Asepsis

 Identify risks for nosocomial

infections.
 Explain chain of infection.

 Identify factors influencing a

microorganism's capability to
produce an infectious process.
 Identify measures that break each

link in the chin of infection.

 Asepsis
Asepsis is the freedom from
disease-causing microorganisms.
To decrease the possibility of
transferring microorganisms
from one place to another,
asepsis is used.
Sepsis is the state of


infection and can take

many forms, including
septic shock.
 Types of
microorganisms
causing infections
1. Bacteria can live and be transported
through air, water, food, soil, body tissues
and fluids, and inanimate objects.
2. Viruses (causes the common cold)
hepatitis, herpes, and human
immunodeficiency virus.
3. Fungi include yeasts and molds. Candida
albicans
4. Parasites They include protozoa such as
the that causes malaria.
 Method of transmission
 Direct : from person to person (droplet spread).
 Indirect:
- Vehicle-born (substance transport the infectious
agent (e.g . Surgical instrument, infected milk
….etc
- vector-born (animal serves a an intermediate means
of transporting the infectious agent).
 Airborne (e.g. dust, tuberculosis can remain in air
for along period)
 Nosocomial infections

classified as infections that are
associated with the delivery of health
care services in a health care facility.
Nosocomial infections can either
develop during a client's stay in a
facility or manifest after discharge.
 The incidence of nosocomial infections is
significant. Major sites for these
infections are the respiratory and
urinary tracts, the bloodstream, and
wounds.
 Sources could be

1. endogenous ( from the patients

themselves).
2. Exogenous (from the hospital
environment)
 Factors that contribute to nosocomial
infection risks are
1. iatrogenic (medical therapy like invasive
procedures)
2. the existence of a large number of susceptible
persons (compromised hosts whose defenses
have been lowered,
3. inappropriate use of antibiotics, and
insufficient hand washing after client contact
and after contact with body substances.
Chain of
infection
 1
Etiologic agent
microorgnanisms(
)

6 2
Susceptible Reservoir
host )source(

5 3
Portal of entry Portal of exit
to the from reservoir
susceptible host

4
Method of
transmission
1. Etiologic agent
The any microorganism
is capable of producing
an infectious process
depends on the number
of microorganisms
present.
 Reservoir .2
There are many
reservoirs, or sources of
microorganisms,
common sources are
other humans, the
client's, plants, animals,
or general environment.
 3. Portal of exit from
reservoir

Before an infection can
establish itself in a host,
the microorganisms must
leave the reservoir.
 4. Method of
transmission
There are three
mechanisms
 Direct transmission .1
Involves immediate and direct
transfer of microorganisms
from person to person through
touching, biting, kissing, or
sexual intercourse. Droplet
spread is also a form of direct
transmission.
 Indirect transmission .2
 Material objects, such as toys,
soiled clothes, cooking or
eating and surgical
instruments, or dressing,
water, food, blood, serum, and
plasma. Animal or flying.
3. Airborn transmission

may involve
droplets or dust.
 Portal of entry .5

Before a person can become
infected, microorganisms must
enter the body. The skin is a
barrier to infectious agents;
however, any break in the skin
can readily serve as a portal of
entry.
 Susceptible Host .6
A susceptible host is any
person who is at risk for
infection. A compromised
host is a person at
"increased risk"
 Factors Increasing
Susceptibility to Infection
1. Age influence the risk of
infection.
2. Heredity influences the
development of infection.
3. The nature, number,
and duration of physical
and emotional stressors
can influence
susceptibility to infection.
 Stressors elevate blood
cortisone. Prolonged
elevation of blood cortisone
decrease anti-inflammatory
responses depletes energy
stores, lead to a state of
exhaustion, and decrease
resistance to infection.
4. Resistance to infection depends on
adequate nutritional status.
5. pre-existing disease
6. Current medical therapies
predispose a person to infection. For
example, radiation treatments for
cancer, some diagnostic procedures
may also predispose the client to an
infection.
7. Certain medication also
increase susceptibility to
infection. Anticancer
medications may depress bone
marrow function, resulting
inadequate production of white
blood cells, anti-inflammatory
and antibiotics medications.
 Cleaning, Disinfecting, and*
Sterilizing
The first links in the chain of infection, the
etiologic agent and the reservoir, are
interrupted by the use of antiseptics (agents
that inhibit the growth of some
microorganisms) and disinfectants (agents
that destroy pathogens other than spores)
and by sterilization (destroy all
microorganisms including spores and
viruses.
 Cleaning
Cleanliness inhibits the growth
of microorganisms. When
cleaning visibly soiled objects,
nurses must always wear gloves
to avoid direct contact with
infections microorganisms.
 Disinfecting
 A disinfectant is a chemical
preparation, such as phenol or iodine
compounds, used on inanimate objects.
 Disinfectants are frequently caustic and

