1. FUNDAMENTALS OF NURSING
LESSON 3
MEDICAL ASEPSIS AND
INFECTION CONTROL

2. HISTORY OF ASEPTIC TECHNIQUE
ROBERT HOOKE
ANTON VON LEUWENHOEK
IGNAZ SEMMELWEIS
LOUIS PASTEUR
JOSEPH LISTER
INFECTION—THE INVASION OF MICROBES. MICROBES CAUSE MANY DISEASES.
ETIOLOGY—THE STUDY OF THE CAUSE OF DISEASE.

3. MEDICAL VS. SURGICAL ASEPSIS
MICROORGANISMS
NONPATHOGENIC—DO NOT PRODUCE DISEASE
PATHOGENIC—PRODUCE SPECIFIC DISEASE OR INFECTIONS
Some helpful
Some dangerous
Some travel to places they don’t belong

4. MEDICAL VS. SURGICAL ASEPSIS
ASEPSIS—FREE OF PATHOGENIC MICROBES
A = without
Sepsis = contamination
MEDICAL ASEPSIS
Clean Technique
SURGICAL ASEPSIS—
Sterile Technique

5. Page 4 in Quantum
Figure 12-1
The chain of infection.

7. CHAIN OF INFECTION INFECTIOUS PROCESS
FOR MICROBES TO SPREAD OR LIVE, A CYCLE MUST BE PRESENT
TO BREAK THE CYCLE:
MEDICAL ASEPSIS &
IMMUNIZATIONS
BREAK THE CYCLE OF INFECTION BY ALTERING THE DEFENSES OF THE HOST

8. 1ST LINK IN CHAIN OF INFECTION
INFECTIOUS AGENTS—THE PATHOGEN
BACTERIA
BACTERIAL SHAPES
COCCI—ROUND OR OVAL
BACILLI—ROD
SPIRILLA—SPIRAL (UNCOMMON)
SHAPE HELPS IDENTIFY TYPE

9. Some common disease-producing bacteria.
Figure 12-3
Some common disease-producing bacteria.

10. 1ST LINK IN CHAIN OF INFECTION
Quantum Page 5&6
1ST LINK IN CHAIN OF INFECTION
INFECTIOUS AGENTS—THE PATHOGEN
BACTERIA
STREPTOCOCCUS BACTERIUM
***Responsible for more disease than any other organism
STAPHYLOCOCCUS AUREUS
Pus producing
Staph epidermidis lives on human skin
Nonpathogenic
DIPLOCOCCUS
Pneumoccus
Gonococcus
Meningococcus

11. 1ST LINK IN CHAIN OF INFECTION
- VIRUS
SMALLEST KNOWN AGENTS THAT CAUSE DISEASE.
NOT A COMPLETE CELL
Example: common cold
***Treat the symptoms and not the virus

12. 1ST LINK IN CHAIN OF INFECTION
FUNGI—(Mycotic infections)
Coccidioidomycosis
Histoplasmosis
Candida Albicans
Normally inhabits the GI tract
In the mouth (thrush)
In the vagina (vaginitis)
Diaper rash

13. 2nd, 3rd, 4th LINKS IN THE CHAIN OF INFECTION
RESERVOIR—any place the microbes are able to grow and reproduce.
Carrier (Typhoid Mary)
Requirements for microbe growth
Body’s 1st response is fever—attempt to kill invading organisms. Often become dehydrated due to anorexia and fever. Hand washing is most important thing we can do.

14. 2nd, 3rd, 4th LINKS IN THE CHAIN OF INFECTION
EXIT ROUTE—Microbes must be able to leave the reservoir to infect others.
TRANSMISSION
Vehicle—means by which microbes are carried.
Direct contact—nurse to patient
Fomite
Vector—living carrier (dog, insect)
Airborne—droplet

15. 5TH LINK IN CHAIN OF INFECTION
ENTRANCE—often the same route they used to exit last host.
Skin
Saliva
Respiratory tract
Urinary tract
GI tract
Vagina

