Hand Washing ,GOWNING,GLOVING,PPE,ISOLATION TECHNIQUE ,STERILIZATION

1. Medical & Surgical Aseptic
Practices and Isolation
Techniques
Demonstration - On
Hand washing, Using PPE &
Isolation techniques
MATHEW VARGHESE V
MSN(RAK),FHNP (CMC Vellore), CSTPN,CCEPC
Nursing officer
AIIMS Delhi

2. INTRODUCTION
• Florence Nightingale once said that the first
requirement of a hospital is to do the patient
no harm.
• It is really obvious Hospital acquired infections
leads to waste of resources and elevating
mortality rate.
• According to WHO, 15% of all hospitalized
patients suffer from these.
• Most of these could be easily preventable by
taking simple measures by healthcare
professionals.

3. RELATED TERMINOLOGY
• Asepsis: It means a state of being free from
pathogenic organisms or infection.
• Antisepsis: It means the prevention of sepsis /
infection. It inhibits the growth and
development of microorganisms on skin and
other body tissues by’ using a chemical agent
(antiseptic).
• Pathogenic Organism: Organism which can
produce disease.

4. RELATED TERMINOLOGY
• Spore: A resistant encapsulated form taken by certain
organism when conditions are not suitable for their
existence. This is important in surgical asepsis because
the protective shells of the micro-organisms are
resistant to heat and are difficult to destroy.
• Direct Transmission: Infection spreads through direct
contact with the diseased person e.g. touch droplet
infection etc.
• Sepsis: It is the infection of the body by pus-forming
bacteria, or the presence of bacteria and their toxin in
the body (usually following the infection of a wound),
which kill tissues and produce pus.

5. RELATED TERMINOLOGY
• Sterilization: It is the process of destruction of all
the micro-organisms, both pathogenic and non-
pathogenic, including their spores.
• Droplet infection: In this the infection spreads by
means of fine particles i.e. nuclei of saliva and
mucus that are expelled through sneezing,
coughing and speaking.
• Fumigation: It is the process of disinfection by
exposure to the fumes of a vaporized germicide.

6. RELATED TERMINOLOGY
• Isolation: lt is the separation of infected persons
from a non-infected person for the period of
communicability under conditions. This will
prevent the transmission of infection to others.
• Portal of entry: They are ways through which
pathogens enter the body.
E.g. respiratory tract, gastro-intestinal tract etc.
• Portal of exit: They are ways through which
pathogens leave the body.e.g.Excretion of body
fluids through urinary tract etc.

7. RELATED TERMINOLOGY
• Quarantine: It is detention or isolation of a well person
who has come in contact with an infectious disease for
a period of time equal to the longest incubation period
of that disease.
• Carrier: A person who harbors pathogens of a disease
in his body without showing signs and symptoms of
that disease.
• Disinfection: It means destroying of all the pathogenic
organisms outside the human body by direct exposure
to a chemical or physical agent.

8. RELATED TERMINOLOGY
• Concurrent disinfection: It is the immediate
disinfection of all contaminated articles and bodily
discharges during the course of the disease.
• Terminal disinfection: It means disinfection of the
patient's unit with all the articles (furniture, linen,
mattress, pillows, utensils etc.) used by the patient
on his discharge, death or release from isolation.
• Epidemic: A disease which attacks a large number of
people in a community at the same time or during
the same season

9. NORMAL BODY DEFENCES
• NON SPECIFIC DEFENCE
• SPECIFIC BODY DEFENCE
– Active immunity
– Passive immunity

10. CHAIN OF INFECTION:

11. MODES OF TRANSMISSION OF
INFECTION
• CONTACT
– Direct Contact
– Indirect contact
– Droplet contact
• AIR
– Droplet nuclei
– Dust
• VEHICLES
– Contaminated item, liquids, water, drugs, blood, food and
improperly handled or stored fruit and vegetables.
• VECTORS
– Insects

