PRINCIPLES 

AND PRACTICES OF ASEPSIS

Role of Hands and the Environment in 
Disease Transmission
OBJECTIVES
• Describe the principles and practice of asepsis. 

• Understand hand hygiene.
 Medical Asepsis Surgical Asepsis

Definition Clean Technique Sterile Technique

Emphasis Freedom from most  Freedom from all

pathogenic organisms pathogenic organisms

Purpose Reduce transmission of Prevent introduction of

pathogenic organisms any organism into an
from one patient-to-another open wound or sterile
body cavity
MEDICAL ASEPSIS
 Measures aimed at controlling the number of 
microorganisms and/or preventing or reducing the 
transmission of microbes from one person‐to‐another:  
Clean Technique
• Know what is dirty.
• Know what is clean.
• Know what is sterile.
• Keep the first three conditions separate.
• Remedy contamination immediately.
 PRINCIPLES OF MEDICAL ASEPSIS

When the body is penetrated, natural barriers such as skin 
and mucous membranes are bypassed, making the patient  susceptible to microbes that might enter.

•Perform hand hygiene and put on gloves

•When invading sterile areas of the body, maintain the  sterility of the body system

•When placing an item into a sterile area of the body, make  sure the item is sterile.
 PRINCIPLES OF MEDICAL ASEPSIS

 Even though skin is an effective barrier against microbial 
invasion, a patient can become colonized with other 
microbes if precautions are not taken.

• Perform hand hygiene between patient contacts

• When handling items that only touch patient’s intact skin, 
or do not ordinarily touch the patient, make sure item is  clean and disinfected
(between patients).
 PRINCIPLES OF MEDICAL ASEPSIS

 All body fluids from any patient should be considered 

contaminated

• Body fluids can be the source of infection for the patient and you.

• Utilize appropriate personal protective equipment (PPE)
 PRINCIPLES OF MEDICAL ASEPSIS

 The healthcare team and the environment can be a source 
of contamination for the patient

• Health care providers (HCP) should be free from disease 

• Single use items can be a source of contamination

• Patients environment should be as clean as possible
 SURGICAL ASEPSIS 

 Practices designed to render and maintain objects and 
areas maximally free from microorganisms:  
Sterile Technique
• Know what is sterile
• Know what is not sterile
• Keep sterile and not sterile items apart
• Remedy contamination immediately
 PRINCIPLES OF SURGICAL ASEPSIS

• The patient should not be the source of  contamination.

• The operating personnel should not be the source  of contamination

• The surgical scrub should be done meticulously.

• The OR technique of the surgeon is very important.

• Recognize potential environmental contamination.
 Principles of Sterile Technique

 The principles of Sterile Technique are applied in various ways. If the

principle itself is understood the applications of it become obvious.
Strict aseptic technique is needed at all times in the Operating Room.
 Principles of Sterile Technique
1. All articles used in an operation have been sterilized previously.
2. Persons who are sterile touch only sterile articles; persons who are not
sterile touch only unsterile articles.
3. Sterile persons avoid leaning over an unsterile area; non-sterile
persons avoid reaching over a sterile field. Unsterile persons do not get
closer than 12 inches from a sterile field.
4. If in doubt about the sterility of anything consider it not sterile. If a
non-sterile person brushes close consider yourself contaminated.
5. Gowns are considered sterile only from the waist to shoulder level in
front and the sleeves to 2 inches above the elbows.
6. Keep hands in sight or above waist level away from the face.
7. Arms should never be folded.
8. Articles dropped below waist level are discarded.
 Sterile persons keep well within the sterile area and follow these rules from passing:
1. Face to face or back to back.
2. Turn back to a non-sterile person or when passing.
3. Face a sterile area when passing the area.
4. Ask a non-sterile person to step aside rather than trying to crowd past him.
5. Step back away from the sterile field to sneeze or cough.
6. Turn head away from sterile field to have perspiration mopped from brow.
7. Stand back at a safe distance from the operating table when draping the patient.
8. Members of the sterile team remain in the operating room if waiting for the case.
9. Do not wander around the room or go out in the corridors.
 Sterile persons keep contact with sterile areas to a minimum.
1. Do not lean on the sterile tables or on the draped patient.
2. Do not lean on the nurse’s mayo tray.
 Non-sterile persons — when you are observing a case, please stay in the room
until the case is completed. Do not wander from room to room as traffic in the
operating room should be kept as a minimum. Patient privacy needs to be
respected.
 Keep non-essential conversation to a minimum.
 The circulating nurse is in charge of the room — if you have any questions, please
refer them to her, the supervisor or your instructor. Ask circulating nurse when it is
an appropriate time to ask questions so that explanations/rationale can be given.