Transcript ASEPSIS - Nurses Rock Society #23

ASEPSIS
PRPD/CIN2/2007
ASEPSIS
 The term asepsis means the
absence of disease-producing
microorganisms
Concept of Asepsis
 The nurse’s efforts to minimize the onset &
spread of infection are based on the
principles of aseptic technique.
 Aseptic technique is an effort to keep the
client as free from exposure to infectioncausing pathogens as possible.
Definition
 Aseptic technique is the effort taken to keep the
patient as free from hospital micro-organisms as
possible (Crow 1989).
 It is a method used to prevent contamination of
wounds & other susceptible sites by organisms
that could cause infection.
 This can be achieved by ensuring that only
sterile equipment & fluids are used during
invasive medical & nursing procedures.
Types of Asepsis Technique
 There are two types of asepsis:
Medical asepsis & Surgical asepsis.
 Medical or Clean Asepsis reduces the number of
organisms & prevents their spread.
Surgical or Sterile Asepsis or
Sterile Technique
 includes procedures used to eliminate micro-
organisms from an area & is practiced by
nurses in OTs, labour & delivery area, major
diagnostic areas & Rx areas.
Medical Asepsis
 During daily routine care, the nurse uses basic
medical aseptic techniques to break the
infection chain.
 Eg.of medical asepsis are changing client’s bed
linen daily, handwashing, barrier techniques, &
routine environmental cleaning.
Cont…
 Follow Isolation technique as appropriate.
 Clients with high susceptibility to infection
require special precautions to prevent
exposure to pathogens.
Cont…
 In medical asepsis, an area or object is
considered contaminated only if it is
suspected of containing pathogen (e.g., used
bedpan, the floor & a wet piece of gauze).
Surgical Asepsis
 Sterilization destroys all microorganisms & their spores.
 Surgical asepsis demands the highest level of aseptic
technique & requires that all areas be kept as free as
possible of infectious micro-organisms.
Cont…
 These techniques can be practiced by nurses
in the OR (surgical incision) or at the bedside
(e.g, inserting IV or urinary catheter &
reapplying sterile dressings) where sterile
instruments & supplies are used.
Cont…
 In surgical asepsis, an area or object may be
considered contaminated if touched by an
object that is not sterile (e.g., a tear in a
surgical glove during a procedure, a sterile
instrument placed on an unsterile surface).
Cont…
 The nurse working with a sterile field or with
sterile equipment must understand that the
slightest break in technique results in
contamination.
Cont…
 A nurse in an operating room follows a series of steps to
maintain sterile techniques, including applying a mask,
protective eyewear, and a cap; performing a surgical
hand washing; & applying a sterile gown & gloves.
Cont…
 Effectiveness of aseptic practices depends on
the nurse’s conscientiousness & consistency
in using effective aseptic techniques.
Aseptic Practices
Aseptic Practices
Aseptic Practices
INFECTION CAUSE BY MICROORGANISMS
 BACTERIA
 FUNGI
 PROTOZOA
 ALGAE
 VIRUSES
CONTROL OR ELIMINATION
OF INFECTIOUS AGENTS
Cleansing
 Is the removal of all foreign materials such as soil & organic material
from objects.
 Generally, cleansing involves use of water & mechanical action with
or without detergents.
- Disposable object has to be discarded.
- Reusable objects must be cleansed thoroughly before disinfection
& sterilization.
 When cleaning equipment that is soiled by
organic material such as blood, fecal matter,
mucus or pus, the nurse applies a mask,
protective eyewear, & waterproof gloves.
 These barriers provide protection from
infectious organisms.
 A brush, detergent or soap are
needed for cleaning.
Disinfection & Sterilization
 Disinfection – eliminates pathogenic
organisms on inanimate objects with the
exception of bacterial spore. Noninfectious
microorganisms may or may not be killed.
 Sterilization – is the process of eliminating
and destroying all microorganisms, including
spores & viruses.
DISINFECTION
 The principle of disinfection is that of
denaturation of the bacterial cell protein.
 This process can be carried out by two
methods:
1. Physical
-
boiling
2. Chemical
-
disinfectants
Choice of method depends on:
A) Types of microorganisms
Certain strains of bacteria are more resistant to
destruction than vegetative forms.
B) Number of microorganisms present on articles
The more heavily contaminated the articles are,
the harder for destruction.
Essential factors for maximum
effectiveness of disinfection are:- Cleanliness of items
- Unlocking all locked instruments
- Complete immersion of articles
Use of Disinfectants
Indications for use of Hospital Disinfectants:
1. Disinfection of skin & mucous membranes.
2. Disinfection of instruments & other items.
3. Decontamination of the inanimate environment.
Chemical Disinfectants are such as:
1. Phenolics a) clear soluble fluids, e.g., 2% Printol. 1% Sudol
b) Hexachlorophene e.g., Phisohex, Gamaphene
- for wide range of antibacterial activity.
