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Asepsis, Isolation, and Sterile Technique
 Definitions
 Aseptic: absence of ________________
 Sterile: absence of any living microorganisms
 Medical asepsis: removal or destruction of disease organisms or infected material
 Surgical asepsis: protection against infection by the use of sterile technique
 Sterile technique: use of specific techniques to eliminate transfer of microorganisms from non-sterile
to sterile
 Chain of Infection
 Chain of infection involves six steps
 Infectious agent
 Reservoir
 Portal of Exit
 Mode of transmission
 Portal of entry
 Susceptible host
 Pathogens and Infectious Agents
 Bacteria
 Fungi
 _____________________
 Parasites
 Human Reservoirs/Portals of Exit
 Respiratory tract
 Nose, mouth, trach: sneezing, coughing etc
 GI tract
 Saliva, vomit, NG tubes
 Anus/ostomies: feces
 Reproductive/urinary tract
 Urethral meatus: urine
 Blood
 Open wounds, needle puncture site, any break in intact skin or __________________
 Mode of Transmission
 Direct contact
 Person to person
 Indirect contact
 Inanimate objects
 ________________
 Portal of Entry
 Susceptible Host
 The very young and the elderly
 Poor nutritional status
 Patients with chronic disease
 The immuno-compromised
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 Surgical procedures
 Diagnostic or therapeutic procedures that involve an __________________
 Nosocomial Infections (HAIs)
 Acquired while in the hospital
 Over 99,000 deaths per year in the United States
 Increased ICU stay 8 days
 Increased average hospital stay between 7.4 and 9.4 days
 Total dollar cost between $4.5 and $5.7 billion
 Average cost per infection of $13,973
 Increased total cost per patient who survived approximately $40,000
 Major Organisms
 Three common HAIs:
 Clostridium difficile bacteria (C. diff)
 “good” bacteria in the gut flora is wiped out by antibiotics
 Intestines becomes overrun with C. difficile resulting in severe diarrhea
 Methicillin resistant staphylococcus aureus (_________________)
 any strain of staphylococcus aureus that has developed resistance to beta-lactam antibiotics, which
include the penicillins and the cephalosporins.
 Vancomycin-resistant enterococcus (_______________)
 bacterial strains of the genus Enterococcus that are resistant to the antibiotic vancomycin.
 Preventing Infection Transmission: “Hand Hygiene”
 Wash with antiseptic soap and water or alcohol based handrub:
 Before and after client contact and in between clients
 Before and after preparing medications
 After handling soiled linens, equipment, or supplies
 Before putting gloves on and after removing gloves.
 Before and after eating
 At the beginning and end of your shift

 Proper Handwashing Technique 15-Second Procedure Saves Lives (and you already know how to do
it)
 Personal Protective Equipment (_______________)
 Gloves, gowns, goggles, masks
 Face shields, full body suit
 CPR barrier devices
 Use of Isolation as Infection Control Measure
 Standard (Universal) Precautions (used with __________________)
 Standard Precautions define all the steps that should be taken to prevent spread of infection from
person to person when there is an anticipated contact with:
 Blood
 Body fluids
 Secretions, such as phlegm
 Excretions, such as urine and feces (not including sweat) whether or not they contain visible blood
 Nonintact skin, such as an open wound
 Mucous membranes, such as the mouth cavity.
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 Transmission Based Precautions:
 Contact
 Private room or with roommate infected with same organism
 Health care workers wear gloves (minimum)or may need to gown or mask if indicated
 Dedicated patient care items (like stethoscopes) remain in room or are cleaned prior to use on other
patients
 Droplet
 Private room or with roommate infected with same organism
 Patient wears mask if leaves room for any reason
 Staff wear glove/gown/mask for direct patient contact
 Door to room may be _________________
 Dedicated patient care items
 Airborne
 TB, measles, chickenpox
 Door to room shut at all times/should be private room
 Patient wears mask if leaves room
 Staff wear mask (minimum) or respirator/glove/gown
 Dedicated patient care items
 Principles of Sterile Technique
 #1: All items used within a sterile field must be sterile.
 #2: The edges of sterile containers are not considered sterile once the package is open.
 #3: Gowns are considered sterile in front from shoulder to table level. The sleeves are also sterile.
 #4: Tables are sterile only at table level.
 #5: Sterile persons and items only contact sterile areas; Unsterile persons and items only contact
unsterile areas.
 #6: Movement within or around a sterile field must be such as not to cause contamination of the field.
 #7: A sterile barrier that is permeated is considered contaminated.
 #8: Items of doubtful sterility are considered _______________________
 How to Put on Sterile Gloves