Asepsis.ppt Student
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Nursing 1ANursing 1AWeeks 1-3Weeks 1-3
Mt. San Antonio College Mt. San Antonio College Associate Degree Nursing ProgramAssociate Degree Nursing Program
AsepsisAsepsis
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AsepsisAsepsis
Absence of microorganismAbsence of microorganism Microorganisms are everywhere!Microorganisms are everywhere! Healthy people have effective resistance Healthy people have effective resistance
to most organismsto most organisms Patients are more susceptible to Patients are more susceptible to
infections due to decreased resistance infections due to decreased resistance (elderly, infants and the chronically ill)(elderly, infants and the chronically ill)
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Microorganisms Microorganisms (Bacteria Viruses, Fungi)(Bacteria Viruses, Fungi)
Spread by: Spread by: Direct contactDirect contact DropletDroplet Contact with infected articleContact with infected article Air currentsAir currents Moist or wet surfacesMoist or wet surfaces
Contact is the most common route of Contact is the most common route of transmissiontransmission
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Medical AsepsisMedical Asepsis
Includes all practice intended to Includes all practice intended to confine a specific organism to a confine a specific organism to a specific areaspecific area
Limits the number, growth and Limits the number, growth and transmission of microorganismtransmission of microorganism
Objects are “clean” or “dirty”Objects are “clean” or “dirty”
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Sterile AsepsisSterile Asepsis
Sterile technique (no microbes!)Sterile technique (no microbes!) Practice that keeps and area or Practice that keeps and area or
objects free of all microorganismobjects free of all microorganism Practice that destroys Practice that destroys
microorganisms and sporesmicroorganisms and spores Used for all procedures Used for all procedures
involving a sterile area of bodyinvolving a sterile area of body
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Types of InfectionTypes of Infection
ColonizationColonization LocalLocal SystemicSystemic BacteremiaBacteremia SepticemiaSepticemia Acute vs. Chronic InfectionAcute vs. Chronic Infection Nosocomial InfectionNosocomial Infection
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Chain of InfectionChain of Infection
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Breaking the Chain of InfectionBreaking the Chain of Infection
Etiologic Agent (microorganism)Etiologic Agent (microorganism) Correct cleansing, disinfecting or Correct cleansing, disinfecting or
sterilizing of article before usesterilizing of article before use Educating pt and support person Educating pt and support person
about appropriate methods to clean about appropriate methods to clean and disinfectand disinfect
Reservoir (source)Reservoir (source) Changing dressing when wet/soiledChanging dressing when wet/soiled Appropriate skin and oral hygieneAppropriate skin and oral hygiene Disposing of damp/soiled linen Disposing of damp/soiled linen Emptying suction and drain bottles at Emptying suction and drain bottles at
end of shiftend of shift
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Portal of exit (from reservoir)Portal of exit (from reservoir) Avoid talking, coughing. Or Avoid talking, coughing. Or
sneezing over open wounds or sneezing over open wounds or sterile field (cover your mouth)sterile field (cover your mouth)
Method of transmissionMethod of transmission Proper hand hygieneProper hand hygiene Educate pt and support person to Educate pt and support person to
perform hand hygiene prior to perform hand hygiene prior to eating, after elimination and after eating, after elimination and after touching infectious materialtouching infectious material
Initiating standard precaution on all Initiating standard precaution on all pt, wearing protective equipment pt, wearing protective equipment when warrantedwhen warranted
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Portal of entry to susceptible hostPortal of entry to susceptible host Using sterile technique for invasive Using sterile technique for invasive
procedures, when exposed to open procedures, when exposed to open wounds or when handling dressingswounds or when handling dressings
Placing needles and syringes in puncture-Placing needles and syringes in puncture-resistant container resistant container
Susceptible hostSusceptible host Maintaining the integrity of the pt skin and Maintaining the integrity of the pt skin and
mucous membranemucous membrane Ensuring that the pt receives a balance dietEnsuring that the pt receives a balance diet Educating the public about importance of Educating the public about importance of
immunizationimmunization
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Signs of Localized Signs of Localized InfectionInfection Localized swellingLocalized swelling Localized rednessLocalized redness Pain or tenderness with Pain or tenderness with
palpation or movementpalpation or movement Palpable heat in the infected Palpable heat in the infected
areaarea Loss of function of the body part Loss of function of the body part
affected, depending on the site affected, depending on the site and extent of involvement and extent of involvement
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Signs of Systemic Signs of Systemic InfectionInfection
FeverFever Increased pulse and respiratory Increased pulse and respiratory
rate if the fever highrate if the fever high Malaise and loss of energyMalaise and loss of energy Anorexia and, in some Anorexia and, in some
situations, nausea and vomitingsituations, nausea and vomiting
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Defense against infectionDefense against infection
Proper hand hygiene (washing/gel)Proper hand hygiene (washing/gel) Environmental controlEnvironmental control Sterile technique when warrantedSterile technique when warranted Identifying and managing patients Identifying and managing patients
at riskat risk
Hand washing is the single most Hand washing is the single most effective way to prevent the spread of effective way to prevent the spread of organisms.organisms.