2. 70% - 75% Ethyl or Isopropyl Alcohol - for wide
range of antibacterial activity, most active against
TB.
Chemical Disinfectants cont….
3. Halogens - for inactivation of viruses and anti bacterial activity
except TB.
a) Chlorine (hypochlorites) e.g., Milton, Eusol.
b) Iodine.
4. Glutardehyde, e.g., Cidex - wide range of antibacterial activity, very
effective against Hepatitis B virus. Best for heat sensitive
instruments.
5. Quaternary ammonium compounds
e.g., Cetrimide (Cetavlon) - good detergent
(more active against gram +ve organisms).
6. Diguanides,
e.g., Chlorhexidine (Hibitane)
Chlorhexidine + detergent (Hibiscrub, Savlon) useful skin ‘disinfectant’. Very active against
gram +ve organisms.
STERILIZATION
This process can be carried out by 4 methods: HEAT
- moist heat (Autoclave)
- dry heat (Hot Air Oven)
 CHEMICAL
- in solution, e.g., Ethicon
Fluid, Glutaraldehyde
- vapour, e.g.,
Formaldehyde
- gas, e.g., Ethylene
Oxide
 IRRADIATION
- ultra violet light
- gamma rays/cobalt 60
 FILTRATION
- applicable to
pharmaceutical
laboratory where it is
used in combination
with ultra violet light.
THE PRINCIPLES OF ASEPTIC
TECHNIQUE IN WOUND CARE
 Medical Hand Washing – cleaning of trolley, opening the
dressing pack, to cleaning the wound.
 Surgical Hand Washing – scrubbing in surgery.
Gowns & Aprons
 protective clothing is used to reduce bacterial
spread by contact (nurse’s uniforms become
heavily contaminated during clinical
procedures.
 Gloves – The purpose of wearing gloves is
both to protect the hands from contamination
by micro-organisms and to prevent the
transfer of micro-organisms already on the
hands.
Single-use
 irrigation devices should not be used for
multi-use purposes as there is potential for
cross-infection between pts.
e.g., IV lines & buckets.
BLOOD TRANSMISSABLE DISEASES
&
SEXUALLY TRANSMITTED DISEASES (STDs)
 HIV Infection/AIDS
 Hepatitis B (HBV)
 Hepatitis C (HCV)
 Syphilis
 Gonorrhoea
 Chlamydia
 Herpes Simplex
 Cytomegalovirus
INFECTION PREVENTION MEASURES:
Body Substance Isolation System (BSIS)
 Hand washing / Hand Scrub
Wash hands before touching pts, before scrubbing &
any time hands have been soiled.
 Gloves
- put on clean gloves just before contact
with mucous membranes & non intact skin.
- wear appropriate gloves any time hands
likely to have contact with moist body
substances.
- remove gloves immediately after task is
completed.
Infection Prevention Measures: BSIS
 Gowns or Plastic Aprons
Wear any time it is likely that clothing or skin will be soiled.
 Masks
- wear in OR / sterile area
-wear when working directly over large areas of open skin.
- wear when it is likely that nasal & oral mucous membranes
will be spattered with moist body substances.
Needles & Sharps
- Discard in rigid, puncture-resistant containers.
- Do not recap used needles by hand.
- Be particularly careful when manipulating
small devices such as heparin locks.
Infection Prevention Measures: BSIS
 Room Selection
- Assign patient with infectious disease to an individual
OR or last on surgical list.
 Trash & Linen
- Bag all soiled trash & linen securely.
- Discard according to facility policy.
- Wear gloves & protective garments when
handling soiled linen & trash.
Infection Prevention Measures: BSIS
 Housekeeping
- Clean all rooms on regular
schedule.
- Clean articles, equipment &
furniture soiled with moist body
substances immediately. Wear
gloves.
 Laboratory Specimens
- Handle all laboratory specimens with equal
care. Special precautionary labels are
required.
Infection Prevention Measures: BSIS
 Compliance of Care Providers
- Develop programme to ensure that health care
workers comply with the infection precautions
system.
Remember !!!
 The nurse is responsible for providing the client with a
safe environment.
 The nurse’s first responsibility to the client is to first do no
harm.
 It is easy to forget key procedural steps or, when hurried,
to take shortcuts that break aseptic procedures. However,
the nurse’s failure to be meticulous will place the client at
risk for an infection that can seriously impair recovery.
(Florence Nightingale, 1859)
THE END