ASEPTIC MEASURESASEPTIC MEASURES
SHAHEENA MASOODI
HICN
SKIMS
ASEPSISASEPSIS
Definition
Asepsis means those practices that decrease
or eliminate infectious agents, their
reservoirs, a...
ASEPTIC TECHNIQUEASEPTIC TECHNIQUE
Purpose
 absence of pathogenic organisms in the
clinical setting.
Goal
to protect th...
Chain of InfectionChain of Infection
Pathogen
Reservoir
Portal of
ExitMode
of
Transmission
Portal of
Entry
Susceptible
Hos...
CROSS INFECTIONCROSS INFECTION
METHODS
Direct contact: transmitted from person to
person. (droplets, sexual contact, han...
PREVENTION OF CROSSPREVENTION OF CROSS
INFECTIONINFECTION
well ventilated hospitals
General cleanliness in hospitals
Sa...
PREVENTION OF DIRECTPREVENTION OF DIRECT
CONTACTCONTACT
Respiratory
isolation: masks
and gowns are
worn.
Enteric isolation:
Recommended to wear
gloves and gowns
while handling soiled
articles.
Thorough hand
washing by patient ...
Wound and skin isolation
Use of gowns and gloves
Safe disposal of dressings and discharges
Articles must be kept separ...
BLOOD ISOLATIONBLOOD ISOLATION
Equipment that comes in contact with the
client’s blood must be carefully disinfected
befo...
ISOLATION PRECAUTIONS:ISOLATION PRECAUTIONS:
TWO TIERSTWO TIERS
Standard: used routinely for the care of all
patients reg...
ContdContd
Transmission-based: designed for
patients documented or suspected to be
infected or colonized with organisms t...
Standard PrecautionsStandard Precautions
Hand Hygiene Wash/Decontaminate hands:
•After touching bodily fluids or contamina...
Environmental Care Environmental surfaces should be cleaned and disinfected on a routine basis and when visibly
soiled/con...
Standard PrecautionsStandard Precautions
Every Patient, Every Time,Every Patient, Every Time,
Every EncounterEvery Encount...
Medical asepsisMedical asepsis
those practices that confine or reduce the
numbers of microorganisms. Also called,
clean t...
Examples of medical asepticExamples of medical aseptic
practicespractices
using antimicrobial agents,
performing hand hy...
1. Using Antimicrobial Agents1. Using Antimicrobial Agents
Antimicrobial agents are chemicals that
destroy or suppress th...
AntisepticsAntiseptics
Antiseptics: inhibit the growth of, but do
not kill, microorganisms. An example is
alcohol
DisinfectantsDisinfectants
Disinfectants, also called and , destroy
active microorganisms but not spores.
Phenol, househo...
Anti-Infective DrugsAnti-Infective Drugs
Antibiotics
Antiviral
2. Hand washing2. Hand washing
Hand washing is
an aseptic practice
that involves
scrubbing the
hands with soap,
water and...
 Hands should be washed:
– Before and after patient contact
– Before putting on gloves and after taking them off
– After ...
Performing a Surgical ScrubPerforming a Surgical Scrub
A surgical scrub, a type of skin and nail
antisepsis, is performed...
Wearing Personal ProtectiveWearing Personal Protective
EquipmentEquipment
uniforms
scrub suits or gowns
masks
gloves
...
Key Points About PPEKey Points About PPE
Don before contact with the patient,
generally before entering the room
Use car...
Sequence for Donning PPESequence for Donning PPE
Gown first
Mask or respirator
Goggles or face shield
Gloves
How to Safely Use PPEHow to Safely Use PPE
Keep gloved hands away from face
Avoid touching or adjusting other PPE
Remov...
““Contaminated” and “Clean”Contaminated” and “Clean”
Areas of PPEAreas of PPE
Contaminated – outside front
• Areas of PPE...
Sequence for Removing PPESequence for Removing PPE
Gloves
Face shield or goggles
Gown
Mask or respirator
Where to Remove PPEWhere to Remove PPE
At doorway, before leaving patient room
or in anteroom*
Remove respirator outside...
Removing Isolation GownRemoving Isolation Gown
Unfasten ties
Peel gown away from
neck and shoulder
Turn contaminated
ou...
Removing a MaskRemoving a Mask
Untie the bottom,
then top, tie
Remove from face
Discard
Hand HygieneHand Hygiene
Perform hand hygiene immediately after
removing PPE.
• If hands become visibly contaminated duri...
Keeping the Environment CleanKeeping the Environment Clean
Health agencies employ laundry staff and
housekeeping personne...
