Transcript Asepsis - Home - KSU Faculty Member websites

Unit four
Mr. Ahmad Ata
RN,CNS,MSN
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Lecture Objectives
At the end this lecture the students will able to:
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Define concept related to asepsis.
Identify the types of infection.
Describe the chain of infection and nursing
interventions to break the chain.
Know CDC and prevention guideline.
Ability to implement technique correctly.
Ability to use isolation and precaution system.
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Introduction:
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Micro organisms exist every where in the
environment: in water, soil, on body surface
such as skin, intestinal tract, mouth.
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The bacteria which found in intestine
produce substance called bacterocin which
are lethal to other bacteria, these bacteria
called normal flora.
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INTRDUCTION:
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Example of resident bacteria: staphylococcus
epidermidis and cornybacterium xerosis founds
in skin.
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Some infections are asymptomatic or sub
clinical for example cytomegalovirus (CMV)
which transmitted from animal specifically cats
to pregnant woman can lead to unborn child
disease
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Definitions terms:
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Infection: is an invasion of bacteria in the body
tissue by microorganism and their proliferation
there.
Virulence: their ability to produce disease.
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CONT
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Communicable disease: is condition which
transmitted microorganism to individual by
direct or indirect contact through air borne
infection, vector or vehicle borne disease.
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CONT
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Nosocomial infections: Infection associated
with the delivery health care services in health
care facilities
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Example: urinary tract infection due to
catheterization technique.
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CONT:
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Asepsis: Is freedom from disease - causing
micro organism order to decrease the possibility
of transferring microorganism.
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Sepsis: is the opposite of asepsis state.
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There are two basic types of asepsis:
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Medical asepsis: includes all type of practice
intended to confine specific microorganism to
specific area in order to limiting number or
decrease transmission of microorganisms.
Medical asepsis is referred to:
Clean: the absence of almost all
microorganism.
Dirty: contaminated the likely presence
microorganism.
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Examples of medical asepsis:
Hand washing: practice that involve scrubbing with
antimicrobial soup and water.
 Personal protective equipment: uniform, gown,
gloves.
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CONT
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Using anti microbial agent.
 Anti microbial agent: are chemical to hat limit the
number of infection microorganism by destroying
them or suppressing their growth.
 antiseptic:
organism.
inhibit growth but don’t kill micro
 Disinfectant:
chemical destroy active micro
organism in dead space.
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CONT:
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Surgical asepsis (sterile technique): refer
those practice that keep an area free of all
micro organism.
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Sterilization technique
Purpose: elimination of microorganisms
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Steam (Autoclaving)
instruments, dressings
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Dry heat
instruments that could be corroded
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Gas
ethylene oxide
if heat sensitivity (rubber, plastic materials,
endoscopic instruments)
Radiation
gamma rays
solutions, catheters, sealed plastic materials
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Type of organism causing infection:
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Bacteria: the most common infection causing
microorganism can live in water, soil, air.
Viruses: consist primarily of nucleic acid ( rhino
virus cause common called).
Fungi.
Parasite.
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Classification of bacteria:
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1) Shape: spherical (cocci), rod shaped (bacilli),
corkscrew (spirochetes).
2) Reaction to gram stain: gram negative and
gram positive.
3) Need of oxygen: aerobic and anaerobic.
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Types of infection:
1) Local infection: is limited to the specific part of
the body where microorganisms remain.
2) Systematic infection: when microorganisms
spread and damage different part of body.
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Bacteremia: when culture of persons blood
reveals microorganisms.
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CONT
 Septicimia:
when Bacteremia results in
systematic infection.
3) Acute infection: infection appears suddenly or
in short time.
4) Chronic infection: infection may occur slowly
and takes long time.
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Chain of infection:
1. Etiologic agent: bacteria, virus.
 Factors effect on the infection agent:
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Number of organism.
Virulence.
Pathogenicity: ability to produce disease.
Invasiveness: the ability of microorganism to enter
the body.
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CONT
2. Reservoir:
 Human, animal, plants and general
environment.
 Example: the person who have influenza virus
is frequently spread to other people.
 Insects, birds and other animals are common
reservoir of infection.
 Food, water and milk also can be reservoirs.
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CONT
3. portal exist:
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After microorganism leave its reservoir, its
need to method to reach to another person
these methods are:
Direct transmission: involves direct transfer
of microorganism from person to another
through, touching, biting, kissing or sexual
intercourse sneezing and coughing.
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CONT
3. portal exist:
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After microorganism leave its reservoir, its
need to method to reach to another person
these methods are:
Direct transmission: involves direct transfer
of microorganism from person to another
through, touching, biting, kissing or sexual
intercourse sneezing and coughing.
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Indirect transmission may be:
vehicle born transmission: is any substance
that serves as intermediate means to transport
infectious agent such as surgical instrument,
cooking, water and milk.
Vector borne transmission: is animal or flying
or insect that serve intermediate mean of
transportation.
