y Asepsis is the freedom from disease. y The nurse s effort to minimize the spread of infection

are based on the principle of aseptic technique.

There 2 type of Asepsis
y Medical y Surgical

Medical Asepsis .

.Surgical Asepsis y Refers to those practice that keep an area or object free of all microorganism. y Used for all procedures involving the sterile area of the body.

Nasocomial Infection y Infection that are associated with the delivery of health care service in a health care facility. hospital environment or hospital personnel (exogenous). y Microorganism that cause Nasacomial infection can be originated from client themselves(endogenous) . .

Latrogenic infection y Direct result of diagnostic of therapeutic procedure e.g intravenous line .

.Hand Washing y Is the most important procedure for preventing nasomial infection because hand is the important route of transsmision of infection.

Purpose y To prevent cross infection of the patient. . y To protect the nursing personnel from pathogenic organism.

y Wash between finger . .Hand Washing y Use soap & warm water y Scrub your hand very well. wrist under fingernails . & back of hands.

.Social Hygienic hand washing y The lathering time should no less than 30 second.

This hygienic hand washing should be done prior to : y Giving medication y Before & after eating y After using toilet y When hand look dirty y After contact with patient .

Rub back of fingers to opposing palm with finger interlaced. Spreads fingers interlaced & rub firmly. Rub both palms firmly with closed fingers. Apply soap onto hand.Social/hygiene/medical hand washing y Avoid wearing ring. Place one hand into others. . y Turn on tap with elbow. Wet both hand under the running water. Allow water to run cotinuosly y y y y y y along the procedure.

Turn off tap with elbow. Repeat for the other hand. Repeat for other hand. Rinse both hands. y Grasp the thumb with other hand & rub in circular y y y y y motion..Continue . . Rubs clasped fingers on right hand in left palm using circular movement. y Repeat for other hand.

y Maintain both hands above the waist(pinggang) line.Continue . . y Repeat to other hand. y Dry other hand with tissue using one part of towel.

Picture .

Antiseptic/surgical Hand washing y The lathering time should no less than 1 minutes .

y On entering & leaving all high risk infection areas. . y After handling with contaminated material.This should be done prior to : y Before & after any procedure requiring an aseptic technique.

Antiseptic/surgical hand washing y Avoid wearing rings. wash fingertips untill elbow. Remove if wearing ring. . y Like the social hand washing .

Picture of hand washing .

. y The process which is an antimicrobial agents are applied to non-living object to destroy microorganisms.Disinfection y A process of eliminates all microorganisms.

y Antibiotics destroy microorganisms within the body. y Antiseptic destroy microorganisms on living tissue..Continue . .

Type of Disinfection y Alcohol y Halogens y Chlorine y Hypochlorite y Iodine y Oxidizing agents .

Alcohol y Wipes over benches skin & allowed to evaporated for quick disinfection. .

y Chlorine used to disinfect swimming pools & is added in a small quantity to reduce waterborne disease.Halogens y Chloramines used in drinking water treatment instead of chlorine. .

used to disinfect toilet & drains. .Hypochlorite y Often in form of common household bleach .

Iodine y Antiseptic for skin cut. .

.Oxidizing agents y Act by oxidizing the cell membrane result in liss of structure & leads to cell lysis & death.

Continue . y Acetid acid y Potassium permanganate . y Hydrogen peroxide used in hospital to disinfect surface.

.Sterilization y Is the complete elimination of all microorganisms including spores. y Use steam under pressure. y Hydrogen peroxide plasma & chemical. y Ethylene oxide gas (ETO).

Antiseptic y An antimicrobial substance that applied to living tissue or skin to reduce the possibility of infection. .

y Antibacterial are antiseptic that only act against bacteria.Some antiseptic are true y Germicides capable of destroying microbes. y Bacteriostatic only prevent their growth. .

Common Antiseptic y Alcohol used to disinfect the skin before injection are given. y Hydrogen peroxide solution to clean & deodorize wounds & ulcer. y Boric acid used in suppositories to treat yeast of the vagina. .

y Iodine used in alcohol solution (as pre & post- operative antiseptic) y Sodium chloride used as a general cleanser. Also used an antiseptic mouthwash..Continue . y Chlorhexidine used as skin antiseptic. .

respiratory tract & gastrotestinal tract. . y The skin .Barrier System Defense y Body s organ system have unique defenses against disease.

Universal/Standard Precaution y Technique of infection control : y .the use of barrier (gloves) y . y .proper hand washing y . .appropriate disposal of waste product & needles.proper care of spills.

All blood & body fluid like .
y y y y y y y y y

Blood Spinal fluid Vaginal secretion Semen Pericardial fluid Breast milk Amniotic fluid Peritoneal fluid *all blood & body fluid is considered potential infectious.

Personnel protective
y Gown y Mask y Protective eyewear y gloves

Primary reason for gowning
y To prevent soiling clothes during contact with the

client. y Protect health care personnel & visitor from coming in contact with infected material & blood or body fluid. y Can be disposable & reusable.