Surgical AsepsisSurgical Asepsis
means those measures that render supplies
and equipment totally free of
microorganisms. ...
SterilizationSterilization
consists of physical and chemical
techniques that destroy all microorganisms
including spores.
1. Physical Sterilization1. Physical Sterilization
Microorganisms and spores are destroyed
physically through radiation o...
RadiationRadiation
Ultraviolet radiation can kill bacteria,
especially the organism that transmits TB.
Boiling WaterBoiling Water
Boiling water is a convenient way to
sterilize items used in the home. To be
effective, contam...
Free-Flowing SteamFree-Flowing Steam
Free-flowing steam is a method in which
items are exposed to the heated vapor that
e...
Dry HeatDry Heat
Dry heat, or hot air sterilization, is similar
to baking items in an oven. To destroy
microorganisms wit...
Steam Under PressureSteam Under Pressure
Steam under pressure is the most
dependable method for destroying all
forms of o...
2. Chemical Sterilization2. Chemical Sterilization
Both gas and liquid chemicals are used to
sterilize invasive equipment.
Principles of Surgical AsepsisPrinciples of Surgical Asepsis
They preserve sterility by touching one
sterile item with an...
The longer the time since sterilization, the
more likely it is that the item is no longer
sterile.
A commercially packag...
sterile wrapper, if it becomes wet, wicks
microorganisms from its supporting
surface, causing contamination.
Any opened ...
Reaching across an area that contains
sterile equipment has a high potential for
causing contamination and is therefore
a...
Creating a Sterile FieldCreating a Sterile Field
A sterile field means a work area free of
microorganisms.
THANK YOUTHANK YOU
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Infection control by Shaheena Masoodi

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  • ISOLATION – foundation for preventing transmission of infectious agents associated w/healthcare delivery Role – creates a protective environment that is required to contain the transmission of infectious agents
  • Antibiotic Resistant – Global Health Problem Increasing morbidity contributes to increasing mortality increase hc costs – nosocomial pathogens est to exceed 1.3 Billion annually
  • Break the chain - pathogen – appropriate antibiotics Reservoir – patients – frown when we get rid of them portal of exit – Mask mode of transmission – isolation portal of entry – N-95 resp susceptible host - immunizations
  • The front of the mask is considered contaminated and should not be touched. Remove by handling only the ties or elastic bands starting with the bottom then top tie or band. Lift the mask or respirator away from the face and discard it into the designated waste receptacle.
  • Infection control by Shaheena Masoodi

    1. 1. ASEPTIC MEASURESASEPTIC MEASURES SHAHEENA MASOODI HICN SKIMS
    2. 2. ASEPSISASEPSIS Definition Asepsis means those practices that decrease or eliminate infectious agents, their reservoirs, and vehicles for transmission.
    3. 3. ASEPTIC TECHNIQUEASEPTIC TECHNIQUE Purpose  absence of pathogenic organisms in the clinical setting. Goal to protect the patient from infection.
    4. 4. Chain of InfectionChain of Infection Pathogen Reservoir Portal of ExitMode of Transmission Portal of Entry Susceptible Host Why Isolation?.. because transmission isWhy Isolation?.. because transmission is easier to control than the source / host!easier to control than the source / host!
    5. 5. CROSS INFECTIONCROSS INFECTION METHODS Direct contact: transmitted from person to person. (droplets, sexual contact, hands) Indirect contact: through fomites, contaminated food, insects, dusts, carriers.
    6. 6. PREVENTION OF CROSSPREVENTION OF CROSS INFECTIONINFECTION well ventilated hospitals General cleanliness in hospitals Safe food and water supply(kitchen protected from flies) Safe disposal of excreta (urine, stool &sputum) Safe disposal of refuse (dressing & garbage) Destruction of rodents and insects.
    7. 7. PREVENTION OF DIRECTPREVENTION OF DIRECT CONTACTCONTACT Respiratory isolation: masks and gowns are worn.
    8. 8. Enteric isolation: Recommended to wear gloves and gowns while handling soiled articles. Thorough hand washing by patient & staff. Soiled linen to be disinfected
    9. 9. Wound and skin isolation Use of gowns and gloves Safe disposal of dressings and discharges Articles must be kept separate in case of tetanus, gas gangrene, scabies
    10. 10. BLOOD ISOLATIONBLOOD ISOLATION Equipment that comes in contact with the client’s blood must be carefully disinfected before touching another patient.