12. COURSE OF INFECTION
• Incubation period-Interval between entrance
of pathogen into body and appearance of first
symptoms; e.g. Chicken pox 2 to3 weeks
• Prodromal stage- Interval from the onset of
non-specific signs and symptoms .Micro-
organisms grow and multiply and the client is
more capable of spreading disease to others
during this time

13. COURSE OF INFECTION
• Period of illness-Interval when the client
manifests signs and symptoms specific to the
type of infection
• Convalescence Stage-Interval when acute
symptoms of an infection disappear, length of
recovery depends on severity of infection and
the clients’ general state of health. Recovery
may take several days to months

14. RISK FACTORS FOR INFECTION:
• INADECQUATE PRIMARY DEFENCE
– Broken skin or mucous membrane.
– Traumatized tissue.
– Decreased ciliary action.
– Obstructed urine outflow
• INADECQUATE SECONDARY DEFENCE:
– Reduced hemoglobin level.
– Suppression of white blood corpuscles (drug or disease-
related).
– Suppressed inflammatory response (drug or disease-
related).
– Low WBC count (leukopenia).

15. RISK FACTORS IN OLDER ADULTS
– Thinner dermal and epidermal layers of skin,
decreased sweat and skin elasticity.
– Reduced sensitivity.
– Circulatory and heart disorders like congestive
heart disease, calcified valves of heart.
– Reduce elasticity of veins, blood pooling in lower
extremities.
– Decreased cough reflex
– Exposure to nosocomial infections

16. NOSOCOMIAL INFECTIONS:
• Iatrogenic infections: type of nosocomial
infections that result from a diagnostic or
therapeutic procedure, e.g. urinary tract infection
may result due to catheterization.
• Exogenous infection: arises from micro-
organisms external to the individual, which do
not exist as normal flora. e.g. clostridium tetani.
• Endogenous infection: can occur when part of
the client’s flora becomes altered and an
overgrowth results; e.g. infections due to
enterococci,

17. NURSING PROCESS IN CONTROL OF
INFECTION
• NURSING ASSESSMENT
• LOCAL: Redness, swelling/edema, pain,
tenderness, inflammation, drainage from
open lessons or wounds.
• SYSTEMIC INFECTION: More generalized
symptoms can be seen. Fever, fatigue,
tachypnea, tachycardia, malaise, enlarged
swollen lymph nodes, anorexia, nausea and
vomiting.

18. NURSING DIAGNOSIS RELATED TO
INFECTION:
• High Risk for infection related to altered
immunity,tissue destruction and malnutrition
• High risk for Injury related to altered nutrition
• Impaired tissue integrity related to altered circulation
and exposure ton irritants
• Altered oral mucous membrane related to traumatic
irritation of nasogastric tube
• Social Isolation related to Misconceptions about
various diseases like STDs. etc.
• Body image disturbance related to Client's aversion to
open wound

19. GOAL OF NURSING CARE
• Prevent exposure to infectious organisms.
• Control or reduce the extent of infection.
• Maintain resistance to infection.
• Understand infection control self-care
practices.

20. NURSING MEASURES TO PREVENT
AND CONTROL INFECTION
General measures :
• Maintain general cleanliness of the hospital and ensure good
ventilation.
• Daily antiseptic mopping and sweeping of floors must be ensured.
• Practice good housekeeping.
• Ensure safe water supply and food in health setting.
• Safe disposal of excreta, urine, stool, Sputum etc. is important. They
should be disinfected before disposal.
• Destruction of rodents and insects by using appropriate chemicals is
important as they play a great role in Spread of an infection.
• Ensure routine hygienic measures such as personal hygiene, oral
hygiene etc. for the clients.

