Asepsis
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
Related terms
 Virulence (Pathogenicity): the
ability of microorganism to produce
disease.
 Opportunistic pathogen
 CDC (Centre for Disease
Control)
Asepsis
 The freedom from disease-causing microorganisms
 Medical asepsis all 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.
Microorganisms causing infections
 Bacteria (Staphs, Streptococci)
 Viruses (Hepatitis, Herpes..)
 Fungi (Candida albicans)
 Parasites (Malaria) (mites, flees,
ticks).
Types of infections
 Colonization : microorganisms
become resident flora, they may grow
and multiply, but do not cause
disease.
 Septicemia : when bacteremia
results in systemic infection.
 Acute infection : sudden and in
short time.
 Local Infection : infection limited
to specific area of the body.
 Chronic infection : slow and in
very long period.
 Systemic Infection : spread to
different parts of the body.
 Bacteremia : Blood culture reveals
microorganisms
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.).
Chain of Infection
Susceptible Host
Microorganism
Etiologic agent
Portal of Entry
to susceptible host
Reservoir
Method of
Transmission
Portal of Exit
from reservoir
Example on Chain of Infection
Hepatitis B Virus
Susceptible Host
Human being
HBV
HBV
Portal of Entry
to susceptible host
Blood, secretions
Method of
Transmission
Blood, Sexual intercourse
Reservoir
CARRIERS
Portal of Exit
from reservoir
Open wound, needle, mucous memebrane
Method of transmission
1.
2.
Direct transmission : droplet, touch, bite, sexual
intercourse.
Indirect transmission:
- Vehicle-borne (handkerchiefs, toys, soiled clothes)
- Vector-borne (animals, flies)
3.
Airborne transmission (Tuberculosis) (droplet nuclei).
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)
FACTORS INFLUENCE SUSCEPTIBILITY OF THE HOST
 Age
 Heredity
 Stressors
 Nutritional status
 Medical therapy
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
Nursing interventions in infection control and
prevention of NCI’S.
1.
•
•
•
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
Nursing interventions in infection control and
prevention of NCI’S. (Hand washing)…..
 Nails should be kept
short
 Remove jewelry
 Skin breaks
Nursing interventions in infection control and
prevention of NCI’S.
2. Supporting defense:
- Hygiene (bathing and shampooing)
- Nutrition (well-balanced diet) to maintain healthy tissues.
- Rest and sleep
- Immunization
Nursing interventions in infection control and
prevention of NCI’S.
3. 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.
Nursing interventions in infection control and
prevention of NCI’S.
4.
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.
Nursing interventions in infection control and
prevention of NCI’S.
5.
Sterilization
- is the process of destroying
all microorganisms,
including spores and
viruses.
- Moist heat: steam+
pressure or free steam
(autoclaving: 1517pound/121-123˚ c/ 2030 min.
Nursing interventions in infection control and
prevention of NCI’S. (sterilization)….
 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 nonionizing radiation (UV
rays). It is very expensive.
Nursing interventions in infection control and
prevention of NCI’S.
6. 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 nonsterile gown, correct disposals and prevent injuries
Nursing interventions in infection control and
prevention of NCI’S. (Isolation
Precautions…..
 Transmission-based
precautions (airborneprecautions):
- 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).
Nursing interventions in infection control and
prevention of NCI’S. (Isolation
Precautions…..
 Droplets precautions
- Used in droplettransmitted D’s (diphtheriapertussis-mumps)
- private room
- mask
- limit patient’s movement
(surgical mask).
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
Nursing interventions in infection control and
prevention of NCI’S.
7.
Personal protective
equipments (medical
asepsis)
- Gloving
- Gowns
- Eyewear
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
Nursing interventions in infection control and
prevention of NCI’S.
9.
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