Prepared By: Mr. Val L. Ramilo RN
Prepared By: Mr. Val L. Ramilo RN
Prepared By: Mr. Val L. Ramilo RN
Ramilo RN
MEDICAL ASEPSIS
Is the freedom from
disease-causing
microorganisms.
To decrease the possibility
of transferring
microorganisms from
one place to another,
asepsis is used.
SURGICAL ASEPSIS OR STERILE
TECHNIQUE
Refers to those practices
that keep an area or
object free of all
microorganisms; it
includes practices that
destroy all
microorganisms and
spores.
TYPES OF MICROORGANISMS
CAUSING INFECTIONS
Bacteria – the most
common infection-
causing microorganisms.
Viruses – Consist
primarily of nucleic acid
and therefore must enter
living cells in order to
reproduce.
Fungi – Include yeasts
and molds
Parasites – Live on other
living organisms. They
include protozoa such as
the one that causes,
malaria, helminths
(worms), and
anthropods (mites, fleas,
ticks)
TYPES OF INFECTION
Colonization – Is the
process by which strains
of microorganisms
become resident flora. In
this state, the
microorganisms may
grow and multiply but
do not cause a disease.
1. Local Infection- Is
limted to specific part
of the body where the
microorganisms
remain.
2. Systemic Infection –
Microorganisms
spread and damage
different parts of the
body.
Bacteremia – When a
culture of the person’s
blood reveals a
microorganisms.
Septicemia – When
bacteremia results in
systemic infection.
Acute Infection –
Generally appear and
suddenly or last a short
time.
Chronic Infection- may
occur slowly, over a long
period, and may last
months or years.
NOSOCOMIAL INFECTION
Are classified as
infections that are
associated with the
delivery of health care
services in a health care
facility.
Endogenous source –
microorganism causing
disease originates from
the client
Exogenous source –
Coming from the
hospital environment or
hospital personnel.
Iatrogenic Infections
Are the direct result of
diagnostic or therapeutic
prcoedures.
The hands of personnel are
a common vehicle for the
spread of microorganisms.
Insufficient hand washing
is thus an important factors
contributing to the spread
of nosocomial
microorganism.
CHAIN OF INFECTION
INFECTIOUS AGENT
A microbial organism with the
ability to cause disease. The
greater the organism's
virulence (ability to grow and
multiply), invasiveness (ability
to enter tissue) and
pathogenicity (ability to cause
disease), the greater the
possibility that the organism
will cause an infection.
Infectious agents are bacteria,
virus, fungi, and parasites.
RESERVOIR
A place within which
microorganisms can
thrive and reproduce.
For example,
microorganisms thrive in
human beings, animals,
and inanimate objects
such as water, table tops,
and doorknobs.
PORTAL OF EXIT
A place of exit providing a
way for a microorganism
to leave the reservoir. For
example, the
microorganism may leave
the reservoir through the
nose or mouth when
someone sneezes or
coughs. Microorganisms,
carried away from the
body by feces, may also
leave the reservoir of an
infected bowel.
MODE OF
TRANSMISSION
Method of transfer by
which the organism
moves or is carried from
one place to another.
The hands of the health
care worker may carry
bacteria from one
person to another.
PORTAL OF ENTRY
An opening allowing the
microorganism to enter
the host. Portals include
body orifices, mucus
membranes, or breaks in
the skin. Portals also result
from tubes placed in body
cavities, such as urinary
catheters, or from
punctures produced by
invasive procedures such
as intravenous fluid
replacement.
SUSCEPTIBLE HOST
A person who cannot resist
a microorganism invading
the body, multiplying, and
resulting in infection. The
host is susceptible to the
disease, lacking immunity
or physical resistance to
overcome the invasion by
the pathogenic
microorganism.
