TOPIC I:

ASEPSIS AND INFECTION CONTROL

RLENCM103 FUNDAMENTALS OF NURSING
 ASEPSIS
Asepsis is the state of being free from
disease-causing contaminants (such
as bacteria, viruses, fungi, and
parasites) or preventing contact with
microorganisms. The term asepsis
often refers to those practices used to
promote or induce asepsis in an
operative field in surgery or medicine to
prevent infection. (Berman et al., 2016)
 MEDICAL ASEPSIS
1. All practices intended to confine a
specific microorganism to a
specific area are included.
2. Reduces the number, growth, and
spread of microorganisms.
3. Objects classified as clean or dirty
(soiled, contaminated)
SURGICAL ASEPSIS
1. Sterile technique
2. Practices for keeping a specific
area or object free of all
microorganisms.
3. Practices that result in the
annihilation of all microorganisms
and spores
4. Used for all procedures involving
sterile body parts.
 Principles of Aseptic Technique
1. When sterile objects come into contact with unsterile objects, they become
unsterile.
2. Unsterile items are those that are out of vision or below the nurse's waist level.
3. Prolonged exposure to airborne microorganisms can render sterile objects
unsterile.
4. Fluids move in the direction of gravity.
5. By capillary reaction, moisture that passes through a sterile object draws
microorganisms from unsterile surfaces above or below the surface.
6. The edges of a sterile field are regarded as unsterile.
7. The skin is unsterile because it cannot be sterilized.
8. Maintaining surgical asepsis requires conscientiousness, alertness, and
honesty.
 INFECTION
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
 INFECTION
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
Factors Influencing Microorganism’s
Capability to Produce Infection
Number of microorganisms present
Virulence and potency of the microorganisms
(pathogenicity)
Ability to enter the body
Susceptibility of the host
Ability to live in the host’s body
Anatomic and Physiologic Barriers
Defend Against Infection
Intact skin and mucous membranes
Moist mucous membranes and cilia of the
nasal passages
Alveolar macrophages
Tears
High acidity of the stomach
Resident flora of the large intestine
Peristalsis
Low pH of the vagina
Urine flow through the urethra
 Interventions to Reduce
Risk for Infection
Proper hand hygiene techniques
Environmental controls
Sterile technique when warranted
Identification and management of
clients at risk
 CHAIN OF INFECTION
Chain of infection refers to those
elements that must be present to cause
an infection from a microorganism.
Basic to the principle of infection is to
interrupt this chain so that an infection
from a microorganism does not occur in
client. (Snyder, 2016)
 CHAIN OF INFECTION
1. Infectious agents - are
microorganisms capable of
causing infections
2. Reservoir - the environment in
which the microorganism lives
3. Portal of exit - pathogen
escapes from its reservoir; on
humans, common escape
routes are the gastrointestinal,
respiratory, and genitourinary
tracts
 CHAIN OF INFECTION
4. Modes of transmission - to move
from one location to another; direct
and indirect transmission
5. Portal of entry - pathogen enters
a host
6. Susceptible host - a host (human
or animal) lacking sufficient
resistance to a specific pathogen
 Asepsis and Infection Control
Breaking the Chain of Infection

1. Etiologic Agents - proper

methods for cleaning,
disinfecting, and sterilizing
articles.
Asepsis and Infection Control
2. Reservoir - infection
prevention policies.
3. Portal of exit - Talking,
coughing, or sneezing should
be avoided near open wounds
or sterile fields.
 Asepsis and Infection Control
Breaking the Chain of Infection
4. Modes of transmission - Proper
hand hygiene, Personal Protective
Equipment, Food Safety, Isolation,
Cleaning, disinfection, Sterilizatio
5. Portal of entry - When performing
Asepsis and Infection Control
invasive procedures, exposing open
wounds, or handling dressings, use
sterile technique.
6. Susceptible host - Immunization,
Health education
 Modes of Transmission
1. Direct Contact - transfer from
person to person through biting,
touching, kissing, or sexual
intercourse Asepsis and Infection Control

2. Indirect Contact - occur via fomites

or vectors
3. Air-borne Transmission - involves
droplets or dust
 Course of Infection
1. Incubation - the time between first contact with an
infectious agent and the onset of symptoms
2. Prodromal Stage - the time between the onset of
nonspecific symptoms and the appearance of
Asepsis and Infection Control
specific symptoms
3. Full Stage - manifestations of specific signs and
symptoms of infectious agent
4. Convalescence - the time it takes for the host to
return to the pre-illness stage
Asepsis and Infection Control
 Types of Immunity
Active Immunity - In response to natural or artificial
antigens, the host produces antibodies.
Natural active immunity
Artificial active immunity
Asepsis and Infection Control