21. DIFFERENCES BETWEEN MEDICAL
ASEPSIS AND SURGICAL ASEPSIS
Medical Asepsis Surgical Asepsis
The number growth and
transmission of microorganisms
are /is controlled.
Objects / articles are free from
pathogenic and non-pathogenic
organisms.
Transmission of pathogenic
organisms is prevented.
Pathogenic and non-pathogenic
organisms are totally destroyed.
A clean technique is used eg.
hair combing, mouthwash etc.
A sterile technique is used,
giving injection and doing
surgical dressing.

22. MEDICAL ASEPSIS
• Medical asepsis is the combination of all practices
that are intended to confine a specific micro-
organism to a specific area, limiting the number,
growth and transmission of micro-organisms.
• In medical asepsis, objects are often referred to
as clean or dirty.
• Clean denotes the absence of almost all micro-
organisms. Dirty (soiled, contaminated) denotes
the likely presence of micro-organisms, some of
which may be capable of causing infection.

23. Control or elimination of infectious
agents including
• Proper cleaning by water and mechanical
action with or without detergents
– Disinfection
– Sterilization of contaminated objects.

24. Measures for control or elimination of
reservoirs of infections
• Bathing with soap and water to remove
secretion, drainage, perspiration, etc.
• Frequent change of dressings.
• Proper disposal of wastes and contaminated
articles.
• Keep the patient's bedside unit clean, dry and
biologically safe.
• Bottled solutions should be placed with tight caps
as per instructions.

25. Control of portals of exit
• Practice aseptic precautions.
• Avoid talking directly into the client's face to
prevent droplet infections.
• Wearing of masks is important once the nurse
herself has infection or deals with clients
suffering from infections.
• Careful handling of wastes like urine, faces,
emesis and blood is important.

26. Control of transmission of infection
• Discourage sharing of bedpans, urinals, basins,
eating utensils, etc.
• Use separate thermometers for infectious
patients.
• Practice hand-washing technique.

27. Control of portals of entry
• Maintain integrity of skin and mucous
membranes.
• Proper positioning of tubing, etc. may prevent
injuries and skin breakdown.
• Turning and positioning of debilitated clients
will help in preventing a skin breakdown.
• Ensure personal hygiene of clients regularly.

28. Protection of susceptible host
• Maintaining an adequate fluid intake.
• Encouraging deep breathing and coughing
exercises.
• Encouraging proper immunization of children
and adult clients.
• Promotion of intake of a well-balanced diet
containing essential proteins, vitamins, fats
and carbohydrates.

29. SURGICALASEPSIS
• Surgical asepsis is the combination of all
practices that ensure absence of all micro-
organisms, including pathogens and spores
from an object. In surgical asepsis, sterile field
is important

30. These involve:
• Hand washing
• Opening of sterile wrapped packages
• Gowning
• Gloving
• Wearing mask
• Sterilization of articles.

31. PRINCIPLES OF SURGICAL ASEPSIS:
PRINCIPLES RATIONALE
Always face the sterile field. Don’t turn
your back or side on a sterile field.
Sterile objects which are out of vision are
considered questionable and their sterility is
not guaranteed.
Keep sterile equipment above your waist
level or above table level.
Because waist level and table level are
considered margins of safety and will
promote a maximum sterile field.
Don’t speak or cough over a sterile field. If
it is necessary to do so, turn your head
from the sterile field.
To prevent droplet infection.
Never search or cross a sterile field. When a non-sterile object crosses the sterile
field, gravity causes the micro-organisms to
fall into the sterile field.

32. PRINCIPLES RATIONALE
Prevent excessive air currents around sterile
areas. Air current can be caused by/moving
fast, flapping the cloth sand drapes and by
closing the doors etc.
Micro-organisms are present in the air and
they travel in air current.
Keep the wet unsterile object away from the
sterile.
Micro-organisms may be transferred whenever a
non-sterile wet field. Object touches a sterile
field. The micro-organisms may be transferred
consequently. The sterile area becomes unsterile
by capillary action.
Keep the sterile field dry Micro-organisms do not pass easily through a dry
surface
Handle liquids cautiously near the sterile field
or prevent drapes or wrappers from becoming
wet.
When a liquid comes in contact with a non-sterile
field, the micro-organisms may be transferred.
Consequently, the sterile area becomes unsterile
by capillary action.

