C.

1 ASEPSIS AND
INFECTION CONTROL
NCM 103
 INFECTION
An infection is the result of an interaction between a susceptible
host and an infectious agent (bacteria, viruses, fungi, parasites) a
clinical syndrome caused by the invasion and multiplication of a
pathogen in the body.

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 INFECTIONS ARE:
O Localized
O Systemic

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 COURSE OF INFECTION THE COURSE OF AN
INFECTION CAN BE
DIVIDED INTO FOUR MAJOR PHASES:

1. Incubation
2. Prodromal
3. Period of Clinical illness
4. Convalescence

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 TRANSMISSION OF INFECTIONS
Health Care institutions can present a danger in infectious disease
transmission.

Nosocomial infection - a hospital-acquired infection

Iatrogenic infection – a direct result of treatments

Patients are at risk for nosocomial infection because they often have weakened
immune systems and because the health care facility contains patients and
equipment that harbor infection. An Iatrogenic infection is the direct result of
treatments.
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 PRIMARY DEFENSES AGAINST
INFECTION
1. Skin and mucous membrane
2. Respiratory system
3. Gastrointestinal system
4. Circulatory system

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 SECONDARY DEFENSES AGAINST
INFECTION
1. INFLAMMATORY RESPONSE - Local reaction to an infectious agent.
Serves to localize, destroy, dilute, neutralize, remove a pathogen
SIGNS – redness (rubor), heat (calor), swelling (tumour) and pain (dolor)

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 SECONDARY DEFENSES AGAINST
INFECTION
2. IMMUNITY is a
measure of a person’ s
ability to fight disease
by forming
immunoglobulins
(antibodies formed
against invading
antigens), or
producing interferon.
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 COMPONENTS
OF THE
INFECTION
CYCLE

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 Components of the Infection Cycle
Infectious agent—bacteria, viruses, fungi
Reservoir—natural habitat of the organism
Portal of exit—point of escape for the organism
Means of transmission—direct contact, indirect contact,
airborne route
Portal of entry—point at which organisms enter a new host
Susceptible host—must overcome resistance mounted by
host’s defense
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 CHAIN OF
INFECTION

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 SOURCE OF INFECTION/
PATHOGENIC ORGANISM

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 FACTORS AFFECTING AN ORGANISM’S
POTENTIAL TO PRODUCE DISEASE

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 POSSIBLE RESERVOIRS FOR
MICROORGANISMS
O Other humans
O Animals
O Soil
O Food, water, milk
O Inanimate objects

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 COMMON PORTALS OF EXIT
O Respiratory
O Gastrointestinal
O Genitourinary tracts
O Breaks in skin
O Blood and tissue

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 MODE OF TRAMNSMISSION

O Direct contact
O Droplets
O Vectors
O Airborne

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 PORTAL OF ENTRY TO HOST
O Eyes
O Mucous membranes
O Respiratory tract
O Placenta Breaks in
the host barriers

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FACTORS AFFECTING HOST SUSCEPTIBILITY
O Intact skin and mucous membranes
O Normal pH levels (7.35 – 7.45)
O Body’s white blood cells
O Age, sex, race, hereditary factors
O Immunization - natural or acquired
O Fatigue, climate, nutritional and general health status
O Stress
O Use of invasive or indwelling medical devises

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  FACTORS PREDISPOSING PATIENTS TO
NOSOCOMIAL INFECTIONS
O Use of invasive medical devices
O Antibiotic-resistant organisms developed in hospitals

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 MEASURES TO REDUCE INCIDENCE OF
NOSOCOMIAL INFECTIONS
O Constant surveillance by infection-control committees and
nurse epidemiologists
O Written infection-prevention practices for all agency personnel
O Hand hygiene recommendations
O Infection control precaution techniques
O Keeping patient in best possible physical condition

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  STAGES OF INFECTION
O Incubation period—organisms growing and
multiplying
O Prodromal stage—person is most infectious, vague
and nonspecific signs of disease
O Full stage of illness—presence of specific signs and
symptoms of disease
O Convalescent period—recovery from the infection

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 NATIONAL PATIENT SAFETY GOAL
O Reduce the risk of health care–associated infection.
According to the Center for Disease Control and
Prevention, each year, millions of people acquire an
infection while receiving care, treatment, and services
in a health care organization. Consequently, health
care-associated infections (HAIs) are a patient safety
issue affecting all types of health care organizations.

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 QUALITY AND SAFETY EDUCATION IN
NURSING (QSEN)
The goal of QSEN is to address the challenge of
preparing future nurses with the knowledge, skills
and attitudes (KSA) necessary to continuously
improve the quality and safety of the healthcare
systems in which they work. They have 6
competencies and Safety is one of the main
competencies.
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 SAFETY – INFECTION CONTROL
Infection control measures used in the hospital
include:
1. Medical Asepsis
2. Standard Precautions
3. Isolation Precautions

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 INFECTION CONTROL -- MEDICAL
ASEPSIS
Definition:
Practices designed to reduce the numbers of pathogenic
microorganisms and limit their growth and transmission
in the patient’s environment
Medical asepsis, or clean technique, refers to practices
designed to reduce the numbers of pathogenic
microorganisms and limit their growth and transmission
in the patient’s environment.
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 MEDICAL ASEPSIS – HAND HYGIENE
The first line of defense in
medical asepsis is hand
hygiene.
Proper hand-hygiene is
considered the single most
effective way to stop the
spread of microorganisms
and preventing infection.
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 WHEN SHOULD YOU WASH YOUR
HANDS ?
At the start of each shift Before and after performing
After sneezing or coughing any treatments
After using the bathroom After removing gloves
After handling contaminated At the end of each shift before
items leaving the health facility
Before and after giving patient
care and between patients.
After handling body excretions-
even with gloves on
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 Guidelines and Principles Medical Asepsis

