Asepsis

Microorganisms

• Microorganisms are everywhere in the air ,

soil and water and on and within everyone

• Once microorganisms invade one of the three

events occurs:
• 1- body’s immune system mechanism
eliminate them
 Continue

• 2- Inside of the body without causing disease

• 3- or they cause infection or infectious disease
• The type and number of microorganisms are
factors that influence whether an infection
develops
 Types of Microorganisms
• 1- Nonpathogens or Normal Flora : harmless
beneficial microorganisms m live on human
body, find in an external of the body such as
skin , nose , mouth , throat , lower urethra
and intestines.
• This type of non- pathogens inhabit
pathogenic growth and reproduction
 Continue
• 2- Pathogens : Have a high potential for
causing infectious communicable disease :
disease that can be transmitted to other
people also called . Contagious disease and
community-acquired infectious.
• Examples of communicable diseases are
measles , streptococcal sore throat , sexually
transmitted infections and TB
• Can lead to death
 Continue
• Can cause illness and treatment by using
broad-spectrum antibiotics , those drugs
prescribed to eliminate bacteria
• Pathogen may cause infectious when the host
is immunosuppressed AIDS , cancer
chemotherapy or steroid drug therapy
• Non-pathogen and pathogen include : bacteria , viruses ,
fungi , rickettesiae , protozoan's , mycoplasmes , helminthes
and prions
 Bacteria

• Appears in various shapes : round (coci) , rod

shape ( bacilli) , and spiral (spirochetes)
• Aerobic bacteria require oxygen to live
• Anaerobic bacteria exist without oxygen
 Viruses
• Smallest microorganisms known to cause
infectious disease , visible only under
microscope .Some virus can be dormant and
reactivated occurrence such as herpes which
can cause cold sores , fever blister
• Some virus are minor can be itself treated
such as common cold , some are fatal such as
rabies , poliomyelitis , hepatitis and AIDS
 Fungi
• Include yeasts and molds , three types
• 1- superficial ( Mycotic) effect skin , mucous
membrane , hair and nails example tinea pedis
athlete’ foot…
• 2- intermediate affect subcutaneous tissue such
as fungal granuloma inflammatory lesion under
the skin
• 3- Systemic effect deep tissue organs such as
histoplasmosis in the lungs
 Rickettsiae
• Resemble bacteria , like viruses they cannot
survive outside another living species
• Fleas , ticks , lice , mites transmit rickettsiae
disease to humans , problem found in a
wooded areas
• Protozoan's : are single-celled animals
classified to their ability to move some extent
to the cell wall , some to the hair like and
some cannot move
 Mycoplasmas
• Infect the surface lining of the respiratory ,
genitourinary and gastrointestinal tracts
• Helminthes : infectious worms are
microscopic classified into 3 major groups
• Helminthes : invade the body and excreted
and the cycle begins again
• Prions ( are students self study )
 Chain of Infection
• Are six essential components in the chain of
infection
• 1- An infectious agent
• 2- A reservoir for growth & reproduction
• 3- Exist route from the reservoir
• 4-A means of transmission
• 5- Portal of Entry
• 6- Susceptible host – “discuss fig 135”
 1- Infectious Agents
• The agents for infection as we discussed
before : bacteria , virus. Fungi…
• 2- Reservoir : is a place where microbes grow
and reproduce , some produce disease S&S
• Asymptomatic clients or animals that harden
pathogens but do not show evidence of
infectious disease are known as carries .
Nonliving reservoirs are fomites
 3-Exist Route
• How microorganisms escape from their
original reservoir and move about
• When present within or on humans they are
displaced by handling or touching objects or
whenever blood , body fluids , secretions and
excretions are released
• Soil provide mechanism for escape
 4- Means of Transmission
• is how infectious microorganisms move to
another location
• Microorganisms are transmitted by one of the
five route : contact , droplet , airborne ,
vehicle , vector
• Discussion table 10-1 page 136
• ( Important one )
 5- Portal of Entry
• Is where microorganisms find their way onto
or into a new host
• Common port of entry is an open skin or
mucous membranes
• Microorganism can be inhaled . Swallowed ,
introduce into the blood or transferred into
body tissues or cavities through unclean
hands or contaminated medical equipments
 Continue

• There are 2 types of biologic defense

mechanisms :
 Continue
• A-Mechanical : defense mechanisms are
physical barriers that prevent microorganisms
from entering the body example include intact
skin and mucous membrane , reflexes ,
sneezing and coughing , the Phagocytes and
Macrophage all are type of mechanical
defense
 Continue
• B-Chemical defense mechanism : destroy the
capacity of microorganisms for example
Lysozyme an enzyme found in the tears can
dissolve the cell wall of some microorganisms
• 6-Suscetible Host : to the human that the
biologic defense mechanism is weakened , the
most susceptible client to the infection are
those :
 Continue
• Burn *Suffered from major trauma
• Invasive procedures such as endoscopes or
catheterization
• Intravenous catheter *Infection with HIV
• Inappropriate taken of antibiotics which
promote microbial resistance
• Receiving anticancer drugs or anti-
inflammatory drugs that suppers the immune sys
 5- Susceptible Host
• Humans when the defense mechanism
diminished or impaired become susceptible to
infection ( discuss box 10-2 page 137)
• Particularly susceptible clients include those
who:
• Points page 137
 Asepsis

• Nurses must understand and practice

methods to prevent : Health Care-associated
infections , infection acquired while a person
is receiving care in a health care agency also
called Nosocomial infection
 Asepsis
• Means those practices that decrease or
eliminate infectious agents , their reservoirs
and vehicles for transmission , it is the major
method for controlling infection so we use
Medical & Surgical Asepsis to accomplish our
goal in infection control
 Medical Asepsis
• Means those practices that confine or reduce
the numbers of microorganisms also we called
Clean Technique , it involve measures that
interfere with the chain of infection in various
ways
• The following principles underlie medical
asepsis: points page 137
 Continue