PREVENTION AND CONTROL OF INFECTION:
Breaking the Chain
Nurses maintain the immediate health The practice of medical asepsis
care environment. Because they helps to contain infectious
provide care for a variety of organisms and to maintain an
patients, the risk of contamination environment free from
from pathogenic microorganisms contamination. The techniques
is increased. The practice of used to maintain medical asepsis
medical asepsis and standard include hand washing, gowning and
precautions provides the nurse with wearing facial masks when
techniques for destroying or appropriate, as well as separating
containing pathogens and for clean from contaminated or
preventing contamination to other potentially contaminated materials
people or to bedside materials and and providing information to
equipment. patients about basic hygienic
practices. Appropriate hand washing
by the nurse and the patient remains
the most important factor in
preventing the spread of
microorganisms.
Standard precautions Universal precautions help
combine the major features of control contamination from
universal precautions and bloodborne viruses such as
body substance isolation. human immunodeficiency virus
These standard precautions (HIV) and hepatitis viruses.
alert the health care worker to When in contact with a
patient situations that require patient's blood or any body
special barrier techniques. secretion that may be
These barrier techniques are contaminated with blood,
used when working with any protective measures such as
patient where potential or wearing gloves, gown, facial
actualized contact with blood or mask, and/or goggles must be
body fluid exists. followed.
Body substance isolation Strict adherence to basic
protects against bacterial techniques such as hand
organisms that may exist in washing, wearing barrier gloves
body substances. Body and protective isolation
substance isolation applies in provides the foundation for life
all patient encounters regardless saving measures. However, the
of the diagnosis. The application physical protection gained from
of gloves for contact with moist barrier isolation may have a
body surfaces and areas of negative psychological impact on
nonintact skin, gowns when in the patient.
contact with body secretions,
and facial mask when in danger
of contact with respiratory
droplet secretions, prevents the
contamination of both health
care worker and patient.
An elderly patient, hospitalized with a gastrointestinal disorder, was on bed rest and required assistance for activities of daily living. The
patient had frequent uncontrolled diarrhea 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. The
nurse's hands were not washed before assisting the second patient.
Escherichia coli
Large intestine
E. coli, bacteria in the large intestine of humans forms the greater part of the normal intestinal flora.
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.
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.
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.
NOSOCOMIAL INFECTIONS
Most Common Microorganisms Causes
Urinary Tract ( E. Coli, Enterococcus Improper catheterization technique
species Contamination of closed drainage
system
Inadequate handwashing
Surgical Sites ( Staphylococcus Aureus, Inadequate Handwashing
Psedomonas Aeruginosa) Improper dressing change technique
Bloodstream ( Staphylococcus aureus) Inadequate handwashing
Improper intravenous fluid, tubing,
and site care technique
Pneumonia (Staphylococcus aureus, Inadequate hand washing
Pseudomonas aeruginosa) Improper suctioning technique
HUMAN BODY RESERVOIRS, COMMON
INFECTIOUS MICROORGANISM AND PORTALS OF
EXIT
BODY AREA COMMON PORTALS OF EXIT
INFECTIOUS
ORGANISMS
Respiratory Tract Parainfluenza virus Nose or mouth through
sneezing, coughing,
breathing or talking.
GIT Hepatitis A virus Mouth, saliva, vomitus,
Salmonella species anus, feces, ostomies
Eschirechia Coli
enterococci
Urinary Tract E. Coli enterococci Urethral meatus and
urinary diversion
Reproductive Tract Neisseria gonorrhea Vagina; vaginal discharge
Blood Hepatitis B virus Open wound, needle
puncture site
BODY DEFENSE AGAINST INFECTION
Non-specific Defenses – Specific – (Immune)
protect the person defenses by contrast, are
against all directed against
microorganisms, identifiable bacteria,
regardless of prior viruses, fungi or other
exposure. infectious agents.
NON SPECIFIC DEFENSESES
Anatomic an physiologic Inflammatory response
barriers
1. Intact skin Inflammation- Is a local and
2. Nasal passages no specific defensive
3. Oral cavity response of the tissues to
4. Eye
an injurious or infection
agent.
5. Vagina An adaptive mechanism that
destroys or dilutes the
injurious agents, prevents
further spread of injury
and promotes and repair
of damaged tissue.
FIVE SIGNS OF INFLAMMATION
1. Pain (Dolor) Commonly, words with
2. Swelling (tumor) the suffix –it is describe
an inflammatory
3. Redness (rubor)
process. For example,
4. Heat (calor or color) appendicitis means an
5. Impaired function of inflammation of the
the part appendix; gastritis
means inflammation of
the stomach.