toxic to tissues. An antiseptic is a

chemical preparation used on skin or
tissue.
 Disinfectants and antiseptics
often have similar chemical
components, but the disinfectant
is a more concentrated solution.
When disinfecting articles,
nurses need to follow
agency protocol and
consider the following:
1. The type and number of infectious
organisms.
2. The recommended concentration of
the disinfectant and the duration of
contact.
3. The temperature of the environment.
4. The presence of soap. Some disinfectants
are ineffective in the presence of soap or
detergent.
5. The presence of organic materials, the
presence of saliva, blood, pus can readily
inactive many disinfectants.
6. The surface areas to be treated. The
disinfecting agent must come into contact
with all surfaces and areas.
 Sterilizing

Sterilization is a process
that destroys all
microorganisms, including
spores and viruses.
 Four commonly used
methods of sterilization are
1. Moist heat (steam under
pressure or free steam)
2. Gas (ethylene oxide)
3. Boiling water
4. Radiation
 Universal precaution for
infection prevention
 Isolation: is these measures
designed to prevent the spread of
infection to health personal clients,
and visitors.
 Isolation precaution: are medical
aseptic methods to limit the spread
of infectious disease (various
barriers).
The main purposes for isolation
precautions
 Block contact with any way those
organisms may exit from the client
 Protect the nurse from self-
contamination through a portal of
entry
 Prevent the transfer of pathogens to
other clients or visitors
 Systems of precaution
 1. category-specific isolation
 2. disease-specific isolation
 Category-specific isolation
precautions
 Table 4-1 category- specific isolation
precautions (very important)
 Definition of Isolation Precautions
.Source: Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier

 Special precautionary measures,

practices, and procedures used in the care
of patients with contagious or
communicable diseases

40
CDC Guidelines for Isolation 1996
Precautions in Hospitals
Hospital infection control practices
advisory committee (HICPAC)
)page 129-137(

41
 Isolation Precautions

Hand hygiene

Patient
placement PPE

Patient
Transport
Isolation
Routine and
Precautions Terminal Cleaning

Linen & laundry

Patient care equipment
And articles

Unit 6 - Infection Control Mea 42

sures
 Standard Precaution - Hand hygiene
Handwashing with either plain or antiseptic
containing soap and water, and use of
alcohol-based products (gels, rinses,
foams) that do not require the use of
water

Perform hand hygiene:

• Before and after patient contact
• After removing gloves or any other
PPE item
• After touching blood, body fluids,
secretions, excretions, and
contaminated items, whether or not
gloves are worn

43
 Standard precautions
Personal protective equipment
(PPE)
 The selection of PPE based on
• The nature of patient interaction and/or
• The likely mode(s) of transmission
 Designated containers for used
disposable or reusable PPE should be
placed in a convenient to the site of
removal
 Hand hygiene is always the final step
after removing and disposing of PPE
44
 Standard precautions – Gloves (PPE)

1. Exposure to blood, body

fluids, secretions, excretions, 2.Change gloves when heavily
mucous membranes and non- contaminated
intact skin, and contaminated
items

3. Perform hand hygiene

immediately after glove 4. Disposable glove should not
removal be reused

45
 Standard precautions – Gown (PPE)

When splashes or .1
sprays of blood and
body fluids,
secretions and When working clothes .2
excretions to skin and
has substantial
working clothes are
likely contact with patient,
environmental
surfaces or patient
items

Select an appropriate gown for the procedure .3

46
Standard precautions – Mask and eye protection (PPE)

Surgical masks and eye protection:

• When splashes or sprays of blood
and body fluid, secretions and
excretions are likely
• Sterile technique
• Respiratory protocol

Change PPE promptly if heavily

contaminated during the procedure

47
Sterile Technique
The basic principles
of surgical asepsis
1. All objects used in a sterile field
must be strile.
2. Sterile objects become un-sterile
when touched by un-sterile
objects.
3. Sterile items that are out of
vision or below the waist level of
the nurse are considered unsterile.
4. Sterile objects can become
unsterile by prolonged
exposure to airborne
microorganisms.

5. Fluids flow in the direction

of gravity.
6. Moisture that passes through
a sterile object draws
microorganisms from un-
sterile surfaces above or
below to the sterile surface by
capillary action.
7. The edges of a sterile
field are considered un-
sterile.

8. The skin cannot be

sterilized and is un-sterile.