    11. 11. ISOLATION PRECAUTIONS:ISOLATION PRECAUTIONS: TWO TIERSTWO TIERS Standard: used routinely for the care of all patients regardless of diagnosis or presumed infection status and organism These precautions apply to – airborne – droplet – contact transmissions
    12. 12. ContdContd Transmission-based: designed for patients documented or suspected to be infected or colonized with organisms that require additional precautions beyond the standard precautions necessary to interrupt transmission.
    13. 13. Standard PrecautionsStandard Precautions Hand Hygiene Wash/Decontaminate hands: •After touching bodily fluids or contaminated items •After removing gloves •Between (before and after) patient contacts Gloves •Wear gloves when touching bodily fluids or contaminated items •Put on clean gloves before touching mucous membranes or non-intact skin •Change gloves between "dirty" and "clean" tasks on the same patient •Remove gloves promptly after use (before going to another patient); wash hands immediately Mask, Eye Protection, Face Shield, Gown •Use personal protective equipment (PPE) as necessary to protect against splashes or sprays of bodily fluids •Facial protection including eye, nose, and mouth protection is essential when there is any aerosolized-generating procedures being performed •Prescription eyeglasses are NOT considered personal protective equipment Patient-Care Equipment & Linens •Equipment and linens soiled with bodily fluids should be handled in a way that avoids cross-contamination •Clean and reprocess reusable equipment appropriately before use on another patient •Discard single-use items appropriately
    14. 14. Environmental Care Environmental surfaces should be cleaned and disinfected on a routine basis and when visibly soiled/contaminated. Bloodborne Pathogens •Use sharps (needles, scalpels, etc.) carefully and appropriately. For example, do not bend or recap needles •Take care to prevent accidental sticks Patient Placement Patients who contaminate the environment should be placed in private rooms. Disposal of Waste Regulated Medical Waste includes: •Infectious cultures and stocks of infectious agents •Bulk blood/blood products •Pathological wastes/body parts •Sharps •Animal carcasses/bedding Handling of Medical Waste •Must be collected, stored and shipped in leak-proof containers Specimen collection All specimens are considered biohazardous and should be handled using gloves. All specimens must be placed in zip lock specimen bags with the universal biohazard symbol on the front. Specimens must go inside the zip lock, and the requisitions must be placed in the pouch in front of the zip lock.
    15. 15. Standard PrecautionsStandard Precautions Every Patient, Every Time,Every Patient, Every Time, Every EncounterEvery Encounter Foaming in and foaming out. Cleaning your stethoscope with alcohol pads.  Cleaning all other equipment with Sani-Cloth between each patient contact.
    16. 16. Medical asepsisMedical asepsis those practices that confine or reduce the numbers of microorganisms. Also called, clean technique, it involves measures that interfere with the chain of infection in various ways.
    17. 17. Examples of medical asepticExamples of medical aseptic practicespractices using antimicrobial agents, performing hand hygiene, wearing hospital garments, confining and containing soiled materials appropriately, and keeping the environment as clean as possible.
    18. 18. 1. Using Antimicrobial Agents1. Using Antimicrobial Agents Antimicrobial agents are chemicals that destroy or suppress the growth of infectious microorganisms Examples are antiseptics, disinfectants, and anti-infective drugs.
    19. 19. AntisepticsAntiseptics Antiseptics: inhibit the growth of, but do not kill, microorganisms. An example is alcohol
    20. 20. DisinfectantsDisinfectants Disinfectants, also called and , destroy active microorganisms but not spores. Phenol, household bleach, and formaldehyde are examples. Disinfectants are used to kill and remove microorganisms from equipment, walls, and floors
    21. 21. Anti-Infective DrugsAnti-Infective Drugs Antibiotics Antiviral
    22. 22. 2. Hand washing2. Hand washing Hand washing is an aseptic practice that involves scrubbing the hands with soap, water and friction.
    23. 23.  Hands should be washed: – Before and after patient contact – Before putting on gloves and after taking them off – After touching blood and body substances (or contaminated patient-care equipment), broken skin, or mucous membranes (even if you wear gloves) – Between different procedures on the same patient
    24. 24. Performing a Surgical ScrubPerforming a Surgical Scrub A surgical scrub, a type of skin and nail antisepsis, is performed before donning sterile gloves and garments when the nurse is actively involved in an operative or obstetric procedure. The purpose is to more extensively remove transient microorganisms from the nails, hands, and forearms.