Vascular and Cellular Response
During inflammation
Hyperemia – marked
increase in blood supply,
responsible for the
characteristic signs of
redness and heat.
EXUDATE PRODUCTION
The second stage of
inflammation, the
inflammatory exudate is
produced, consisting of
fluid that escaped form
the blood vessels.
REPARATIVE PHASE
The third stage of
inflammatory response
involves the repair of
injured tissues by
regeneration or
replacement with
fibrous tissue (scar)
formation.
SPECIFIC DEFENSES
Antigen – Is a substance Humoral Immunity –
that induces a state of resides ultimately in the b
sensitivity or immune lymphocytes and are
responsiveness (immunity) mediated by antibodies
If the proteins originate in produced by B cells.
a person’s own body, the Antibodies, also called
antigen is called Immunoglobulins, are part
autoantigen. of the body’s plasma
proteins. The antibody-
mediated responses
defend primarily against
the extracellular phases of
bacterial and viral
infections.
TYPES OF IMMUNITY
TYPE ANTIGEN OR ANTIBODY DURATION
SOURCE
Bactericidal – destroys
bacteria
Bacteriostatic – prevents
the growth and
reproduction of some
bacteria.
The type and number of
infectious organisms
The recommended
concentration of the
disinfectant and the
duration of contact
The temperature of the
environment
The presence of soap
The presence of organic
materials
The surface area to be
treated.
STERILIZING
Sterilization – Is a process
that destroys all
microorganisms,
including spores and
viruses. Four commonly
methods of sterilization:
1. Moist Heat – For
sterilizing, moist heat
(steam) can be
employed in two ways.
2. Gas – Ethylene oxide gas
destroys microorganism
interfering with their
metabolic processes. It is
also effective against
spores.
3. Boling water – Most
practical and
inexpensive method of
sterilizing in the home.
5. Radiation – Both
ionizing ( such as alpha,
beta, and x-rays) and
non-ionizing (ultraviolet
light) radiations are used
for disinfection and
sterilization.
ISOLATION PRECAUTIONS
Isolation – refers to
measures designed to
prevent the spread of
infections or potentially
infectious
microorganisms to
health personnel, clients
and visitors.
1. Category-specific isolation
precaution – use seven
categories:
a. Strict isolation
b. Contact isolation
c. Respiratory isolation
d. Tuberculosis isolation
e. Enteric precautions
f. Drainage/secretions
precautions
g. blood./body fluid precautions
2. Disease-specific isolation
precautions – provide
precautions for specific
disease. These precautions
delineate use of private rooms
with special ventilation,
having the client share a
room with other clients
infected with the same
organism and gowning to
prevent gross soilage of
clothes for specific infectious
disease.
UNIVERSAL PRECAUTIONS
Are techniques to be
used with all clients to
decrease the risk of
transmitting
unidentified pathogens.
Obstruct the spread of
bloodborne pathogens,
RECOMMENDED ISOLATION
PRECAUTIONS IN HOSPITALS
Standard precautions
Transmission-based
precautions
Droplet Precautions
Contact precautions
Transmission-Based Precautions
Airborne precautions –
Used for clients known
to have or suspected of
having serious illnesses
transmitted by airborne
droplet nuclei smaller
than 5 microns.
Examples, measles,
varicella, tuberculosis.
Droplet Precautions –
Used for clients known
or suspected to have
serious illnesses
transmitted by particle
droplets larger than 5
microns. Examples,
diphtheria, pertussis,
mumps, rubella.
Pneumonia.
ISOLATION PRACTICES
Use aseptic technique
when performing any
invasive procedures( eg.
Inserting an intravenous
needle or catheter)
Change intravenous tubing
and solution containers
according to hospital.
Check all sterile supplies
for expiration date and
intact packaging.
Prevent urinary infections by
maintaining a closed urinary
drainage system with a
downhill flow of urine.
Implement measure to
prevent impaired skin
integrity and to prevent
accumulation of secretions
in the lungs (encourage the
client to move. Cough, and
breathe deeply at least every
2 hours)
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