33. PRINCIPLES RATIONALE
The edge of the sterile field is
considered unsterile.
Proximity to a contaminated area
makes sterility doubtful.
Each sterile supply should be clearly
labeled as to its contents, time and
date of sterilization.
To ensure sterility.
Never assume that an object is
sterile. Always check the expiry date
of sterility.
Sterility of an object wrapped in paper
or cloth becomes doubtful after four
weeks and those sealed in polythene
bags after one year
Avoid sweeping and dusting when
sterile objects are opened.
Micro-organism travel in dust
particles.

34. PRINCIPLES RATIONALE
Wash hands, put on gowns, gloves and mask before
handling the sterile supplies.
To prevent contamination.
Open the sterile package in such a way that the
edges of the wrapper are directed away from the
worker.
To avoid the possibility of a sterile surface touching the
uniform.
Hold the transfer forceps pointing downwards. To prevent the solution from flowing into the
contaminated areas (the handle of the forceps) and then
back to the sterile area (the up of the forceps).
When removing the forceps from the container lift it
without touching the sides and the rim of the
container.
The tip of the forceps becomes contaminated when
touching the container that is not in direct contact with
the disinfectant solution.
Keep the prongs together directly over the container
to remove the excess solution.
To prevent the solution from dribbling onto the sterile
held and wet it.
Transfer forceps and the container should be
sterilized daily.
There is a great possibility of these articles becoming
contaminated because of the frequency and varied use.

35. USE OF THE CONTAINER: WITH STERILE
SUPPLIES
Remove the cover from the container
when necessary and only for a short
period.
Air currents can contaminate the cover.
Leave the cover of the container in such a
way that the inside of the lid is pointing
downwards.
Air currents can contaminate the inside
of the cover
Consider the rim of the container to be
contaminated.
Contact with, the unsterile surface
contaminates sterile objects.
Don’t return the container, once
the cover container to be contaminated.
Proximity to a contaminated area makes
the sterility doubtful.
Don’t return the unused sterile objects to
the container, once they have been taken
out.
It is considered to be contaminated by air
currents.

36. DISINFECTION
• Disinfection refers to chemical or physical
processes used to reduce the numbers of
pathogens from an object’s surface.
• Concurrent disinfection
Immediate disinfection of contaminated articles
and bodily discharges during the course of the
disease eg; daily cleaning of the ward
• Terminal disinfection
Disinfection of the unit and articles on discharge,
transfer or death of the patient.eg; fumigation
using baccishield

37. STERILIZATION
• Sterilization is the process by which an object
becomes free of all micro-organisms.
• By sterilization both pathogenic and
nonpathogenic organisms are destroyed.
There are various methods used for
sterilization of articles.

38. METHODS OF STERILIZATION
• DIRECT SUNLIGHT
• Direct sunlight will have an effect on acid fast micro-
organisms. Place the linen or bed pans in direct
sunlight for six hours for two consecutive days.
• BOILING
• Boiling is an effective method of sterilization. Boiling
for five to ten minutes at boiling point kills all the
bacteria except spores and virus. It is used in home
environment.
• CHEMICAL DISINFECTION
• A chemical disinfectant acts by coagulating the
bacterial protein or by changing the composition of
protein so that it no longer exits in the same form. It is
used to sterilize articles destroyed by heat.

