Infection, Asepsis
and
Sterile Technique
MICROORGANISMS



living cells
found
everywhere in
the environment
can be beneficial
 mold for
cheese
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MICROORGANISMS



can be harmful
 HIV causes AIDS
understanding disease
transmission helps create
technology for disease
prevention
you will care for patients
with:
 infectious diseases
 communicable diseases
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MICROORGANISMS

Structure and Function


similar cell structure to animals
and plants
metabolic process
 take in oxygen
 burn food for energy and
growth
 excrete wastes
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MICROORGANISMS

Structure and Function




increase in size, divide
and mutate
react to environmental
changes
able to move on their
own
form protective
capsules
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MICROORGANISMS

Nature of microorganisms
 all human beings contain
microorganisms in and on their bodies
 most do not produce disease under
normal conditions
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MICROORGANISMS

Nature
 pathogenic (disease
causing) microorganisms
have the potential to
negatively affect a
person’s health
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MICROORGANISMS

Growth of microorganisms

beginning of a bacterial
infection


hundreds of bacterial cells
as bacteria reproduce



millions of bacterial
cells
colonies
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MICROORGANISMS

Growth
environmental factors
 oxygen
 nutrients
 temperature
 moisture
 pH
 light
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MICROORGANISMS

Types
 algae
 rarely cause disease
 fungi
 yeasts
 thrush/vaginitis
 molds
 athlete’s foot
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MICROORGANISMS

Types
 protozoa
 microscopic
 vaginal infection
 urinary tract
infection
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MICROORGANISMS

Types
 bacteria
 spores
 difficult to control
& destroy
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MICROORGANISMS

Types
 bacteria
 pathogenic
 gonorrhea
 upper
respiratory
infection
 meningitis
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MICROORGANISMS

Types
 Viruses
 affect every system and
tissue of the body
 HIV
 immunization is most
effective in prevention
of specific viruses
 polio, smallpox &
measles
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INFECTIOUS DISEASE

Definition
 caused by pathogenic
microorganisms
 communicable
 spreads from one
person to another
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INFECTIOUS DISEASE

Definition
 contagious
 transmitted to many
individuals quickly &
easily
 can cause an epidemic
 large number of people
in the same area are
infected in a short time
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INFECTIOUS DISEASE

Chain of Infection
 reservoir
 people
 animals
 insects
 inanimate objects
 portal of exit
 all body orifices
 discharges
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INFECTIOUS DISEASE

Chain of Infection
 Vehicle
 direct/indirect contact
 human carrier
 airborne
 water-borne
 food-borne
 vectors
 blood borne
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INFECTIOUS DISEASE

Chain of Infection
 Portal of Entry
 respiratory tract
 GI/GU
 reproductive
 open wounds
 incisions/puncture
sites
 body orifices
 tubes/catheters
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INFECTIOUS DISEASE

Chain of Infection
 High Risk Host

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


hospitalized/inactive
chronic fatigue
poor nutrition
infants/elderly
injury/wound/shock/trauma
medications side effects
emotional factors
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INFECTIOUS DISEASE

Breaking the Chain of Infection
 reservoir
 HANDWASHING
 sterilize
 disinfect
 clean/soap & water
 discard disposable equipment
 dressing changes PRN
 contaminated/proper disposal
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INFECTIOUS DISEASE

Breaking the Chain of Infection
 Portal of Exit
 HANDWASHING
 waste disposal
 secretions/drainage
 protect open wounds/
sterile fields
 gloves/masks
 medications
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INFECTIOUS DISEASE

Breaking the Chain of Infection
 Vehicle

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
HANDWASHING
trash incinerators
linen/toiletries
infected wounds
food handling
isolation/airflow
sterilization
sharps
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INFECTIOUS DISEASE

Breaking the Chain of Infection
 Portal of Entry
HANDWASHING
 clean, dry skin; use
moisturizer
 prevent skin breakdown
 clean, dry linen
 tubes/collection bags
 wound care
 BSI/sterile procedure

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INFECTIOUS DISEASE

Breaking the Chain of Infection
 High risk Host
 HANDWASHING (infection
control)
 treat underlying condition
 rest/skin care
 nutrition/fluids
 reduce anxiety
 cough/deep breathe
 immunization
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RESPONSE TO INFECTION

Response
 depends on organism and host
 normal course of infection
st phase (incubation period)
 1
 when pathogen enters the body to
the appearance of first symptoms
nd phase (prodromal stage)
 2
 from appearance of first symptoms
to more severe symptoms
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RESPONSE TO INFECTION

Response
 normal course of infection
rd phase (full stage)
 3
 symptoms are acute and specific
to type of infection
 final phase (convalescence stage)
 when acute symptoms subside
and patient recovers
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RESPONSE TO INFECTION

Factors that Influence Infection
 Body’s defense mechanisms
 Portal of entry
 only if they gain access
to the body through a
specific portal of entry
 Number of microorganism
 greater the number, greater
the opportunity to cause
disease
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RESPONSE TO INFECTION