    25. 25. Wearing Personal ProtectiveWearing Personal Protective EquipmentEquipment uniforms scrub suits or gowns masks gloves protective eyewear Hair (caps) and Shoe Covers
    26. 26. Key Points About PPEKey Points About PPE Don before contact with the patient, generally before entering the room Use carefully – don’t spread contamination Remove and discard carefully, either at the doorway or immediately outside patient room; remove respirator outside room Immediately perform hand hygiene
    27. 27. Sequence for Donning PPESequence for Donning PPE Gown first Mask or respirator Goggles or face shield Gloves
    28. 28. How to Safely Use PPEHow to Safely Use PPE Keep gloved hands away from face Avoid touching or adjusting other PPE Remove gloves if they become torn; perform hand hygiene before donning new gloves Limit surfaces and items touched
    29. 29. ““Contaminated” and “Clean”Contaminated” and “Clean” Areas of PPEAreas of PPE Contaminated – outside front • Areas of PPE that have or are likely to have been in contact with body sites, materials, or environmental surfaces where the infectious organism may reside Clean – inside, outside back, ties on head and back • Areas of PPE that are not likely to have been in contact with the infectious organism
    30. 30. Sequence for Removing PPESequence for Removing PPE Gloves Face shield or goggles Gown Mask or respirator
    31. 31. Where to Remove PPEWhere to Remove PPE At doorway, before leaving patient room or in anteroom* Remove respirator outside room, after door has been closed*  Ensure that hand hygiene facilities are available at the point needed, e.g., sink or alcohol-based hand rub
    32. 32. Removing Isolation GownRemoving Isolation Gown Unfasten ties Peel gown away from neck and shoulder Turn contaminated outside toward the inside Fold or roll into a bundle Discard
    33. 33. Removing a MaskRemoving a Mask Untie the bottom, then top, tie Remove from face Discard
    34. 34. Hand HygieneHand Hygiene Perform hand hygiene immediately after removing PPE. • If hands become visibly contaminated during PPE removal, wash hands before continuing to remove PPE Wash hands with soap and water or use an alcohol-based hand rub
    35. 35. Keeping the Environment CleanKeeping the Environment Clean Health agencies employ laundry staff and housekeeping personnel to assist with cleaning Terminal disinfection is more thorough than concurrent disinfection and consists of measures used to clean the client environment after discharge.
    36. 36. Surgical AsepsisSurgical Asepsis means those measures that render supplies and equipment totally free of microorganisms. Sterile technique is those practices that avoid contaminating microbe-free items.
    37. 37. SterilizationSterilization consists of physical and chemical techniques that destroy all microorganisms including spores.
    38. 38. 1. Physical Sterilization1. Physical Sterilization Microorganisms and spores are destroyed physically through radiation or heat (boiling water, free-flowing steam, dry heat, and steam under pressure).
    39. 39. RadiationRadiation Ultraviolet radiation can kill bacteria, especially the organism that transmits TB.
    40. 40. Boiling WaterBoiling Water Boiling water is a convenient way to sterilize items used in the home. To be effective, contaminated equipment needs to be boiled for 15 minutes at 212°F (100°C)
    41. 41. Free-Flowing SteamFree-Flowing Steam Free-flowing steam is a method in which items are exposed to the heated vapor that escapes from boiling water.
    42. 42. Dry HeatDry Heat Dry heat, or hot air sterilization, is similar to baking items in an oven. To destroy microorganisms with dry heat, temperatures of 330°to 340°F (165° to 170°C) are maintained for at least 3 hours.
    43. 43. Steam Under PressureSteam Under Pressure Steam under pressure is the most dependable method for destroying all forms of organisms and spores. The autoclave is an example
    44. 44. 2. Chemical Sterilization2. Chemical Sterilization Both gas and liquid chemicals are used to sterilize invasive equipment.
    45. 45. Principles of Surgical AsepsisPrinciples of Surgical Asepsis They preserve sterility by touching one sterile item with another that is sterile. Once a sterile item touches something that is not, it is considered contaminated. Any partially unwrapped sterile package is considered contaminated. If there is a question about the sterility of an item, it is considered unsterile.
    46. 46. The longer the time since sterilization, the more likely it is that the item is no longer sterile. A commercially packaged sterile item is not considered sterile past its recommended expiration date. Once a sterile item is opened or uncovered, it is only a matter of time before it becomes contaminated.
    47. 47. sterile wrapper, if it becomes wet, wicks microorganisms from its supporting surface, causing contamination. Any opened sterile item or sterile area is considered contaminated if it is left unattended. Coughing, sneezing, or excessive talking over a sterile field causes contamination.
    48. 48. Reaching across an area that contains sterile equipment has a high potential for causing contamination and is therefore avoided. Sterile items that are located or lowered below waist level are considered contaminated because they are not within critical view.
    49. 49. Creating a Sterile FieldCreating a Sterile Field A sterile field means a work area free of microorganisms.
    50. 50. THANK YOUTHANK YOU

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