.
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 Hand Hygiene Guidelines
● Bar soap racks should allow drainage to ensure that the soap dries.
● Alcohol-based hand sanitizer technique includes applying a palmful amount of
sanitizer, covering all surfaces, and rubbing hands until dry.
● Surgical hand hygiene recommendations include removal of jewelry, no brushes, and
use of antimicrobial soap according to the maker’s recommendations.
● Selection of hand hygiene agents should consider input from healthcare workers,
interaction with other products or gloves, the risk for contamination, accessibility and
proper functioning of dispensers, approval of dispensers for flammable materials, and
cost comparisons.
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 Hand Hygiene Guidelines

● Soap or alcohol-based hand sanitizer should not be added to partially

empty soap dispensers.
● Skin irritation in healthcare workers can be avoided by providing
educational programs, alternative hand hygiene products for those with
allergies or adverse reactions to standard products, and hand moisturizers
to reduce irritant contact dermatitis.
● Glove use does not replace the need for hand sanitizer or handwashing.
● Gloves should be used if contact with potentially infectious body fluids,
mucous membranes, or nonintact skin is anticipated.
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 Hand Hygiene Guidelines
● Gloves should be removed or changed after each patient or after contact with a
contaminated body site.
● Artificial nails or extenders should not be used, and the length of natural nail tips
should be less than 0.5 cm.
● Educational and motivational programs for healthcare workers should focus on
behavior, be multimodal, include senior executive support, educate about the
advantages and disadvantages of various hand hygiene methods, monitor adherence
and provide performance feedback, and encourage partnership among patients,
families, and healthcare workers.
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 Hand Hygiene Guidelines
● Healthcare administrators should provide and monitor safe, continuous water supply;
provide alcohol-based hand sanitizer at the point of patient care; prioritize compliance;
provide leadership, administrative support, and financial resources; ensure training;
implement a multidisciplinary, multifaceted, and multimodal program to improve
adherence; and adhere to national safety guidelines and local legal requirements.
● National governments should prioritize adherence; consider funded, coordinated
implementation and monitoring; support the strengthening of infection control in
healthcare settings; promote community hand hygiene, and encourage the use of hand
hygiene as a quality indicator in healthcare settings.
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 ● Disinfection - refers to chemical or physical processes
used to reduce the number of pathogens on an object’s
surface.
● Sterilization - Equipment and instruments that come in
contact with sterile body sites or vascular spaces are
called critical items. Critical items must be sterilized and
kept sterile until use. Sterilization refers to the complete
destruction of all microorganisms, including spores.
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 Transmission-based Precautions
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 STANDARD PRECAUTIONS

A. Wear clean gloves when touching:

1. Blood, body fluids, secretions, and excretions, and items these body substances
2. Mucous membranes
3. Nonintact skin
B. Perform handwashing immediately:
1. When there is direct contact with blood, body fluids, secretions and excretions,
or contaminated items
2. After removing gloves
3. Between patient contacts
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 STANDARD PRECAUTIONS

C. Wear a mask, eye protection, or face shield during procedures and patient care
activities that are likely to generate splashes or sprays of blood, body fluids, or secretions
and excretions.
D. Wear a cover gown during procedures and patient care activities that are likely to
generate splashes or sprays of blood, body fluids, secretions, or excretions or cause
soiling of clothing.
E. Remove soiled protective items promptly when the potential for contact with reservoirs
of pathogens is no longer present.
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 STANDARD PRECAUTIONS

F. Clean and disinfect or reprocess all equipment before reuse with another patient.
G. Discard all single-use items promptly in appropriate containers to prevent contact with
blood, body fluids, secretions, and excretions, contamination of clothing, and transfer of
pathogens to other patients and the environment.
H. Handle, transport, and process linens soiled with blood, body fluids, and secretions
and excretions in such a way as to prevent skin and mucous membrane exposures,
contamination of clothing, or transfer to other patients and the environment.
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 STANDARD PRECAUTIONS
I. Prevent injuries with used needles, scalpels, and other sharp devices by:
1. Never removing, recapping, bending, or breaking used needles
2. Never pointing the needle toward a body part
3. Using a one-handed “scoop” method, special syringes with a retractable
protective guard or shield for enclosing a needle, or blunt-point needles
4. Depositing disposable and reusable syringes and needles in puncture-resistant
containers.
J. Use a private room or consult with an infection control professional for the care of
patients who contaminate the environment or who cannot or do not assist with appropriate
hygiene or environmental cleanliness measures.
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 Masks and Respirators
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Gowns
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 Caps and Shoe Coverings
STERILE GLOVES
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 Goggles or Face Shields
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 ● Private Rooms
● Equipment and Refuse Handling - Items and linen soiled by any body fluid require special
handling. Place these articles in impervious bags before they are removed from the patient’s bedside. Bagging in
fluid-resistant containers prevents exposure of personnel and contamination of the environment.
● ISOLATION SYSTEMS (TWO)

