RT 207 MEDICAL ASEPSIS

RT 207 MEDICAL ASEPSIS BY YJV

Medical Asepsis

Any practice that helps reduce the number and spread of microorganisms

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

Means that microorganisms and their spores have been completely destroyed by means of heat or by a chemical process

Any medical procedure that involves penetration of body tissues (invasive) requires the use pf surgical aseptic technique.

Medically aseptic handwashing

easy and effective method to control the transmission of infection

Good housekeeping

________ in the workplace reduces the incidence of airborne infections and the transfer of pathogens by fomites.

A clean, dry environment discourages the growth of all microorganisms.

1. Chemical

2. Dry heat

3. Conventional Gas Sterilization

4. Gas plasma technology

5. Autoclaving

Sterilization

Chemical Sterilization

Involves the immersion and soaking of clean objects in a bath of germicidal solution followed by a sterile water rinse

The effectiveness of this process depends on solution strength, temperature and the immersion time

One of the less satisfactory methods for providing surgical asepsis

Dry Heat

Required to sterilize some sharp instruments, certain powders, and greasy substances

Type of sterilization varies from 1 to 6 hours at a temperature range of (165 ° - 170°c)

Conventional Gas Sterilization

Items that would be damaged by high temperatures are usually sterilized with a mixture of gases (freon and ethylene oxide) heated to 57°c

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

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.

Auto Claving

• Provides steam sterilization under pressure,

• Most used sterilization method

• Quickest and most convenient means of sterilization for items that can withstand heat and moisture

• High temperatures (121°-135°c) can be achieved under pressure, making this an extremely effective method

Steam Under Pressure

Chemical Sterilization

Ethylene Oxide

Methods of Sterilization

Steam Under Pressure

Items are double-wrapped and placed in autoclave

Autoclaves are manufactured to sterilize by gravity displacement and dynamic air removal

High-speed sterilizers or flash sterilization is an abbreviated gravity displacement method

Low-temperature sterilization

Chemical Sterilization is referred to as _________. A maximum temperature if 54 c to 60 c of gaseous sterilization is used. An antimicrobial and sporicidal agent must be used

Ethylene Oxide

Used for items that cannot withstand moisture and high temperatures. All items sterilized in this manner must be cleansed and dried since water united with ethylene oxide forms ethylene glycol, which cannot be eliminated by aeration and is toxic

chemical indicators

change color

STERILITY INDICATORS

• Most forms of hospital sterilization use ______ to identify that a pack has been sterilized

• Indicators ______ when the required conditions have been met.

Autoclave tape indicator

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.

• The first step in preparing a sterile field is to confirm the sterility packaged supplies and equipment.

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:

Surgeon

Surgical assistant

Anesthesiologist

Nurse anesthetist

Circulating nurse

Scrub nurse

Radiologic Technologist

Surgical Team

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 assistants 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 anesthesiologist

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

Scrub nurse or scrub technician

dons sterile attire and sets up the sterile fields for the operation. Assists the surgeon by presenting sterile instruments and sterile equipment need 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

persons 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. Those directly involved in the operation are dressed in sterile gowns and sterile gloves. They are often referred to as “being scrubbed.”

Airborne Precautions

Droplet Precautions

Contact Precautions

Combination Airborne and 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.

• droplet precautions 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 and 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.

Involves treating items with heat, gas, or chemicals to make them germ-free.

Any medical procedure that involves penetration of body tissues

The sterile items are then stored in a manner that prevents contamination.

The Joint Commission

Sets requirements for hospital safety, infection control practices, and patient care standards (Quality Assurance, QA) 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 illness, inspects work sites, and makes and enforces regulations concerning workplace safety

Centers for Disease Control and Prevention

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 and 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

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 pre-clinical tests for toxicity of new drugs on animals and the testing of medications clinically on humans in three phases before marketing

World Health Organization

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; also assists with educational programs for deprived children

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

Specifies and notifies agents to destroy various types of medical waste

The 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