Medical Asepsis

Medical Asepsis

Any practice that helps reduce the number and

spread of microorganisms

Medical Asepsis

Means microorganisms have been eliminated

using soap, water, friction, and various chemical

disinfectants.

Surgical Asepsis

Process of creating and maintaining an area that

is completely free of pathogens

Clean technique

Medical Asepsis aka ...

Sterile technique

Surgical asepsis aka ...

Surgical Asepsis

Means that microorganisms and their spores

have been completely destroyed by means of

heat or by a chemical process

Medically aseptic handwashing

easy and effective method to control the

transmission of infection

Housekeeping

Good ... in the workplace reduces

the incidence of airborne infections and the

transfer of pathogens by fomites.

Housekeeping

A clean, dry environment discourages the growth

of all microorganisms.

sodium

hypochlorite bleach (Clorox)

The CDC recommends ... as an inexpensive,

effective disinfectant for preventing the spread of

HIV.

1:10

Mix bleach in a ... : ... solution daily, because its

effectiveness declines rapidly when diluted

biohazard

Objects contaminated with blood or body fluids

be discarded in a suitable container and marked

with the ... symbol

red

plastic

Contaminated bandages and dressings are

handled with gloves and placed directly into ...

Surgical Asepsis

The complete destruction of all organisms and

spores from equipment used to perform patient

care or procedures.

Heat, gas, chemicals

Methods of sterilization

Chemical sterilization

Involves the immersion and soaking of clean

objects in a bath of germicidal solution

followed by a sterile water rinse

- solution strength

- temperature

- immersion time

The effectiveness of chemical sterilization depends on:

Chemical sterilization

One of the less satisfactory methods for

providing surgical asepsis

Dry heat

Required to sterilize some sharp

instruments, certain powders, and greasy

substances

1 to 6 hours

Duration of dry heat sterilization

165 - 175 C

Temperature range of dry heat sterilization

Conventional gas sterilization

• Used primarily for electrical, plastic, and

rubber items, and for optical ware

• Telephones, stethoscopes, blood pressure

cuffs, and other equipment used in isolation

rooms may be sterilized in this manner

Freon and ethylene oxide

Mixture of gases for conventional gas sterilization

57 C

Freon and ethylene oxide is heated to ... for conventional gas sterilization

Gas plasma technology

Items are cleaned, wrapped, and placed in a

compact mobile unit where low-temperature

hydrogen peroxide gas plasma diffuses through the wrapped instruments and effectively kills both microorganisms and

spores

low-temperature

hydrogen peroxide gas plasma

Gas Plasma Technology: Items are cleaned, wrapped, and placed in a

compact mobile unit where ... diffuses through the wrapped instruments and effectively kills both microorganisms and

spores

Autoclaving

Most used sterilization method

Autoclaving

Quickest and most convenient means of

sterilization for items that can withstand heat

and moisture

121 - 135 C

Temperatures for Autoclaving

chemical indicators

Most forms of hospital sterilization use

... to identify that a pack

has been sterilized

Sterility indicators

Changes colors when the required conditions have been met

Autoclave tape indicators

Are used to indicate that the instruments have been properly sterilized by changing colors

Sterile field

A microorganism-free area prepared for the use

of sterile supplies and equipment.

Confirm the sterility of packaged supplies and equipment

The first step in preparing a sterile field is to ...

1. They are clean, dry, and unopened.

2. Their expiration date has not been exceeded.

3. Their sterility indicators have changed to a

predetermined color, confirming sterilization.

Packages are considered sterile if they meet the

following criteria:

Buffer zone

A 1-inch border at the perimeter of the sterile field is considered to be a ... and is treated as if it were contaminated

tabletop or waist

A sterile field ends at the level of the ... or

at the ... of the sterile person's gown.

moisture

The cuffs of the sterile gown are considered non-

sterile because they collect ...

back-to-back

If one sterile person must pass another, they

must pass ...

edge

When a sterile solution is to be poured into a

container on a sterile field, the container is

placed at the ... of the sterile field by the

sterile person.

The Surgical team

Consists of a variety of staff members who serve the patient prior to and during surgery

Surgeon

The physician who plans and performs the surgical procedure and makes surgical decisions.

Surgical Assistant

-usually another surgeon or surgical resident

-there may be several ... if the patient's surgical needs require this

Anesthesiologist

A physician with special education in anesthesia who makes the decisions concerning type of anesthesia required.

Nurse anesthetist

A registered nurse who has had special education in anesthesia who administers anesthesia and monitors the anesthetized patient under the supervision of the anesthesiologist.

