Medical and Surgical Asepsis 2003
Medical and Surgical Asepsis 2003
Medical and Surgical Asepsis 2003
Asepsis
Define isolation.
Cont……..
Etiologic agent
Reservoir (source)
Portal of Exit from reservoir
Method of transmission
Portal of entry to the susceptible host
Susceptible host
Patient Situation 1
The Spread of Infection
An elderly patient, hospitalized with a gastrointestinal
disorder caused by (E,coli), was on bed rest and
required assistance for activities of daily living. The
patient had frequent uncontrolled diarrhoea stools and
the nurse provided excellent care to maintain cleanliness
and comfort. Following one episode of cleaning the
patient and changing the bed linen, the nurse
immediately went to a second patient to provide care
with Foleys catheter. The nurse’s hands were not
washed before assisting the second patient.
Cont......
Infection Agent
(Escherichia coli)
Reservoir
(Large intestine: E.coli, bacteria in the large intestine of
human forms the greater part of the normal intestinal
flora)
Portal of Exit
(E.coli exited the body in feces)
Cont........
Mode of Transmission
The nurse removed the contaminated linen from the bed.
The E.coli organism contaminated the hands of the
nurse who then provided morning care to another
patient.
Portal of Entry
The second patient receiving care had a Foley catheter.
The nurse manipulated the tubing attached to the
catheter. The E.coli organism on the nurse’s hands
contaminated the catheter tubing and ascended to the
patient’s meatus and then into the urinary bladder.
Cont.....
Susceptible Host
The second patient with a Foley catheter. This patient was
elderly and had a chronic illness necessitating complete
bed rest. The Foley catheter contaminated by the E.coli
organism provided a direct route into the urinary bladder.
Patient Situation 2
The Nurse Breaks the Chain
A patient assigned for morning care has an
open wound on her left lower leg. The wound
is draining and when last cultured, the micro
organism MRSA was identified.
In preparation of bed making, hands of the
nurse were washed, clean linen and a bag for
soiled linen were gathered from the linen
room and placed on the patient’s clean bed
side stand.
To remove the soiled linen from the
bed, following procedure was followed:
Hands washed
Gloves worn
Each side of the soiled linen ends folded
towards the middle of the bed
Soiled linen held away from the nurse’s clean
uniform
Soiled linen placed in the linen bag for later
discard
Protective gloves removed.
Cont....
Infection Agent
MRSA
Reservoir
(Patient’s infected wound)
Portal of Exit
(Draining from the open wound)
Cont.......
Sterile Technique
“Use only sterile materials in a sterile field.”
Principles of Sterile Technique
Sterile items only used within a sterile field.
Ensure that the item being opened is sterile
by :
Checking the integrity of the package
Checking the expiration date
Checking the colour of the sterilization
indicator tape
If a sterile package falls to the floor, it must
be discarded
Cont......