Week 4: Part 1 Notes MBP 108 Lecture Medical and Surgical Asepsis Learning Objectives
Week 4: Part 1 Notes MBP 108 Lecture Medical and Surgical Asepsis Learning Objectives
Week 4: Part 1 Notes MBP 108 Lecture Medical and Surgical Asepsis Learning Objectives
3.2 ASEPSIS
1. CHAIN OF INFECTION
infection that starts from a localized - It involves certain procedures to decrease the
infection in one part of the body. number of organisms and prevent their spread in the
general clinical setting.
- The goal of asepsis are to protect the
patient from a hospital-acquired or Ex. Proper hand Hygiene, administration of all meds
nosocomial infections and to prevent the except that are given Intravenously, preparation of
spread of pathogenic microorganisms. patient’s skin before administration of subcutaneous
medication
- All patients in healthcare facilities are
vulnerable to pathogenic organisms. 2. Surgical or sterile asepsis
3.2.2 Some Factors that play role in the - Is defined as the absence of all microorganisms.
occurrence of infection among patients include :
- It involves procedures that aim to eliminate
1. Suppression of the immune system microorganisms from an area in the body where
surgical procedures will be performed as well as the
2. Prolonged duration of illness
location where the surgical procedure will be carried
out.
3. Procedures that patients undergo in the
healthcare facility such as insertion of in- The principles of surgical asepsis are applied when
dwelling catheters, use of antibiotics, and the skin is not intact and when internal areas of the
insertion of IV lines and ET tubes. body are involved in procedures, whether for
diagnostic or treatment purposes.
The primary locations of infections from these 2. Prompt and safe disposal of contaminated
organisms are surgical wounds, urinary tract, materials like bandages and needles;
respiratory tract, and the bloodstream.
3. Regular checking and emptying of
Pathogens may be introduced to the patient through containers for surgical drains;
contact with hospital personnel, hospital
4. Prompt cleaning of soiled or moist areas ;
environment, or hospital equipment such as
respiratory machines, catheters, and intravenous 5. Proper labeling of containers regarding the
lines or needles. date and time of disposal.
Situations that require aseptic measures are surgery 3.2.6. General aseptic procedures:
and the insertion of intravenous lines, urinary
catheters, and drains. 3.2.6.1 HANDWASHING
1. Methicillin-resistant Staphylococcus aureus - Among the various PPEs in use, gloves are
(MRSA) the most commonly used.
2. Vancomycin-resistant Enterococcus (VRE)
- Used during medical procedures – two most
3. Penicillin-resistant Streptococcus pneumoniae
commonly used :
When should handwashing be done : a. Examination gloves (sterile or non-
The United States Center for Disease Control sterile)
recommend routing handwashing for at least 15 b. Surgical gloves (sterile)
seconds with a 10-second rinse.
- Serve as a protective barrier when handling
For healthcare workers, a longer period for our touching open wounds, blood or body
handwashing that entails thorough washing of the fluids.
hands, lathering at least twice, and careful cleaning
- Protection from microorganisms and help
of the fingernails is recommended in the following
prevent the spread of infectious agents
situations :
from one person to another.
1. At the beginning and end of each shift ;
- Sterile, disposable gloves must be provided
2. When the hands are visibly soiled ; to all personnel in healthcare facilities,
particularly those who have direct contact
3. After contact with a possible source of with patients.
microorganisms such as blood or body
fluids, mucous membranes, non-intact skin, - The gloves must be disposed of immediately
or contaminated objects ; after use.
4. Before and after performing invasive - Hands must be washed thoroughly after
procedures; using gloves. Why?
another body site in the course of caring for Likewise wearing gowns is recommended if
a patient. the healthcare worker has close contact
5. Re-using of gloves after decontamination is
with patients, equipment, or materials that
not recommended.
can introduce infectious agents to the
Furthermore, WHO recommends the use of gloves in healthcare worker’s skin, uniform and or
the following situations : other clothing.
3. As soon as the gloves are damaged or there Fluid-resistant gowns or aprons are always
is loss of integrity of the gloves. worn with gloves and other personal
protective equipment.
4. After contact with blood or body fluids,
non-intact skin, and mucous membranes. Healthcare workers must make sure that
they change gowns or aprons in between
treating different patients.
The moment it becomes damp, it should be 1. The gown sleeves are sterile from two
replaced with a clean, and dry one. inches above the elbow to the cuff,
circumferentially.
Remember that mask are supposed to be
single-use items – disposed and discarded 2. The back of the gown is not considered
of as clinical waste. sterile because it cannot be constantly
monitored
Recommended that hands are
decontaminated with soap and water after 3. The neck, sleeve cuffs, and underarms of
mask is disposed. the gloves are not considered sterile and
are not considered as effective microbial
3. STERILE GOWNS barriers.
Healthcare workers are recommended to If contamination of the surgical gown occurs at any
wear gowns or aprons when there is point during the procedure :
probability of contact with blood, body
secretions excluding sweat, or other body Gown as well as the gloves must be changed.
substances. What is the function of the circulating nurse ?
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2. DROPLET PRECAUTIONS
1. Contact Precautions
- Are used to prevent the spread of infections TO prevent post-operative infection,
or infectious agents that are transmitted asepsis must be strictly observed in the
through touching of patients or items in the
operating room. Thorough cleaning of
room where the infectious agents may be
the operating room with detergent or
deposited (called fomites).
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VACCINATION : immunizations
awareness