Passive Immunity - The host is given natural or

synthetic antibodies derived from another source.
Natural passive immunity
Artificial passive immunity
Asepsis and Infection Control
 Factors INCREASING
SUSCEPTIBILITY TO INFECTION
Age
Heredity
Cultural practice
Nutrition
Asepsis and Infection Control
Stress
Rest, Exercise, and personal health habits
Inadequate defenses
Environmental
Immunization history
Medications and medical therapies
 Category-specific Isolation
Precautions
Strict isolation
Contact isolation
Respiratory isolation
Tuberculosis isolation
Asepsis and Infection Control
Enteric precautions
Drainage/secretions precautions
Blood/body fluid precautions
 Category-specific Isolation
Precautions
Disease-specific Isolation Precautions
Delineate practices for control of specific diseases
Universal Precautions (UP)
Used with allAsepsis
clientsand Infection Control
Body Substance Isolation (BSI)
Employs generic infection control precautions for all
clients
Standard Precautions
Used in the care of all hospitalized persons regardless of
their diagnosis or possible infection status
HANDWASHING
 HANDWASHING
It is the act of cleaning one’s hand with any liquid, with or
without soap, to remove dirt or microorganism
The most effective method of reducing the risk of infectious
disease transmission.
The most important and fundamental technique for preventing
and controlling infections, and it cannot be overstated.
 TERMS
Hand hygiene - the general term that applies handwashing, antiseptic
hand wash, antiseptic hand rub, or surgical hand antisepsis.
Handwashing - is the washing of hands with plain soap and water.
Antiseptic hand wash - applies handwashing with an antimicrobial
soap and water.
Surgical hand antisepsis (Surgical hand scrub) - to remove as
many microorganisms from the hands as possible before the sterile
procedure
 Types of Hand Hygiene
Routine hand wash - the use of water and non-antimicrobial soap
for the purpose of removing soil and transient microorganisms.
Antiseptic hand wash - the use of water and antimicrobial soap
for the purpose of removing or destroying transient microorganisms
and reduce resident flora.
Antiseptic hand rub - the use of alcohol-based hand rub.
Surgical antisepsis - the use of water and antimicrobial soap for
the purpose of removing or destroying transient microorganisms
and reduce resident flora. Recommended duration is 2-6 minutes.
 Concepts
Use running water in a sink that drains.
Use antibacterial soap from a Touch Free Soap Dispenser.
Rub your hands together for at least 30 seconds.
Fingernails should be kept short and remove all the jewelry.
It is better to use disposable paper towels rather than cloth
towels.
Turn off the faucet using a paper towel.
 Indicators of hand hygiene
Five Moments for Hand Hygiene according to
World Health Organization (WHO):
1. Before Patient Contact.
2. Before an Aseptic Task.
3. After Body Fluid Exposure Risk.
4. After Patient Contact.
5. After Contact with Patient Surroundings.
 Antiseptic Handrub
1. Ensure jewelry has been removed
2. Apply quantity of alcohol-based hand hygiene product as per
manufacturer’s recommendations into cupped hand.
3. Rub hands palm to palm
4. Right palm over left dorsum with interlaced fingers and vice versa.
5. Palm to palm with fingers interlaced
6. Backs of fingers to opposing palms with fingers interlaced
7. Rotational rubbing of left thumb clasped in right palm and vice versa
8. Rotational rubbing, backwards and forwards with clasped fingers of
right hand in left palm and vice versa
9. Rubbing hands together until hands are dry before continuing with
patient care, do not rub off excess product
 Antiseptic Handwash
1. Collect all of the necessary supplies. Place yourself in front of the sink.
2. Wet your hands and wrists. Keep your hands lower than your elbows
to allow water to flow to your fingertips.
3. Soap all areas of your hands.
4. Wash the palms and backs of the hands, each finger, the knuckles,
wrists, and forearms with firm rubbing and circular motions. Keep this
friction motion going for 30 seconds.
5. Thoroughly rinse with water flowing towards the fingertips.
6. With a paper towel, pat hands dry, beginning with the fingers and
moving upward to the forearms, and discard immediately.
7. In the absence of sensors or a foot pedal, turn off the faucet with
another clean paper towel.
 Surgical Antisepsis
1. Take off all of the jewelry.
2. Wet your hands with sterile water that is close to your body temperature.
3. Hands should be washed with antimicrobial soap and/or povidone-iodine.
4. Subungual areas should be cleaned with a nail file.
5. For at least 4 minutes, scrub each side of each finger, between the
fingers, and the backs and fronts of the hands.
6. Scrub the hands, keeping the hand higher than the arm at all times to
avoid contaminating the hands with bacteria-laden soap and water.
7. Rinse hands and arms in a single direction, from fingertips to elbow,
through running water.
8. Carry your hands above your elbows to the operating room.
9. Using a sterile towel, dry your hands and arms aseptically.
DONNING AND REMOVAL
OF GOWN METHOD
 Surgical gowns are worn by
healthcare providers while performing
care in a sterile area. Gowns used for
additional precautions are usually
called isolation gowns. Isolation
gowns are protective garments worn
to protect clothing from the splashing
or spraying of body fluids and to
reduce the transmission of
microorganisms (Public Health
Ontario, 2020b).
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
DONNING AND REMOVAL OF GOWN METHOD
 GLOVING
(Open and Close Method)
Sterile gloves are gloves that are
free from all microorganisms. They
are required for any invasive
procedure and when contact with
any sterile site, tissue, or body
cavity is expected (PIDAC, 2012).
Thank you!
Asepsis and Infection Control