.Full Face Protection y Mask (topeng) should be worn when working with a client placed on airborne or droplet precaution. y Surgical mask protect a wearer that travel short distance (3 feet).

secretion .Gloves y Help to prevent the transmission of pathogen by direct & indirect contact.excretion. y Non sterile gloves should be worn touching blood. contaminate item . .body fluid .

stethoscope & gloves) y After removing protective equipment such as gloves or clothing.Hand Washing y Should washed hand immediately after & before physical contact with client (e.g diapers change) y Blood or body fluid y After contact with used equipment (e.g. .


& visitors. . client .Isolation Technique y To prevent spread of infectious microorganisms to health personnel .

Category y Specific isolation enteric precaution y Drainage or secretions precaution y Blood or body fluids precaution .

.Specific Isolation Precaution y For specific disease. .use private rooms with special ventilation.

.1.negative-pressure airflow . Airborne Precaution y Disease droplet nuclei smaller than 5um . disseminated zoster .measles .pulmonary or laryngeal TB. y Barrier Protection private rooms .chickenpox.mask or respiratory devices.

mumps . .pertussis. pharyngitis .2.cohort client s mask. y Barrier Protection private rooms .Droplet Precaution y Disease pharyngeal . rubella . pneumonia .

Contact Precaution y Disease . y Barrier Protection private or cohort client s gloves. varicella zoster. gown. . herpes simplex .direct client or environment contact infection with multidrug resistant organisms wound infections .scabies .3.

corridor) y Personal protective equipment.5 Pa. y Clean to dirty airflow in the direction is from the outside adjacent space.(e. y Windows do not open.g.Negative Pressure Isolation Rooms y Pressure differential of 2. .

5 8 Pa . preferable 8 Pa. y Airflow from the room to the outside adjacent space.Positive Pressure y Pressure differential of 2. or fungus that maybe in the environment or carried by staff & visitors. y Protect client from getting infection by bacteria . . viruses.


General/Domestic Waste y Is a waste that not contaminated with any hazardous chemicals .radioactive or other physical agents. infectious . .

Clinical Waste y Is classed hazardous waste that can cause harm to individual person & the environment. .


Group A Disposal y All human tissue soiled dressing & swabs including waste that is contaminated with blood or body fluids must be placed into yellow clinical waste bag. . y When 2/3 full the bag must be securely tied.

. contaminated broken glass.Group B Disposal y Syringes . y When sharp bin container 2/3 full the lid. it must closed closely. needles .

.Group C y Laboratory waste.

disinfection & their container.vaccines . unwanted or expired stock item should be returned to pharmacy. .Group D (A) y Pharmaceutical waste include all medicine products for internal & external use . These should be disposed as follow : 1. 2. Stock item empty stock item & treated as clinical waste group A.

. .Controlled Drug (B) y Empty pack of controlled drugs & treated as clinical group B.used or empty syringes IV bags for infusion which have contained control drugs should be treated as group B item.

apron & gloves must be disposed separately into cytotoxic waste container.Cytotoxic Drugs y All equipment used for their administration including sharps . .

.Vaccines(B) y Expired vaccines or used vaccines containers treated as Group B item.

Group E y Item used for disposal of urine & other body secretion must be treated as clinical waste in the hospital. .

y Black/Blue plastic bag other rubbish .Bins (tong sampah) y Yellow clinical waste y Red plastic beg linen that contaminated with blood. y Green plastic beg linen that contaminated with feaces & urines.


y Is practiced in operating room & special diagnostic areas.Sterile Technique y An object is sterile when is free from all microorganism. .

y Remove the sterilazation tape. .Procedure y Perform hand washing. y Letakkan item di atas tempat kerja. y Grasp (pegang dgn ketat) the outer surface of the tip of the outermost flap. y Open sterile item. y Work area is always above (atas pinggang) waist level.

y Hold the outside surface of the first side flap. y Open the side flap . keeping the arm outstretched & away from the sterile field. keep the arm to the side & do not allow the flap of the spring back over the sterile content.Continue y Open the outer flap away from the body. .

y Stand away from the sterile package &pull the flap back. y Open all the outside surface & the innermost flap. .Continue .

.Adding sterile Item y Use the inner surface of the package as a sterile pack to add additional sterile item.

Pouring Solution To Sterile Area y Held it label in the palm of hand to prevent the possibility of the solution wetting & fading(tumpah) the label. . y The edge (hujung) of the bottle & container is kept away.

. y The bottle should be held outside the edge of the sterile field.y Pour the solution slowly to avoid splashing (tertumpah).


Equipment *Surgical face mask .

. y The two lower ties snugly (comfortable) around neck with mask well under chin. y Ties the top string above the ears. It has thin metal trip along edge.Procedure y Find top of mask.

the untie the top (atas) tie. y Change the mask if wet or contaminated. y Untie the bottom (bawah) .Removal of Surgical Mask y Remove mask by handling only the ties. y Remove the mask from your face. y Properly dispose the mask by touching only the ties. .