39. METHODS OF STERILIZATION
• RADIATION BY UV RAYS
• Ultraviolet light sterilization is effective for disinfecting working surface
and air inside rooms
• HOT AIR STERILIZATION
• High temp and comparatively long exposure time are required. It is not a
suitable sterilization agent for fabrics and dresses which are poor and
uneven conductors and are ruined by excessive heat. It is, however, the
method of choice for fine metal cannula (e.g. L.P. needles) and for glass
syringe
• AUTOCLAVING
• Steam under pressure; Autoclaving is a method of sterilization by steam
under pressure. It is the most widely used, economical and one of the
most effective methods of destroying micro-organisms. This method uses
high temperature, pressure and humidity to destroy all types of micro-
organisms, including spore forming. For effective sterilization autoclaving
is done at 15lbs per square inch pressure and 121°C temperature for at
least 20 minutes.

40. METHODS OF STERILIZATION
• FLAMING
• It is a method of sterilization by putting instrument in a flame for a
while
• FUMIGATION OR GAS STERILIZATION:
• Total surface exposure to formaldehyde gas under conditions of
controlled humidity temperature and time exposure will destroy all
vegetative forms of bacteria, viruses and most of the spores. The
best results can be obtained with high concentration of gas.
humidity above 60 and temperature of not less than 18°C. The
exposure time varies from one to 16 hours. The agents commonly
used for the fumigation are formalin tablets, ethylene oxide liquids
etc.
•

41. PROCEDURES IN MEDICAL AND
SURGICAL ASEPSIS:
HANDWASHING
Hand washing is important in every setting,
including hospitals. It is an effective infection
control measure, as it prevents spread of
micro-organisms. For routine client care, the
vigorous hand washing under a stream of
water for at least 20 seconds using soap.

42. Hand washing should be done in the
following situations:
• -Before contact with clients who are susceptible to
infection.
• -After caring for an infected client.
• -After touching infected material.
• -Before performing invasive procedures like administration
of injections, suction, catheterization, etc.
• -Before and after handling dressings or touching open
wounds.
• -After handling contaminated equipment.
• -Between contact with different clients in high-risk units.

44. PURPOSE
• To remove transient and resident bacteria
from fingers, hands and forearms.
• To prevent the risk of transmission of infection
to patients.
• To reduce the risk of transmission of infection
organisms to oneself.
• To prevent cross infection among clients.

45. EQUIPMENT / ARTICLES
Articles Rationale
Soap in a soap dish Soap contains antibacterial
agents and has a lasting bacteria
static effect.
Nail brush To clean nails.
Running water To rinse soap and thoroughly
wash hands.
Towel To dry hands. To dry hands.

46. STEPS OF PROCEDURE
• 7 Important hand movements in hand washing:
• Wash palms and fingers
• Wash back of hands
• Wash fingers and knuckles
• Wash thumbs
• Wash finger tips
• Interlocking of hands
• Wash wrists.

48. Steps Rationale Scientific Principles Nursing principle
File the nails short, ensure
that nails are free of nail
polish
Short nails are less likely to
harbor transient micro-
organism
Microbiology Safety
Remove all jeweler and
wrist watch.
Micro-organisms can be
inside the settings of
jewellery and under rings.
Removal facilitates proper
cleaning of hands and arms.
-do- -do-
Turn on the water to adjust
the flow so that water is
lukewarm
Warm water remove less of
the protective oil of the skin
than of hot water
Physics Comfort and safety
Medical asepsis: wash the
hands thoroughly by holding
the hands lower than the
elbows so that water flows
from arms to finger tips .
It allows water to now from
the least contaminated area
(elbow) to the most
contaminated area (hands).
Microbiology Safety

49. Steps Rationale Scientific
Principles
Nursing principle
Surgical hand washing : Wet
the hands and forearms under the
running water, letting it run from
the fingertips to the elbows so that
the hands become cleaner Apply
the soap and wash as described in
step 4, but hold the hands higher
than the elbows during this hand
wash.
Water run by gravity from
finger tips to elbows.
Keeping hands elevated
allows water to flow from
least to the most
contaminated area.
Physics Safety
Apply liberal amounts of soap
into hands and lather hands
and arms using hand brushes.
Soap emulsifies the oil and
lowers the surface tension of
water, facilitates the removal
of micro-organisms, dust and
oils. Brushes are used to
enhance mechanical friction
during hand washing.
Physics and Chemistry Safety and Therapeutic
effectiveness

