1. Chapter 10 Asepsis

2. Microorganisms
Living animals or plants visible only with a microscope; also commonly called germs
The body’s immune defense mechanisms eliminate them
They reside within the body without causing disease
They cause an infection or infectious disease

3. Types of Microorganisms
Fungi
Helminths
Rickettsiae
Prions
Bacteria
Protozoans
Viruses
Mycoplasmas

4. Categorization of Microorganisms
Nonpathogens: harmless, beneficial
Pathogens: cause illness
Resident nonpathogens constantly present on the skin
Transient pathogens picked up during contamination
Aerobic: require oxygen to live
Anaerobic: exist without oxygen

5. Survival of Microorganisms
Spores
Temporarily inactive microbial life form; can resist heat and destructive chemicals and survive without moisture; reactivate and reproduce when conditions are favorable
Antibiotic-resistant bacterial strains
No longer respond to drugs that once were effective against them

6. Question Is the following statement true or false?
Transient pathogens are present constantly on the skin.

7. Answer
False.
Transient pathogens are picked up during contamination.

8. Chain of Infection An infectious agent
A reservoir for growth and reproduction
An exit route from the reservoir
A mode of transmission
A port of entry
A susceptible host

9. Chain of Infection (cont’d)

10. Biologic Defense Mechanisms
Anatomic or physiologic methods that stop microorganisms from causing an infectious disorder
Mechanical: physical barriers that prevent microorganisms from entering the body or expel them before they multiply
Chemical: destroy or incapacitate microorganisms through natural biologic substances

11. Nosocomial Infections
Nosocomial infections are infections acquired while a person is receiving care in a health care agency

12. Question Is the following statement true or false?
Mechanical defense mechanisms destroy or incapacitate microorganisms through natural biologic substances.

13. Answer
False.
Chemical defense mechanisms destroy or incapacitate microorganisms through natural biologic substances.

14. Asepsis
Practices that decrease or eliminate infectious agents, their reservoirs, and vehicles for transmission
A major method for controlling infection
Health care professionals use medical and surgical asepsis to prevent spread of infections

15. Medical Asepsis Confines or reduces the numbers of microorganisms
Involves measures that interfere with the chain of infection in various ways
Examples:
Performing hand hygiene
Wearing hospital garments

16. Surgical Asepsis
Measures that render supplies and equipment totally free of microorganisms
Practices that avoid contaminating microbe- free items
Examples:
Physical sterilization
Chemical sterilization

17. Principles of Medical Asepsis
Microorganisms exist everywhere except on sterilized equipment
Frequent handwashing and maintaining intact skin reduces transmission of microorganisms
Blood, body fluids, cells, and tissues are major reservoirs of microorganisms
Personal protective equipments serve as barriers to microbial transmission

18. Principles of Medical Asepsis (cont’d)
A clean environment reduces microorganisms
Cleaning should be done from cleaner to dirtier areas

19. Question Is the following statement true or false?
Surgical asepsis involves measures that interfere with the chain of infection in various ways.

20. Answer
False.
Medical asepsis involves measures that interfere with the chain of infection in various ways.

21. Practicing Hand Antisepsis
Apply about a nickel- to quarter-sized volume of the product to the palm of one hand or the amount recommended by the manufacturer
Distribute the product to cover all surfaces of the hands and fingers
Rub the product between the hands for to 25 seconds until they are dry

22. Hand Antisepsis

23. Question Which of the following is a method of surgical asepsis?
a. Donning a sterile gown
b. Using antimicrobial agents
c. Performing hand antisepsis
d. Performing handwashing

24. Answer a. Donning a sterile gown
Donning a sterile gown is a method of surgical asepsis. Using antimicrobial agents, performing hand antisepsis, and handwashing are methods of medical asepsis.

25. Types of Hospital Garments
Gloves
Scrub suits and gowns
Masks
Uniforms
Hair and shoe covers
Protective eyewear

26. Hospital Garments

27. Utility Rooms
Health care agencies: at least 2 utility rooms (clean and dirty); personnel must not place soiled articles in the clean utility room
The utility room contains:
Covered waste receptacles and laundry hampers
Flushable hopper and a sink
Equipment for testing stool or urine

28. Concurrent Disinfection
Clean less-soiled areas before grossly dirty ones
Wet-mop floors and damp-dust furniture to avoid distributing microorganisms on dust and air currents
Frequently discard solutions used for mopping in a flushable hopper
Never place clean items on the floor

29. Terminal Disinfection
More thorough than concurrent disinfection and consists of measures used to clean the client environment after discharge
Includes scrubbing the mattress and the insides of drawers and bedside stands

30. Sterilization
Consists of physical and chemical techniques that destroy all microorganisms including spores
Physical sterilization: radiation, boiling water, free-flowing steam, dry heat, steam under pressure
Chemical sterilization: peracetic acid, ethylene oxide gas

31. Principles of Surgical Asepsis
Once equipment and areas are free of microorganisms, they remain in that state if contamination is prevented
Sterility preserved: touching one sterile item with another that is sterile
Once a sterile item touches something that is not sterile, it is considered contaminated
Any partially unwrapped sterile package is considered contaminated

32. Principles of Surgical Asepsis (cont’d)
Question the sterility of an item considered unsterile
Longer the time since sterilization, the more likely that the item is no longer sterile
Commercially packaged sterile item is not considered sterile past its recommended expiration date
Opened sterile item or area, left unattended, is considered contaminated

33. Principles of Surgical Asepsis (cont’d)
Once a sterile item is opened or uncovered, it becomes contaminated
The outer 1-inch margin of a sterile area is considered a zone of contamination
A wet sterile wrapper wicks microorganisms from its supporting surface, causing contamination

34. Principles of Surgical Asepsis (cont’d)
Coughing, sneezing, or excessive talking over a sterile field causes contamination
Reaching across an area that contains sterile equipment may cause contamination
Sterile items located or lowered below waist level are considered contaminated

35. Adding an Agency-Sterilized Item

36. Adding Sterile Gauze

37. Adding Sterile Solution

38. General Gerontologic Considerations
Older clients more susceptible to infections
Maintain intact skin, proper aseptic techniques, perineal hygiene, thorough handwashing; indwelling catheters should be avoided
Bladder training, annual immunizations
Ill health care workers should take sick leave rather than expose susceptible clients to infectious organisms