Factors that Influence Infection
 Virulence
 pathogen’s strength to cause
disease
 protective capsules
 enzymes
 Host resistance
 some normal flora have an
antibiotic relationship
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NOSOCOMIAL INFECTION



serious problem
acquired in the
hospital
reasons
 presence
 resistance to
antibiotics
 many reservoirs
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NOSOCOMIAL INFECTION

Conditions that Increase
the Risk




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broad spectrum antibiotic used
frequently
failure of appropriate proper
technique
multiple healthcare personnel
prolonged hospitalization
lowered resistance to disease
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MEDICAL ASEPSIS

Definition (Asepsis)
 practices that minimize or
eliminate organisms that can
cause infection and disease
 medical asepsis
 clean technique
 surgical asepsis
 sterile technique
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MEDICAL ASEPSIS

Definition (Medical Asepsis)
 components
 reduce/prevent number
of microorganism
transmissions
 HANDWASHING
 barrier techniques
 clean environment
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MEDICAL ASEPSIS

Medical Asepsis
 HANDWASHING
 single most effective measure to
prevent the spread of disease
 barrier technique (PPE)
 keep organisms from
entering or leaving the
respiratory tract, your eyes
or breaks in the skin
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MEDICAL ASEPSIS

Medical Asepsis
 gloves
 latex allergy
 eye protection
 goggles/glasses
 gowns/aprons
 fluid resistant
 masks
 disposable
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MEDICAL ASEPSIS


leaving a patient’s room
 discard
gown/mask/gloves
 HANDWASHING
 terminal disinfecting
patient and family teaching
 HANDWASHING
 hygienic practices
 aseptic technique
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SURGICAL ASEPSIS

Asepsis
 dirty
 not been cleaned or sterilized
 clean
 many or the most harmful
microorganisms have been removed
 sterile
 free of all microorganisms and spores
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SURGICAL ASEPSIS

Sterile Technique
 no organisms are carried
to the patient
 used during dressing
changes, administering
parenteral medications &
sterile procedures
 first sterilize articles and
prevent contact with
unsterile articles
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SURGICAL ASEPSIS


Disinfection & Sterilization

disinfectants destroy most pathogens
but not necessarily their spores

sterilization destroys all pathogens
and spores
Sterile Protective Measures

hair covering, surgical mask, sterile
gown and sterile gloves
39
INFECTION CONTROL

Standard Precautions
 Universal Precautions
 reduce risk of
transmission of bloodborne pathogens
 Body Substance Isolation
(BSI)
 reduce transmission from
moist body substances
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INFECTION CONTROL

Standard Precautions
 must consider ALL patients
are potentially infected
 wear gloves when in contact with
blood, body fluids, non-intact skin,
mucous membranes or contaminated
items & change them after each contact
 HANDWASHING if contaminated with
blood, body fluids, after each patient
contact & after removing gloves
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INFECTION CONTROL

Standard Precautions
 wear a gown/apron when clothing could
become soiled
 wear mask, eye protection/face shield if
splashing of blood/body fluids is possible
 do not recap/break needles
 use proper sharps container
 report any exposures
 clean equipment after each use
42
INFECTION CONTROL

Transmission-Based Precautions
 airborne precautions
 tiny microorganisms from
evaporated droplets remain
suspended in the air or carried by
dust particles & inhaled
 TB, measles and chickenpox
 private negative pressure room
 doors of rooms kept closed
 high-filtration particulate respirator
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INFECTION CONTROL

Transmission-Based Precautions

droplet precautions




microorganisms are propelled through the
air through sneezing, coughing, talking or
suctioning
meningitis, pneumonia, influenza, mumps,
rubella, and etc.
mask and private room
doors may remain open
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INFECTION CONTROL


Transmission-Based Precautions
 contact precautions
 most frequent mode of transmission
 direct contact of body surface
 indirect contact such as needle/hand
 HEP A, herpes simplex virus, acute
diarrhea, draining abscess & etc.
 gloves, gown and private room
use in ADDITION to Standard Precautions
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INFECTION CONTROL

Isolation
 administering medications
 unwrap before going into pt’s room
 use disposable med trays and cups
 don’t take med cards into pt’s room
 HANDWASHING
 needles/syringes in sharps container
 use & discard IV bags in pt’s room
 dispose of all materials in pt’s room
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INFECTION CONTROL

Isolation
 sending a specimen to the
laboratory
 before collecting, label
container
 place into bag with
“biohazard” label
 HANDWASHING
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INFECTION CONTROL

Isolation
 taking vital signs
 use equipment in patient’s room
 wear PPE as indicated
 use clock in patient’s room, not
your watch
 use disposable temperature system
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INFECTION CONTROL

Isolation

transporting the patient to other
areas
 wear PPE as indicated to
include pt
 control/contain patient’s
drainage
 escort ambulatory patients
 notify other areas of patient’s
precautions
 disinfect transportation device
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INFECTION CONTROL

Isolation
 caring for the patient’s body after death
 take special precautions to prevent
spread of infection
 protective (reverse) isolation
 protection from outside environment
 for weakened immune response pts
 burns or bone marrow transplants,
HIV positive, chemotherapy and etc.
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REVIEW OF MAIN POINTS



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


Microorganisms
Infectious Disease
Response to Infection
Nosocomial Infections
Medical Asepsis
Surgical Asepsis
Infection Control
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