Asepsis

1. Asepsis

2. Related terms • Normal resident flora (bacteria)the collective vegetation in a given area, yet produce infection in another. • Infection : invasion and proliferation of microorganisms in certain body tissues. • Disease : a detectable alteration in normal tissue function

3. Related terms • Virulence(Pathogenicity):the ability of microorganism to produce disease. • Opportunistic pathogen • CDC (Centre for Disease Control)

4. Asepsis • The freedom from disease-causing microorganisms • Medical asepsisall practices used to limit the number of microorganisms, growth and transmission. - Clean objects: absence of almost all microorganisms. - Dirty (Soiled, Contaminated) : have microorganisms, some of which capable of causing infection. • Surgical asepsis (Sterile Technique): practices that keep area or object free from all microorganisms (sterilization by using autoclave). • Sepsis : the state of infection, may includes septic shock.

5. Microorganisms causing infections • Bacteria (Staphs, Streptococci) • Viruses (Hepatitis, Herpes..) • Fungi (Candida albicans) • Parasites (Malaria) (mites, flees, ticks).

6. Colonization :microorganisms become resident flora, they may grow and multiply, but do not cause disease. Local Infection : infection limited to specific area of the body. Systemic Infection : spread to different parts of the body. Bacteremia : Blood culture reveals microorganisms Septicemia : when bacteremia results in systemic infection. Acute infection : sudden and in short time. Chronic infection : slow and in very long period. Types of infections

7. Nosocomial Infections • Infections associated with delivery of health care services in a health care facility (during stay or after discharge) • Examples : UTI’S, URTI’S, Surgical site infection, Blood stream infections. • It may originates as Endogenous or Exogenous. • Iatrogenic (IV insertion) (Dx. or Rx.).

8. Chain of Infection

9. Example on Chain of InfectionHepatitis B Virus HBV

10. Method of transmission • Direct transmission : droplet, touch, bite, sexual intercourse. • Indirect transmission: - Vehicle-borne (handkerchiefs, toys, soiled clothes) - Vector-borne (animals, flies) • Airborne transmission (Tuberculosis) (droplet nuclei).

11. Body Defense against infection(Susceptible Host) • Nonspecific Defenses : - anatomic & Physiologic Barriers - inflammatory response : vascular and cellular response, exudates production, reparative phase • Specific Defenses : - antibody-mediated (active & passive immunity) - cell-mediated (HIV)

12. FACTORS INFLUENCE SUSCEPTIBILITY OF THE HOST • Age • Heredity • Stressors • Nutritional status • Medical therapy

13. Nursing Diagnoses • Risk for infection • Potential complication of infection: fever • Impaired physical mobility • Imbalanced nutrition: less than body requirements • Acute pain • Impaired social interaction or social isolation • Situational low self-esteem • Anxiety

14. Nursing interventions in infection control and prevention of NCI’S. • Hand washing: - before and after eating - after using toilets, bedpan - contact with body substance (sputum, drainage, wound exudates). • use: antimicrobial foam, hand gel, water (10 min.) with soap, antimicrobial liquid soap. • When using antimicrobial agent: - multiple resistant bacteria - invasive procedures - SCBU, ICU’S - immune-compromised patients. • Frequent use may induce: dryness, contact dermatitis → lotions, moisturisers

17. Nursing interventions in infection control and prevention of NCI’S. (Hand washing)….. • Nails should be kept short • Remove jewelry • Skin breaks

18. Nursing interventions in infection control and prevention of NCI’S. • Supporting defense: - Hygiene (bathing and shampooing) - Nutrition (well-balanced diet) to maintain healthy tissues. - Rest and sleep - Immunization

19. Nursing interventions in infection control and prevention of NCI’S. • Cleaning objects - use gloves - rinse with cold water - wash with hot water and soap - use brushes in cleaning - dry up equipments - clean used utensils by disinfectant.

20. Nursing interventions in infection control and prevention of NCI’S. • Disinfection - using chemical preparations such as phenol or iodine compounds. - used on inanimate objects as it is toxic to tissues. - more concentrated than antiseptics. - bactericidal (destroy bacteria) and bacteriostatic (prevent growth and reproduction of some bacteria) agents. - concentration, duration, temp, organic materials are important to consider when using disinfectants.

21. Nursing interventions in infection control and prevention of NCI’S. • Sterilization - is the process of destroying all microorganisms, including spores and viruses. - Moist heat: steam+ pressure or free steam (autoclaving: 15-17pound/121-123˚ c/ 20-30 min.

22. Gas sterilization Ethylene oxide gas (interferes with metabolism of microorganisms) for sensitive objects and more penetration. Boiled water 100 ˚ c/ 15 min Radiation using ionizing and non-ionizing radiation (UV rays). It is very expensive. Nursing interventions in infection control and prevention of NCI’S. (sterilization)….

23. Nursing interventions in infection control and prevention of NCI’S. • Isolation Precautions: measures designed to prevent spread of infections to health personnel, clients and visitors. • Standard precautions: - for all clients in hospital. - blood, body fluids and secretions, broken skin, mucous membranes. - includes: hand washing, wearing clean gloves, wearing mask, eye protection, face shield, wearing a clean non-sterile gown, correct disposals and prevent injuries

24. Nursing interventions in infection control and prevention of NCI’S. (Isolation Precautions….. • Transmission-based precautions (airborne-precautions): - private room, negative air pressure, 2-same infected clients. - respiratory device - NO entry in cases (rubella, measles, chickenpox- varisella) - limited movement of the patient (surgical mask).

25. Nursing interventions in infection control and prevention of NCI’S. (Isolation Precautions….. • Droplets precautions - Used in droplet-transmitted D’s (diphtheria-pertussis-mumps) - private room - mask - limit patient’s movement (surgical mask).

26. Nursing interventions in infection control and prevention of NCI’S. (Isolation Precautions….. • Contact precautions - used in serious illnesses and immune-compromised patients (wound infections, MRSA) - private room - wear gloves - wear gown - limit movement

27. Nursing interventions in infection control and prevention of NCI’S. • Personal protective equipments (medical asepsis) - Gloving - Gowns - Eyewear

28. Nursing interventions in infection control and prevention of NCI’S. • Disposal of soiled equipment and supplies: - Bagging - Linens - lab. Specimens - Dishes - BP equipments - Thermometers - Sharps

29. Nursing interventions in infection control and prevention of NCI’S. • Sterile technique (surgical asepsis) - can be used in OR, LR, and special Dx. Procedures - sterile field: a microorganism- free area - ensure package intact and dry, and check for sterilization expiry. - double packed objects - using forceps, drape, sterile solutions. - wearing sterile gloves by open and closed methods - wearing sterile gown