1. Standard precautions

2. Transmission-based precautions
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 ● Standard Precautions
● Transmission-Based Precations
● Airborne Precautions
● Droplet Precautions
● Contact Precautions
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 Principles of Surgical Asepsis
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 Principles of Surgical Asepsis
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 Principles of Surgical Asepsis
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 Principles of Surgical Asepsis
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 SURGICAL HANDWASHING
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 SKIN PREPARATION
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 The following are the objectives of surgical scrubs and
patient skin preparation:
● To remove dirt, oil, and microorganisms from the skin
● To reduce bacterial counts to subpathogenic levels
● To avoid abrading the skin
● To leave a layer of persistent antiseptic solution on the skin that inhibits
● the growth of microbes for an extended period
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STERILE FIELD
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STERILE GLOVES
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 CLOSED GLOVING TECHNIQUE
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 ● Newborns and Infants
● Toddlers and Preschoolers
● School-Age Children and Adolescents
● Adults and Older Adults
● Cultural Considerations
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 KEY POINTS
● Infectious disease is the most common reason people contact healthcare providers and
accounts for more clinic and physician office visits than any other cause in the United
States.
● Agents that cause infection, such as bacteria, viruses, fungi, prions, and parasites,
occur everywhere in the environment—on body surfaces, in food, and in products used
in normal activities of daily living.
● The chain of infection includes the infectious agent, the source, the portal of exit, the
mode of transmission, the portal of entry, and a susceptible host.
● The three common modes of transmission are contact, droplet, and airborne. Vectors
and fomites also account for the spread of some diseases.
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 KEY POINTS
● Contact transmission of infectious pathogens on the hands of caregivers is
the most frequent mode of transmission of infection in healthcare facilities.
● Resistance to the drugs used to treat pathogens is emerging rather quickly,
limiting treatment options and increasing mortality and healthcare costs.
● The incidence of healthcare-associated infections (HAIs) can be decreased
with strict adherence to evidence-based infection control practices.
● Risk factors in the development of HAIs include environment, therapeutic
regimen, and the effectiveness of patients’ immune systems.
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 KEY POINTS
● Effective infection control measures have a favorable cost–benefit ratio.
● Hand hygiene is the single most important infection control practice. All
caregivers and patients and their family members should learn hand
hygiene techniques.
● To aid in the fight against infection and to increase compliance with hand
hygiene, alcohol-based hand sanitizers are recommended for all healthcare
delivery sites.
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 KEY POINTS
● Intact skin and mucous membranes are major barriers against organisms and
transmission of infection. Invasive procedures and surgeries can jeopardize this line of
defense.
● Regulatory agencies at local, state, regional, and national levels are involved in the
control of infection and institutional waste to protect patients, staff, and the
community.
● Employee health programs to monitor and counsel personnel are important
components of institutional and community infection control programs.
● Safe, institutional waste disposal methods are important factors in infection control
programs.
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 KEY POINTS
● Safe, institutional waste disposal methods are important factors in infection
control programs.
● Aseptic practices are those techniques used to keep people or objects free from
pathogens. Cleaning, disinfection, and sterilization can be accomplished by
various methods and agents.
● The use of barriers, also known as PPE, such as gloves, gowns, masks, goggles,
and face shields, is important in preventing the spread of infection.
● Gloves should be worn whenever there could be contact with the patient’s body
fluids.
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 KEY POINTS
● Gloves should be worn whenever there could be contact with the patient’s body fluids.
● Private rooms, and cohorting patients infected or colonized with the same pathogen,
are used to decrease the chance of transmission of infection by all routes.
● Sterile technique is used to prevent the introduction of microorganisms from the
environment to the patient during surgery and invasive procedures or in selected high-
risk situations.
● An item is sterile when all organisms and spores on the object are destroyed.
● Exposure to infectious diseases, and the risk of contracting infectious disease, changes
during a person’s life span.
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 To be
continued….
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 UP NEXT….
● Safety and Security
● Complementary and
Alternative
Therapies
● Medications
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Case Closed.
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