50. Steps Rationale Scientific
Principles
Nursing principle
Thoroughly wash and
rinse the hand using firm
rubbing and circular
movements to wash the
palms back and wrist of
reach hand. Interlace the
fingers during hand
washing.
The circular action helps
to remove micro-
organisms mechanically.
Running water and
friction used in cleaning
are the mechanical
action of cleaning.
Physics Safety
Dry arms and hands
thoroughly from fingers to
wrists and forearms .
Discard the towel in a
proper container.
Drying helps in removing
moisture, prevents
chapping and toughening
of skin. Drying from
cleaner to least clean am
prevents contamination.
Microbiology ,Anatomy
and Physiology
Safety

51. Steps Rationale Scientific
Principles
Nursing principle
Turn off the water tap using a
paper towel or using an elbow.
Handle is contaminated. Use
of a paper
towel or an elbow prevents
contamination of washed
hands.
Microbiology Safety

52. GOWNING
• Clean or plastic aprons are worn during procedures
when the nurse’s uniform is likely to become soiled.
Sterile gown may be indicated when the nurse changes
the dressings with extensive wound s, burns etc.
• PROCEDURE: GOWNING TECHNIQUE (STERILE)
• PURPOSE
• To prevent soiling of clothes during contact with the
patient.
• To protect health care personnel from coming in
contact with infected material

53. STEP OF PROCEDURE
Steps Rationale Scientific
Principles
Nursing
Principles
Pick up a sterile gown and allow it to unfold
keeping inside of the gown towards the body
without allowing the outside of the gown to
touch any area.
To prevent soiling/
contamination of the
sterile gown.
Microbiology Safety
With hands at shoulder level, slip both arms
into armholes simultaneously. Ask
circulating nurse to bring the gown over
shoulders.
It prevents
contamination of the
sterile gown.
Microbiology Safety
The circulating nurse fastens the ties at neck.
Overlap the gown at the back as much as
possible and fasten the waist, ties or belt.
It keeps the gown at
place and covers the
uniform at the back.
Microbiology Safety
Prevent the gown from becoming wet. Moisture allows
organisms to travel
through the gown to
the uniform.
Microbiology Safety
While removing avoid touching soiled parts on
the outside of the gown. Roll up the gown with
It prevents
contamination of the
Microbiology Safety

54. GLOVING
• Gloves are worn to protect hands when the nurse
is likely to handle any body substances, eg. Urine,
faces, Sputum, mucous membranes and non-
intactskin. Gloves also reduce the likelihood of
transmission of own endogenous micro-organisms
to individuals receiving care. For most activities ,
disposableclean gloves are used. Sterile gloves are
used when the hands will come in contact with an
open wound or when handsintroduce micro-
organismsinto a body orifice.

55. GLOVING
Gloving Rationale Scientific
principle
Nursing
principle
Thoroughly wash hands. Removes bacteria from skin and
surfaces and reduces transmission
of infection.
Microbiology Safety and
Therapeutic
effectivenes
s
Open a sterile glove packet of proper size
on a flat surface above waist level.
A sterile object held below waist
get contaminated.
Microbiology Safety and
Therapeutic
effectivenes
s
If gloves are not powdered ,take a packet
of powder and apply lightly to hands.
Powder allows the hands to slip on
easily.
Microbiology Safety and
Therapeutic
effectivenes
s
Identify the right and left hand. Glove
dominant hand first.
Proper identification of gloves
prevents contamination by
improper fit.
Microbiology Safety and
Therapeutic
effectivenes
s
With the thumb and the first two fingers
of the non- dominant hand, grasp an edge
of glove’s cuff. For dominant hand, touch
Inner edge of the cuff will lie
against skin and thus it is not
sterile.
Microbiology Safety and
Therapeutic
effectivenes