Circulating nurse

oversees the safety of the patient and maintains the surgical environment; is attired in scrub suit, cap, mask, and shoe covers, but is not clothed in sterile attire

F

T or F: The circulating nurse is clothed in sterile attire

Scrub nurse/Scrub Technician

Dons sterile attire and sets up the sterile fields for the operation. Assists the surgeon by presenting sterile instruments and sterile equipment needed during the procedure

Radiologic Technologist

present at request of the surgeon to perform imaging procedures; is clothed in a scrub suit, cap, mask, and shoe covers

Zone 1: An unrestricted zone

Zone 2: A semi-restricted zone

Zone 3: A restricted zone

There are theoretically three zones designated in the

surgical suite to help decrease the incidents of

infection:

Zone 1: An unrestricted zone

A person may enter in street clothing

Zone 2: A semi-restricted zone

only persons dressed in scrub dress with hair

covered and shoes covered may enter

Zone 3: A restricted zone

only persons wearing scrub dress, shoe

covers, and masks are allowed to be present.

If a surgical procedure is in progress, the

doors to this area are kept closed, and only

persons directly involved in the procedure

may be present.

being scrubbed

Those directly involved in

the operation are dressed in sterile gowns

and sterile gloves. They are often referred to

as "..."

1. Airborne Precautions

2. Droplet Precautions

3. Contact Precautions

4. Combination Airborne & Contact Precautions

Transmission-based precautions:

Airborne precautions

• designed to reduce the risk of transmitting

dust particles containing the infectious

organism or airborne droplet nuclei (5 µm or

smaller) to a susceptible person

• used to prevent diseases such as

tuberculosis and measles (rubeola)

Droplet precautions

• designed to reduce the contact of large-

particle droplets (greater than 5 microns) with

the conjunctivae or with mucous membranes

of the nose and mouth of a susceptible

person.

• are used to prevent the

transmission of diseases such as diphtheria,

pneumonia, and influenza.

Contact precautions

• designed to reduce the risk of transmitting

pathogens by direct skin-to-skin contact or

indirect contact with a contaminated object.

• Used to prevent transmission of diseases

such as multidrug-resistant wound infections

caused by MRSA and VRE, the new strain of

E. coli

Combination Airborne & Contact Precautions

• designed to reduce the risk of transmitting

pathogens by both airborne droplet nuclei

and direct skin-to-skin contact

• used to prevent transmission of the virus that

causes SARS and the varicella virus that

causes chicken pox and disseminated

herpes zoster

Simple cleanliness measures

• Proper cleaning, dusting, linen handling, and

hand hygiene techniques can reduce the

transmission of microorganism.

Disinfection

• Involves the destruction of pathogens by

using chemical materials.

Sterilization

• Complete destruction of all organisms and

spores from equipment used for patient care

or procedures.

The Joint Commission

Sets requirements for hospital safety, infection control practices, and patient care standards that must be met if the institution or agency is to receive accreditation

The Occupational Safety and Health Administration

A federal agency that protects workers and students from work-related injuries and illnesses, inspects work sites, and makes and enforces regulations concerning workplace safety

Center for Disease Control and Prevention (CDC)

Performs research and compiles statistical data concerning infectious diseases; develops immunization guidelines and administers OSHA and OSHA's research institute, the National Institute of Occupational Safety Health (NIOSH)

United States Public Health Service

Investigates and controls communicable diseases, controls carriers of communicable diseases from foreign countries, prevents spread of endemic diseases, and controls manufacture and sale of biologic products.

Food and Drug Administration (FDA)

The United States Public Health Service branch responsible for protecting the public from false drug claims and regulates the manufacture and sale of medications; requires preclinical trials for toxicity of new drugs on animals and the testing of medications clinically on humans in three phases before marketing

World Health Organization (WHO)

Works under the auspices of the United Nations to reduce famine and disease throughout the world. Compiles information concerning infectious diseases from all countries and compiles this information into reports for every country

United Nations Children's Fund

Helps children, especially children in developing countries, to avoid malnutrition and disease throughout; also assists with educational programs for deprived children

U.S Department of Health and Human Services (DHHS)

Specifies and notifies agents to destroy various types of medical waste

U.S. Environmental Protection Agency (EPA)

specifies destruction practices for waste from patients with contagious highly communicable diseases

Nuclear Control Agency (NCA)

controls disposal of nuclear waste

White to black

Sterility indicators changers color from ... to ...