Chapter 10 Asepsis

1. Chapter 10 Asepsis

3. Microorganisms • Living animals or plants visible only with a microscope; also commonly called germs • The body’s immune defense mechanisms eliminate them • They reside within the body without causing disease • They cause an infection or infectious disease

4. Types of Microorganisms • Bacteria • Protozoans • Viruses • Mycoplasmas • Fungi • Helminths • Rickettsiae • Prions

5. Categorization of Microorganisms

6. Survival of Microorganisms • Requirements: warmth, darkness, O2, H2O, & nourishment. • Spores • Temporarily inactive microbial life form; resist heat and destructive chemicals; reactivate and reproduce when possible • Antibiotic-resistant bacterial strains • No longer respond to drugs that once were effective against them

7. Chain of Infection • An infectious agent • A reservoir for growth and reproduction • An exit route from the reservoir • A mode of transmission • A port of entry • A susceptible host

9. Chain of Infection (cont’d)

10. Biologic Defense Mechanisms • Anatomic or physiologic methods that stop microorganisms from causing an infectious disorder • Mechanical: physical barriers that prevent MO from entering the body or expel them before they multiply • Chemical: destroy or incapacitate MO through natural biologic substances

11. Nosocomial Infections • Nosocomial infections are infections acquired while a person is receiving care in a health care agency

13. Asepsis • Practices that decrease or eliminate infectious agents, their reservoirs, and vehicles for transmission • A major method for controlling infection • Health care professionals use medical and surgical asepsis to prevent spread of infections

14. Medical Asepsis • Confines or reduces the numbers of microorganisms • Involves measures that interfere with the chain of infection in various ways • Examples: • Performing hand hygiene • Wearing hospital garments

15. Surgical Asepsis • Measures that render supplies and equipment totally free of MOs • Practices that avoid contaminating microbe-free items • Examples: • Physical sterilization • Chemical sterilization

16. Principles of Medical Asepsis • MOs exist everywhere except on sterilized equipment • Frequent hand washing and maintaining intact skin reduces transmission of MOs • Blood, body fluids, cells, and tissues are major reservoirs of MOs • Personal protective equipments serve as barriers to microbial transmission

17. Principles of Medical Asepsis (cont’d) • A clean environment reduces MOs • Cleaning should be done from cleaner to dirtier areas

18. Practicing Hand Antisepsis • Apply a volume of the product to the palm of one hand or the amount recommended by the manufacturer • Distribute the product to cover all surfaces of the hands and fingers • Rub the product between the hands for 15 to 25 seconds until they are dry

19. Hand Antisepsis

20. Types of Hospital Garments • Gloves • Scrub suits and gowns • Masks • Uniforms • Hair and shoe covers • Protective eyewear

21. Hospital Garments

22. Utility Rooms • Health care agencies: at least 2 utility rooms (clean and dirty); personnel must not place soiled articles in the clean utility room • The utility room contains: • Covered waste receptacles and laundry hampers • Flushable hopper and a sink • Equipment for testing stool or urine

23. Concurrent Disinfection • Clean less-soiled areas before grossly dirty ones • Wet-mop floors and damp-dust furniture to avoid distributing microorganisms on dust and air currents • Frequently discard solutions used for mopping in a flushable hopper • Never place clean items on the floor

24. Terminal Disinfection • More thorough than concurrent disinfection and consists of measures used to clean the client environment after discharge • Includes scrubbing the mattress and the insides of drawers and bedside stands

25. Sterilization • Consists of physical and chemical techniques that destroy all microorganisms including spores • Physical sterilization: radiation, boiling water, free-flowing steam, dry heat, steam under pressure • Chemical sterilization: peracetic acid, ethylene oxide gas

26. Principles of Surgical Asepsis • Once equipment and areas are free of MOs, they remain in that state if contamination is prevented • Sterility preserved: touching one sterile item with another that is sterile • Once a sterile item touches something that is not sterile, it is considered contaminated • Any partially unwrapped sterile package is considered contaminated

28. Principles of Surgical Asepsis (cont’d) • Question the sterility of an item considered unsterile • Longer the time since sterilization, the more likely that the item is no longer sterile • Commercially packaged sterile item is not considered sterile past its recommended expiration date • Opened sterile item or area, left unattended, is considered contaminated

29. Principles of Surgical Asepsis (cont’d) • Once a sterile item is opened or uncovered, it becomes contaminated • The outer 1-inch margin of a sterile area is considered a zone of contamination • A wet sterile wrapper wicks microorganisms from its supporting surface, causing contamination

30. Principles of Surgical Asepsis (cont’d) • Coughing, sneezing, or excessive talking over a sterile field causes contamination • Reaching across an area that contains sterile equipment may cause contamination • Sterile items located or lowered below waist level are considered contaminated

32. Adding an Agency-Sterilized Item

33. Adding Sterile Gauze

34. Adding Sterile Solution

35. General Gerontologic Considerations • Older clients more susceptible to infections • Maintain intact skin, proper aseptic techniques, perineal hygiene, thorough handwashing; indwelling catheters should be avoided • Bladder training, annual immunizations • Ill health care workers should take sick leave rather than expose susceptible clients to infectious organisms