These 3 are necessary to remove O Jewelry makes it difficult to

microorganisms: adequately cleanse the hands. It is
Do not touch the sink when washing best to not wear jewelry in the
hands – stand away clinical setting. Wedding bands
Keep clean items separate from dirty are acceptable sometimes.
ones. O If using hand lotion—allow hands
Turn off water with a dry paper towel to dry about 30 minutes before
– wet acts as a wick. applying. Do NOT apply hand
1. Friction lotion immediately after washing
2. Cleansing Agent hands.
3. Running Water
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 Alcohol Based Handrubs
Alcohol-based hand rubs (foam or gel) kill
more effectively and more quickly than
hand washing with soap and water.
They are less damaging to skin than soap
and water, resulting in less dryness and
irritation.
They require less time than hand washing
with soap and water.
Bottles/dispensers can be placed at the
point of care so they are more accessible.
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How to use Handrubs HAND RUB (foam and gel)
Apply to palm of one hand (the
amount used depends on specific
hand rub product).Rub hands
together, covering all surfaces,
focusing in particular on the
fingertips and fingernails, until dry.
Use enough rub to require at least 15
seconds to dry.
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 STANDARD PRECAUTIONS
O Set of guidelines developed by the Centers for Disease Control
and Prevention (CDC) for preventing contact with potentially
infectious blood or body fluids that may harbor diseases
regardless of whether or not they contain visible blood

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 STANDARD PRECAUTIONS ARE USED
FOR:
All body fluids, secretions and excretions regardless of whether or not they contain visible blood
Sputum
Saliva
Urine
Feces
Nasal secretions
Tears
Vomitus
Spinal fluid/ cerebrospinal fluid
Synovial, pleural, peritoneal , pericardial, amniotic fluid
All moist
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F. MONGE, MAN mucus membranes Blood 10/29/2022 31
 STANDARD PRECAUTIONS
Used for all patient’s, not just those with known infections.
These precautions should be implemented whenever contact with
potentially infectious material is anticipated.
Used to protect the caregiver.

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 COMPONENTS OF STANDARD
PRECAUTIONS
O HAND HYGIENE

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 O PERSONAL PROTECTIVE DEVICES

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O AVOID RECAPPING OF NEEDLES; DISPOSE OF SHARP
OBJECTS APPROPRIATELY

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 O RESPIRATORY HYGIENE/ COUGH ETIQUETTE

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 BLOOD and BODY FLUID SAFETY

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 CONTACT PRECAUTIONS
Purpose is to prevent the transmission of
disease by direct or indirect contact. Direct
contact involves:
Touching
Bathing
Skin-to-skin contact
Indirect contact involve: Contact with
inanimate objects – doorknobs, light
switches, tabletop, telephones
Examples of diseases are: staph, herpes,
diphtheria, and many others

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 O Contact precautions include use of
barrier precautions such as gloves and
impermeable gowns to prevent direct
contact with infectious organism
O Used: With patients who are infected
by a multi-drug resistant organism
(MDRO), For patient with diarrhea
O When coming into contact with
draining wounds
O Patients with acquired antibiotic
resistance infections
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Contact Precautions Place the patient
in a private room if possible
O Wear PPE when entering the room
for all interactions that may involve
contact with the patient or
contaminated areas in the patient’s
environment
O Remove PPE before leaving the room
and perform hand hygiene
O Avoid sharing patient-care equipment
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 DROPLET PRECAUTIONS
Organisms that can be spread by large-
particle droplets. Examples of
organisms include:
Influenza
Cold
Meningitis
Mumps
Pertussis
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 Droplet Precautions Single rooms are
preferable
O Patients with same disease can share the same room
O Standard surgical masks and gloves must be worn for anyone
entering the patients room.
O Gloves should be worn anytime handling tissues or items
contaminated with the respiratory secretions
O Keep visitors 3 feet from the infected patient.

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 AIRBORNE PRECAUTIONS

Used when the organism is capable of

remaining in the air for prolonged
periods of time and can be transported
in the air .Most common organisms are:
Tuberculosis
Chicken pox
Measles
Must wear a special particulate filter
mask
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 A private negative air pressure room is used for patients
needing airborne precautions.

Negative air pressure rooms are

used for patients needing airborne
precautions
Bring air into the room from the
hallway and have a separate
exhaust system.
Outside the room is isolation cart
that contains supplies needed to
care for the patient and protects
persons entering the room.
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O Personal Care - **Remember it is the disease
that is being isolated, not the patient
O Place linens in proper contaminated –waste
container, and soiled paper towels in an
isolation waste container.
O Food Service – disposable paper trays and
disposable dishes that are discarded in proper
isolation waste container.
O Do not put tray back on the food cart.
O Contaminated articles – accordingto agency
policy, usually doublebagged or color-coded
wastebags to indicate contaminated waste. 43
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 Airborne Isolation
O All patients on airborne precautions should wear surgical
masks when leaving the negative air pressure room for x-rays,
tests, or procedures.

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 Protective / Strict Isolation
O Used with patients who are immune compromised such as:
Chemotherapy , AIDS, Organ transplants

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DISINFECTION and
STERILIZATION
NCM 103
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 CLEANING

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 SANITIZING

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 DISINFECTION

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 STERILIZATION

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 STEAM STERILIZATION

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 GAS STERILIZATION

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 RADIATION

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 CHEMICALS

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 BOILING

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 TYPES OF DISINFECTION

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