56. GLOVING(contd.)
Gloving Rationale Scientific
principle
Nursing
principle
Carefully pull the gloves over the
dominant hand. Ensure the thumb and the
finger are in proper spaces.(step 2)
Proper fitting of gloves on fingers. Microbiology Comfort
With gloved dominant hand , slip fingers
underneath the second glove’s cuff.
(step3)
This prevents glove contamination. Microbiology Safety and
Therapeutic
effectivenes
s
Carefully pull the second glove over the
non-dominant hand. Don’t allow fingers of
the thumb of the gloved dominant hand
to touch any part of the exposed non-
dominant hand . (step4)
Contact of the gloved hand with
the exposed hand results in
contamination.
Microbiology Safety and
Therapeutic
effectivenes
s
After the second glove is on interlock Ensures smooth fit over fingers. Microbiology Safety,

57. REMOVING DISPOSABLE GLOVES
Steps Rationale Scientific principle Nursing
principle
Remove the first glove by
grasping it on its palmar
surface just below the cuff,
taking care to touch only glove
to glove. Pull the first glove
completely off by inverting or
rolling the glove inside out.
This keeps the soiled parts
of the used gloves from
touching the skin of the
wrist or hand.
Microbiology Safety
Place the first two fingers of
the bare hand inside the glove
and remove the second
contaminated glove.
To prevent touching the
outside of the second
soiled glove with the bare
hand.
Microbiology Safety
Dispose them of in the
appropriate container.
To prevent cross infection. Microbiology Safety

58. WEARING MASKS
Masks are worn to reduce the risk for transmission of
organisms by the droplet contact, air borne routes, and
splatters of body substances. The CDC r ecommends (7
december 2020) that masks should be worn
• All people should wear masks in public settings and
when around people who don’t live in their household.
• Wash your hands with soap and water for at least 20
seconds or use hand sanitizer with at least 60% alcohol
after touching or removing your mask.

59. WEARING MASKS
Putting mask Rationale Scientific principle Nursing
principle
Hold mask by top two strings. Tie
two top ties at of top of the back
of the head with
ties above ears.
Position of tie at the top of the
the head provides a tight fit. Ties
above ears may cause irritation.
Microbiology Safety
Tie two lower ties snugly around
the neck with the mask well
under the chin.
Prevents ( inhalation & escape
of) micro-organisms from and it
to the air.
Microbiology Safety
If glasses are worn, fit the upper
edge of the To prevent glasses
from clouding. mask under the
glasses.
To prevent glasses from clouding. Microbiology Safety
Avoid unnecessary talking and, if
possible, 0 prevent the mask
from getting sneezing or
coughing. moist.
To prevent glasses from getting
moist.
Microbiology Safety
When removing a mask with
strings, first To prevent the top
part of the mask untie the lower
strings of the mask. from falling
on to the chest.
To prevent top part of the mask
from falling on to the chest.
Microbiology Safety

60. PERSONAL PROTECTIVE EQUIPMENT
• Health care agencies are supposed to provide
their employers with necessary equipment and
supplies so that they can protect themselves from
infections. These include use of gloves, gown,
mask, and protective eye gear.Get into scrubs or
comfortable clothes, remove jewellery, ensure
you had water and food and visited washrooms
etc. nurses are expected to stay inside for at least
6 hrs. . The observer needs to be in PPE when
observing doffing. . Two chairs should be placed
in doffing area labeled DIRTY & CLEAN Check all
PPE before starting donning.

