ppt chapter 10
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 10
Asepsis
Chapter 10
Asepsis
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• 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
Microorganisms Microorganisms
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Types of MicroorganismsTypes of Microorganisms
• Bacteria
• Protozoans
• Viruses
• Mycoplasmas
• Fungi
• Helminths
• Rickettsiae
• Prions
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Categorization of Microorganisms 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
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Survival of Microorganisms 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
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QuestionQuestion
•Is the following statement true or false?
Transient pathogens are present constantly on the skin.
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AnswerAnswer
False.
Transient pathogens are picked up during contamination.
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Chain of InfectionChain of Infection
• An infectious agent
• A reservoir for growth and reproduction
• An exit route from the reservoir
• A means of transmission
• A portal of entry
• A susceptible host
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Chain of Infection (cont’d)Chain of Infection (cont’d)
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Biologic Defense MechanismsBiologic 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
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Nosocomial InfectionsNosocomial Infections
• Nosocomial infections are infections acquired while a person is receiving care in a health care agency
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QuestionQuestion
•Is the following statement true or false?
Mechanical defense mechanisms destroy or incapacitate microorganisms through natural biologic substances.
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AnswerAnswer
False.
Chemical defense mechanisms destroy or incapacitate microorganisms through natural biologic substances.
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Asepsis 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
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Medical Asepsis 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
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Surgical Asepsis Surgical Asepsis
• Measures that render supplies and equipment totally free of microorganisms
• Practices that avoid contaminating microbe-free items
• Examples:
– Physical sterilization
– Chemical sterilization
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Principles of Medical AsepsisPrinciples of Medical Asepsis
• Microorganisms exist everywhere except on sterilized equipment
• Frequent hand washing 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
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Principles of Medical Asepsis (cont’d)Principles of Medical Asepsis (cont’d)
• A clean environment reduces microorganisms
• Cleaning should be done from cleaner to dirtier areas
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QuestionQuestion
•Is the following statement true or false?
Surgical asepsis involves measures that interfere with the chain of infection in various ways.
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AnswerAnswer
False.
Medical asepsis involves measures that interfere with the chain of infection in various ways.
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Practicing Hand AntisepsisPracticing 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 15 to 25 seconds until they are dry
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Hand AntisepsisHand Antisepsis
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QuestionQuestion
•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 hand washing
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AnswerAnswer
a. Donning a sterile gown
Donning a sterile gown is a method of surgical asepsis. Using antimicrobial agents, performing hand antisepsis, and hand washing are methods of medical asepsis.
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Types of Hospital GarmentsTypes of Hospital Garments
• Gloves
• Scrub suits and gowns
• Masks; Respirators
• Uniforms
• Hair and shoe covers
• Protective eyewear
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Hospital GarmentsHospital Garments
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Utility RoomsUtility 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
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Concurrent DisinfectionConcurrent 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
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Terminal DisinfectionTerminal 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
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SterilizationSterilization
• 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
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Principles of Surgical AsepsisPrinciples 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
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Principles of Surgical Asepsis (cont’d)
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
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Principles of Surgical Asepsis (cont’d)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
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Principles of Surgical Asepsis (cont’d)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
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Adding an Agency-Sterilized ItemAdding an Agency-Sterilized Item
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Adding Sterile GauzeAdding Sterile Gauze
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Adding Sterile SolutionAdding Sterile Solution
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General Gerontologic Considerations General Gerontologic Considerations
• Older clients more susceptible to infections
• Maintain intact skin, proper aseptic techniques, perineal hygiene, thorough hand washing; 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