• Examples of medical asepsis practices include

using antimicrobial agents , performing hands
hygiene , wearing protective garments ,
confining and containing soiled materials
appropriately and keeping the environment as
clean as possible
 Using Antimicrobial Agents
• Are chemicals that destroy or suppress the
growth of infections microorganisms
• Table 10-2 page 138
• Some are used to clean equipment , surfaces
and objects , others are applied directly to the
skin or administered internally examples are
antiseptic disinfectants and anti-infective
drugs
 Antiseptics

• Also known as bacteriostatic agents , inhibit

the growth of but do not kill microorganisms
• Example is alcohol
• Antiseptics applied to the skin and mucous
membranes some used to cleaning agents
 Disinfectants
• Also called germicides and bactericides
destroy active microorganisms but not spores
• Phenol and formaldehyde are examples
• Disinfectants are rarely applied to the skin
because they are very strong
• Are used to kill and remove microorganisms
from equipments , walls and floors
 Anti- Infective Drugs
• Two groups of drugs are:
• 1- Antibacterial s 2- Antiviral

• The chemical actions of antibacterial consist

of antibiotics and sulfonamides that damage
or destroy bacteria cell wall but not viruses
 Continue
• Antiviral agents were developed more
recently due to the raising incidence of
influenza and blood-borne viral diseases such
as Hepatitis and AIDS
• Most antiviral do not destroy infecting viruses
control viral replication which is multiplication
or copying , some virus such as type of Herpes
are dormant can be reactivate
 Hand Hygiene
• Hand washing is a medical aseptic practice
that involves cleaning the hands with soap
and water and friction to mechanically
remove dirt and organic substances
• After dealing with soiled equipments , blood ,
fluid , using toilet ….
 Continue
• Hand washing removes : Resident
Microorganisms which is generally non-
pathogens present on the skin
• Transient Microorganisms , which is
pathogens picked up during brief contact with
contaminated reservoirs
• Health care providers use hand washing when
touching or using equipment
 Continue
• It is not surprise that hand hygiene is the
single most effective way to prevent infections
• Skill 10-1 describes the step of hand washing ,
page154 ( students bring video assignment)
• WHO 2009 introduced and identified five
moments for hand hygiene page 140
• table 10-3
 Performing Hand Antisepsis
• To improve compliance with hand washing ,
guidelines for hand antisepsis with alcohol
based hand rubs has been developed
• Hand antisepsis means the removal and
destruction of transient microorganism with
soap and water
• Involves : alcohol based liquid , thick gel and
foams
• Self study box 10-3 page 141
 Continue

• Alcohol – base rub remove microorganisms of

the hands including negative and positive
gram bacteria , fungi , virus…
• Advantages of alcohol – based hand rubs : see
points page 139 are 7 points
 Performing Surgical Hand
Antisepsis
• Previously referred to as surgical scrub , is a
medically aseptic hand-hygiene procedure that is
performed before donning sterile gloves and
garments , when the nurse in operation or obstetric
procedure
• See table 10-3 page
• To remove transient microorganism from hands ,
fingers , nails , forearm , nails short no polish,
remove rings , watch can jewelry:
 Wearing Personal Protective
Equipment
• To reduce the transfer of microorganisms
between themselves and clients health care
providers were various garments : uniform ,
scrub unit or gowns , mask , gloves , hair and
shoes covers and protective eyewear
• Health providers wear some of these items
regardless the diagnosis or the infectious
status
 Continue
• Assignments for the students:
• Prepare and present about;
• UNIFORM SRUB SUITS GOWNS
• MASKS RESPIRATORS
• PROTECTIVE EYEWEAR
• CONFINING SOILED ARTICLES
• KEEPING ENVIRONMENT CLEAN
• (All required for the exams)
 Surgical Asepsis

• Surgical asepsis means those measures that

render supplies and equipment totally free of
microorganisms
• Sterile techniques include practices that avoid
contamination microbe-free items both begin
with the process of sterilization
 Sterilization
• Consists of physical and chemical techniques
that destroy all microorganisms including
spores
• Sterilization of equipment done in health
agency , center sterile supply department
CSSD or commercially
• All identify label and safe use
 Physical Sterilization
• Microorganisms and spores are destroyed
physically through : radiation , or heat , boiling
water , free-flowing steam , dry hear and stem
under pressure.

• Stem under pressure in autoclave most

effective methods CSSD : Explain
 Continue
• -Dry Heat : or hot air sterilization is similar to
baking items in an oven to kill microorganism
need in a dry heat at least 3 hours this is good
for sharp instrument , syringes..
• -Steam under pressure : this is the most
effective way to kill microorganism including
spores using autoclave found in hospital in
Center Sterile Supply Department CSSD
 Chemical Sterilization

• Both gas and liquid chemicals are used to

sterilize invasive equipment
• Chemical we have some questions about
reliability
• Gas using ethylene oxide gas traditional
method to destroyed microorganisms
 Principles of Surgical Asepsis
• Is based on the premise that once equipment
and areas are free of microorganisms can be
remain if there is no contamination
• Health care providers observe the following
principles known as sterile technique
• Points page 145
• Using principles of sterile asepsis during surgery
, invasive procedure such as catheters, caring
for open wound
 Continue
• Practices that involve surgical asepsis include
creating a sterile field , adding sterile items to
the sterile field , adding sterile solutions,
• Putting on and removing sterile gloves ,
putting on sterile gown
• (Shown in the lab )
• Nursing implication ( Nursing Process) page
146