61. PERSONAL PROTECTIVE EQUIPMENT
DONNING
• Wash hands with soap and water
• Wear shoe cover
• Wear 1st pair of gloves
• Wear gown
• Wear the mask/respirator (check for any leaks)
• Wear goggles/face shield
• Wear hood
• Wear 2nd pair of gloves
• Gown fitness check (ask buddy to help)

62. DOFFING OF PPE
• Check for any leak or soiling in PPE before doffing, (disinfect
site if contaminated)
• Disinfect the hands while wearing gloves (similar to hand
hygiene procedure).
• Remove shoe covers only by touching the outer surface (by
sitting on DIRTY chair)
• Perform hand hygiene
• Remove outer gloves
• Perform hand hygiene
• Remove hood
• Perform hand hygiene
• Remove gown
• Perform hand hygiene

63. DOFFING OF PPE
• Remove goggles/face shield
• Perform hand hygiene.
• Remove second pair of gloves
• Perform hand hygiene
• Wear new pair for gloves
• Remove mask (don’t touch the front of mask, handle
with slings/bands)
• Perform hand hygiene
• Clean shoes with alcohol swabs (by sitting on CLEAN
chair)
• Remove last pair of gloves and perform hand hygiene

64. ISOLATION PRACTICES:
• Isolation precautions control the transmission of pathogens
by prevention of direct contact with the infected client,
Barrier Nursing or Isolation Technique is intended to
confine the micro-organisms within a given and recognized
area. There are various isolation techniques, which are
broadly classified into two methods for implementation as
given by Gamer, Simmons, 1984.
•
These are:Disease specific isolation method:Certain
practices are followed for each infectious disease, e.g. covid
19 in which the client is placed in a private room with
precautions to prevent respiratory spread. category
Specific isolation: Diseases requiring similar isolation
perceptions are grouped in eight categories

65. category Purpose
Strict isolation Prevents transmission of highly contagious
virulent infections spread by air and contact.
Contact isolation Prevents transmission of highly transmissible
infections spread by close or direct contacts that
do not warrant strict precautions. .
Respiratory isolation Prevents transmission of highly transmissible
infections spread by close or direct contacts that
do not warrant strict precautions.
Enteric isolation Prevents infections transmitted by direct or
indirect contact with faeces

66. category Purpose
Drainage and secretion precaution
(wound &skin isolation
Prevents infections transmitted by
direct or indirect contact with purulent
material or drainage from infected
body site.
Universal blood and body fluid
precaution (blood isolation
Prevents contact with pathogens
transmitted by direct or indirect
contact with infected blood or body
fluids containing blood.
Careofseverelyimmune-compromised
client
Protects the client with lowered
immunity and resistance from
acquiring infectious organisms

67. BMW Management

68. CONCLUSION
• In every aspect of practice, the nurse encounters various
situations that have a risk of infection. A broad knowledge
base of the nurse about infections, their prevention and
control is important. Any lapse on the part of the nurse in
handling such infection prone situations may further
aggravate the problems of the clients and may pose a
serious threat to the health of the patient. The success of
the nurse who practices infection control techniques is
measured by determining whether the goals for preventing
infections are achieved .Hence medical and surgical asepsis
require more challenging efforts on the part of the nurse to
prevent disease and promote health.
•

69. BIBLIOGRAPHY:
• 1) Fundamentals of nursing a procedure manual TNAI,
FIRST EDITION,TNAI Pp-75-100
• 2) Fundamentals of nursing -the art and science of nursing
care, Fifth edition, Carol Taylor, Lippincott Williams&
Wilkins Pp-649-682
• 3) Potter ,Patricia A and Perry,Anne G . Fundamentals of
Nursing.3rdEd.St Louis :Mosby year Book Inc;1993
• 4) Kozier ,Barbara black wood. Fundamentals of patient
care.Philadelphia:W.Bsaunders company;1967
• 5) Sr. Nancy .Principles and practice of nursing Vol 1.Ed 3rd
.Kerala:N.R Brothers;1997
• 6)6).https://covid.aiims.edu/wpcontent/uploads/2020/03/
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