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Hand washing recommendationHand washing recommendation
When starting shift and leaving When starting shift and leaving for the dayfor the day
Before and after pt contactBefore and after pt contact Before and after proceduresBefore and after procedures Before and after going to the Before and after going to the
bathroombathroom
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Hand Hygiene ProcedureHand Hygiene Procedure
See Procedure in Kozier-pg. See Procedure in Kozier-pg. 688-690, Skill 31-1688-690, Skill 31-1
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CDC Guidelines for CDC Guidelines for Infection ControlInfection Control
AirborneAirborne (small droplet): can (small droplet): can disseminate by air widely. TB, disseminate by air widely. TB, VaricellaVaricella
DropletsDroplets (large droplet): propelled (large droplet): propelled short distance in air by coughing, short distance in air by coughing, sneezing and talking. H Influenza sneezing and talking. H Influenza Meningitis, pneumoniaMeningitis, pneumonia
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ContactContact (touching): MRSA, (touching): MRSA, VRE, RSV, C DIFFVRE, RSV, C DIFF
StandardStandard (all pt’s all the time) (all pt’s all the time)
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Standard precautionsStandard precautions
All blood, body fluids, secretions and All blood, body fluids, secretions and excretions are considered potentially excretions are considered potentially infectious (except sweat)infectious (except sweat)
GlovesGloves: should be worn for contact w/ : should be worn for contact w/ blood, body substance non-intact skin, blood, body substance non-intact skin, mucous membranes, surfaces soiled w/ mucous membranes, surfaces soiled w/ blood and body fluid blood and body fluid
Protective gogglesProtective goggles: should be worn : should be worn during procedures that are likely to cause during procedures that are likely to cause splashes of blood or body substancesplashes of blood or body substance
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MasksMasks: are to be worn to reduce risk of : are to be worn to reduce risk of transmission organism via droplet and transmission organism via droplet and airborne routes and splatter of body airborne routes and splatter of body substancesubstance
GownsGowns: should be worn during : should be worn during procedures that are likely to result in procedures that are likely to result in splashes of blood or body substancesplashes of blood or body substance
Hand washingHand washing: should be done : should be done immediatelyimmediately
NeedlesNeedles: should never be recapped, must : should never be recapped, must be place in puncture resistance containerbe place in puncture resistance container
CPRCPR: should always be performed using a : should always be performed using a barrier device instead of mouth to mouthbarrier device instead of mouth to mouth
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Correct Order for Donning and Correct Order for Donning and Removing Protective EquipmentRemoving Protective Equipment
DonningDonning GownGown MaskMask Protective Protective
EyewearEyewear GlovesGloves
RemovingRemoving GlovesGloves Protective Protective
EyewearEyewear GownGown MaskMask
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Biohazard AlertBiohazard Alert