16. 6TH LINK IN CHAIN OF INFECTION
HOST
PATIENTS MAKE GREAT HOSTS.
SUSCEPTIBILITY
AGE—VERY OLD, VERY YOUNG AT HIGH RISK
STRESS
NUTRITION
HEREDITY
DISEASE PROCESS
ENVIRONMENTAL FACTORS
MEDICAL THERAPY
CHEMOTHERAPY
RADIATION
INVASIVE MEDICAL PROCEDURES
LACK OF IMMUNIZATION OF CHILDREN

17. Nosocomial Infections
Hospital or health agency acquired infection
Approximately 10% of pts will acquire
Common from Foley catheters
3% end in DEATH
These can be prevented by proper medical/surgical asepsis and good hand washing…..

18. HANDWASHING
HEAVILY SOILED HANDS SHOULD BE WASHED LONGER THAN LIGHTLY SOILED HANDS
SOAP--MICROBES ARE WASHED AWAY
RUNNING WATER—FLUSHES
FRICTION—BREAKS BODY OIL DOWN
TIME FRAME—THE LONGER, THE MORE MICROBES ARE GONE
RINSING—FLUSHING
WASH HANDS
BEFORE AND AFTER PATIENT CARE
AFTER CONTACT WITH BODY FLUIDS
BEFORE INVASIVE PROCEDURES
BEFORE CHANGING DRESSINGS
BEFORE AND AFTER MEDICATION ADMINISTRATION
AFTER REMOVING GLOVES

19. PERSONAL PROTECTIVE EQUIPMENT (PPE)
GLOVES
GOWNS
MASKS/PROTECTIVE EYEWEAR
DOUBLE BAGGING
HEP B VACCINATION

20. Skill 12-2: Steps 6 & 7 Gloving.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Gloving.

21. Skill 12-3: Step 5a Gowning for isolation.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Gowning for isolation.

22. Skill 12-3: Step 5b Gowning for isolation.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Gowning for isolation.

23. Skill 12-3: Step 5c Gowning for isolation.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Gowning for isolation.

24. Skill 12-3: Step 6 Gowning for isolation.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Gowning for isolation.

25. Skill 12-4: Steps 2 & 5 Donning a mask.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Donning a mask.

26. Nurse wearing protective goggles and mask.
Figure 12-5
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Nurse wearing protective goggles and mask.

27. Skill 12-5: Step 4 Double bagging.
(From Polaski, A.L., Warner, J.P. [1994]. Saunders fundamentals for nursing assistants. Philadelphia: Saunders.)
Double bagging.

28. CATEGORIES FOR ISOLATION
1ST TIER STANDARD PRECAUTIONS
USED FOR ALL PATIENTS
2ND TIER
AIRBORNE
DROPLET
CONTACT
REVERSE ISOLATION
For the immunocompromised

29. DISINFECTION AND STERILIZATION
DESTROYS PATHOGENS BUT NOT SPORES
STERILIZATION
DESTROYS PATHOGENS AND SPORES
HEAT/RADIATION
CHEMICAL

30. INFECTION CONTROL TEAM
MANY NURSES WORK IN INFECTION CONTROL
THE INFECTION CONTROL NURSE IS RESPONSIBLE FOR
MONITORING INFECTION OUTBREAKS
EDUCATING STAFF ABOUT ISOLATION
ADVISE PERSONNEL ON POLICIES AND PROCEDURES
REVIEW MEDICAL RECORDS
GATHER STATISTICS
COMMUNICATE WITH PUBLIC HEALTH DEPARTMENTS ON COMMMUNICABLE DISEASE
IDENTIFY PROBLEMS WITH EQUIPMENT OR POLICIES

31. PATIENT AND FAMILY TEACHING FOR INFECTION CONTROL
RECOGNIZE SOURCES OF INFECTION
STEPS TO PREVENT TRANSMISSION
NATURE AND TRANSMISSION OF INFECTION
SUSCEPTIBILITY TO INFECTION
SIGNS AND SYMPTOMS TO REPORT TO MD
INCLUDE GOOD HANDWASHING WITH DRESSING CHANGES AND WOUND CARE INSTRUCTIONS

32. THE END
Questions
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