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Ppt chapter 10 Ppt chapter 10 Presentation Transcript

  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 10 Asepsis
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Living animals or plants visible only with a microscope; also commonly called germs – The body’s immune defense mechanisms eliminate them – They reside within the body without causing disease – They cause an infection or infectious disease Microorganisms
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Microorganisms • Bacteria • Protozoans • Viruses • Mycoplasmas • Fungi • Helminths • Rickettsiae • Prions
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Categorization of Microorganisms Nonpathogens: harmless, beneficial Pathogens: cause illness Resident nonpathogens constantly present on the skin Transient pathogens picked up during contamination Aerobic: require oxygen to live Anaerobic: exist without oxygen
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Survival of Microorganisms • Spores – Temporarily inactive microbial life form; can resist heat and destructive chemicals and survive without moisture; reactivate and reproduce when conditions are favorable • Antibiotic-resistant bacterial strains – No longer respond to drugs that once were effective against them
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Is the following statement true or false? Transient pathogens are present constantly on the skin.
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Transient pathogens are picked up during contamination.
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chain of Infection • An infectious agent • A reservoir for growth and reproduction • An exit route from the reservoir • A means of transmission • A portal of entry • A susceptible host
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chain of Infection (cont’d)
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Biologic Defense Mechanisms • Anatomic or physiologic methods that stop microorganisms from causing an infectious disorder – Mechanical: physical barriers that prevent microorganisms from entering the body or expel them before they multiply – Chemical: destroy or incapacitate microorganisms through natural biologic substances
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nosocomial Infections • Nosocomial infections are infections acquired while a person is receiving care in a health care agency
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Is the following statement true or false? Mechanical defense mechanisms destroy or incapacitate microorganisms through natural biologic substances.
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Chemical defense mechanisms destroy or incapacitate microorganisms through natural biologic substances.
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Asepsis • Practices that decrease or eliminate infectious agents, their reservoirs, and vehicles for transmission • A major method for controlling infection • Health care professionals use medical and surgical asepsis to prevent spread of infections
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Medical Asepsis • Confines or reduces the numbers of microorganisms • Involves measures that interfere with the chain of infection in various ways • Examples: – Performing hand hygiene – Wearing hospital garments
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Surgical Asepsis • Measures that render supplies and equipment totally free of microorganisms • Practices that avoid contaminating microbe- free items • Examples: – Physical sterilization – Chemical sterilization
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Principles of Medical Asepsis • Microorganisms exist everywhere except on sterilized equipment • Frequent hand washing and maintaining intact skin reduces transmission of microorganisms • Blood, body fluids, cells, and tissues are major reservoirs of microorganisms • Personal protective equipments serve as barriers to microbial transmission
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Principles of Medical Asepsis (cont’d) • A clean environment reduces microorganisms • Cleaning should be done from cleaner to dirtier areas
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Is the following statement true or false? Surgical asepsis involves measures that interfere with the chain of infection in various ways.
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Medical asepsis involves measures that interfere with the chain of infection in various ways.
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Practicing Hand Antisepsis • Apply about a nickel- to quarter-sized volume of the product to the palm of one hand or the amount recommended by the manufacturer • Distribute the product to cover all surfaces of the hands and fingers • Rub the product between the hands for 15 to 25 seconds until they are dry
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Hand Antisepsis
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Which of the following is a method of surgical asepsis? a. Donning a sterile gown b. Using antimicrobial agents c. Performing hand antisepsis d. Performing hand washing
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer a. Donning a sterile gown Donning a sterile gown is a method of surgical asepsis. Using antimicrobial agents, performing hand antisepsis, and hand washing are methods of medical asepsis.
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Hospital Garments • Gloves • Scrub suits and gowns • Masks; Respirators • Uniforms • Hair and shoe covers • Protective eyewear
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Hospital Garments
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Utility Rooms • Health care agencies: at least 2 utility rooms (clean and dirty); personnel must not place soiled articles in the clean utility room • The utility room contains: – Covered waste receptacles and laundry hampers – Flushable hopper and a sink – Equipment for testing stool or urine
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Concurrent Disinfection • Clean less-soiled areas before grossly dirty ones • Wet-mop floors and damp-dust furniture to avoid distributing microorganisms on dust and air currents • Frequently discard solutions used for mopping in a flushable hopper • Never place clean items on the floor
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Terminal Disinfection • More thorough than concurrent disinfection and consists of measures used to clean the client environment after discharge • Includes scrubbing the mattress and the insides of drawers and bedside stands
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sterilization • Consists of physical and chemical techniques that destroy all microorganisms including spores – Physical sterilization: radiation, boiling water, free-flowing steam, dry heat, steam under pressure – Chemical sterilization: peracetic acid, ethylene oxide gas
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Principles of Surgical Asepsis • Once equipment and areas are free of microorganisms, they remain in that state if contamination is prevented • Sterility preserved: touching one sterile item with another that is sterile • Once a sterile item touches something that is not sterile, it is considered contaminated • Any partially unwrapped sterile package is considered contaminated
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Principles of Surgical Asepsis (cont’d) • Question the sterility of an item considered unsterile • Longer the time since sterilization, the more likely that the item is no longer sterile • Commercially packaged sterile item is not considered sterile past its recommended expiration date • Opened sterile item or area, left unattended, is considered contaminated
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Principles of Surgical Asepsis (cont’d) • Once a sterile item is opened or uncovered, it becomes contaminated • The outer 1-inch margin of a sterile area is considered a zone of contamination • A wet sterile wrapper wicks microorganisms from its supporting surface, causing contamination
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Principles of Surgical Asepsis (cont’d) • Coughing, sneezing, or excessive talking over a sterile field causes contamination • Reaching across an area that contains sterile equipment may cause contamination • Sterile items located or lowered below waist level are considered contaminated
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Adding an Agency-Sterilized Item
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Adding Sterile Gauze
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Adding Sterile Solution
  • Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations • Older clients more susceptible to infections • Maintain intact skin, proper aseptic techniques, perineal hygiene, thorough hand washing; indwelling catheters should be avoided • Bladder training, annual immunizations • Ill health care workers should take sick leave rather than expose susceptible clients to infectious organisms