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Common portal exist:
Respiratory
 Gastrointestinal
 Genitourinary tract.
 Blood
 Breaks skin.
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CONT
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4) Portal entry: microorganism must enter the
body through same route that exist.
5) Susceptible host: is any person who is at risk
for infection
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Stages of infection:
1.
2.
3.
4.
Incubation period: organism growing and
multiplying.
Prodromal stage: person is most infectious and
non specific sign and symptom.
Full stage of illness:
presence of specific sign and symptom.
Convalescent period :recovery from infection.
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Body defense against infection are:
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1) Non specific defense such as:
Anatomic barrier.
Inflammatory response.
2) Specific defense:
 Anti body
 Cell mediated defense.
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Factors increase susceptibility to
infection:
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Age.
Intact skin.
Normal ph level.
Decreased WBC.
Stress
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Assessment:
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Lapratory data indicating infection:
Increased leukocyte ( 4.500 – 11,000).
 Increased specific type of leukocyte.
 Erythrocyte sedimentation rate.
 Positive culture in blood, urine and sputum.
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Sign of local infection includes:
Swelling
 Pain
 Tenderness
 Palpable heat at infected area.
 Loss of function body part in affected area.
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Sign of systematic infection:
Fever
Increased pulse and respiratory rate
Malaise and loss of energy
Enlargement and tenderness of lymph node.
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Nursing diagnosis:
Risk for infection related to broken skin.
Risk for infection related to immunosuppression
Fever related to physiological effect of infection.
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Planning:
 Demonstrate effective hand washing.
 Identify sign of infection.
 Maintain adequate nutritional intake.
 Demonstrate proper disposals of soiled articles
 Use appropriate disinfecting technique.
 Demonstrate awareness of immunization.
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Implementation:
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Teaching about infection control:
Wash hand.
Preventing Nasocomial infection.
Invasive medical device.
Antibiotic Resistant Organism
Strategies to protect patients
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Wearing personal protective equipment (PPE)
such as:
 Uniforms.
 Gown
 Mask and gloves.
 Head caps
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Isolation Precautions
Hand hygiene
Patient
placement
Patient
Transport
PPE
Isolation
Precautions
Linen & laundry
Decontamination
Waste Management
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Hand hygiene
Perform hand hygiene:
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Before and after patient contact
After removing gloves or any other PPE
item
After touching blood, body fluids,
secretions, excretions, and contaminated
items, whether or not gloves are worn
After contact with patient surroundings
Routine hand hygiene by alcohol hand
rub (preferably) or by washing hands
with soap and water
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PPE - Gloves
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When expose to blood,
body fluids, secretions,
excretions, mucous
membranes and nonintact skin, and
contaminated items
Perform hand hygiene
immediately after glove
removal
2. Change gloves when heavily
contaminated
4. Disposable glove should not be
reused
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PPE - Gown
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1. When splashes
or sprays of blood
and body fluids,
secretions and
excretions to skin
and working
clothes are likely
2. When working
3. Select an appropriate gown for the procedure
clothes has
substantial contact
with patient,
environmental
surfaces or patient
items
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PPE – Respiratory & eye
protection
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Surgical masks and eye protection:
When splashes or sprays of blood
and body fluid, secretions and excretions
are likely
Droplet precautions
 Airborne isolation precautions
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Change PPE promptly if heavily
contaminated during the procedure
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Strategy of Patient
Placement
Isolate suspected or
confirmed cases in a
negative pressure isolation
room
When single rooms are fully
occupied
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Cohort patients with same confirmed
diagnosis in same cubicles, maintaining a
minimum of 1 metre distance from each
other
Confirmed and suspected cases should be
nursed in separate
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Transport of Suspected or confirmed
patient
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Limit patient transport unless clinically
indicated
Encourage patients to wear surgical
mask if no contraindication
3. Inform the receiving
service/department of concern
beforehand
4. Clean / disinfect transport vehicles
after use
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Decontamination Environmental Control
Disinfect isolation and procedure rooms after use by
a high risk patient
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Clean and disinfect the environment regularly and additional
session for frequently touched surfaces
Contaminated area should be disinfected by one part of
hypochlorite solution add in 49 parts of water
If blood spills occur:
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Use one part of hypochlorite solution add in 49 parts of water
for non-metallic and 70% alcohol for metallic items.
If spills involve large amount of blood, the blood should be
removed by disposable material soaked with one part of
hypochlorite solution add in 4 parts of water before further
cleaning and disinfection
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Linen and laundry management
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Proper handling of soiled linen:
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Avoid sorting
Minimum agitation and shaking
Well pack soiled linen to prevent leakage
Wear appropriate PPE when handling soiled
linen
Clean linen should be transported and stored
separately to prevent recontamination
Follow hospital policy
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Patient teaching for medical asepsis at home.
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For further information please visit:
www.cdc.org
Center of disease control and prevention
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PLEASE REVIEW CHAPTER 27 FROM
REFFRENCES BOOK
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THE END
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