FUNDAMENTALS

• Asepsis refers to being free from disease-causing contaminants or preventing contact with microorganisms
• Principles of Aseptic Technique:

  • Sterile objects become unsterile when touched by an unsterile field
  • Sterile objects can become unsterile by prolonged exposure to airborne microorganisms
  • The skin cannot be sterile and is unsterile
  • Conscientiousness, alertness, and honesty are essential qualities in maintaining asepsis
• Invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body
• Correctly cleaning, disinfecting, or sterilizing articles before use
• Autoclaving is the method of choice for sterilization in most hospitals, using pressurized steam to heat the material to be sterilized
• Disinfectant Uses:

  • Glutaraldehyde: To disinfect and clean heat-sensitive medical, surgical, and dental equipment
  • Alcohol (Ethanol): Used as an antiseptic and disinfectant, disinfect skin before a needle stick and before surgery
  • Hydrogen Peroxide (3-6%): A powerful disinfectant for cleaning and debridement of wounds
• Antiseptic Uses:

  • Betadine: To treat minor wounds (e.g., cuts, scrapes, burns) and to help prevent or treat mild skin infections
• Proper hand hygiene is essential, instructing clients and support persons to perform hand hygiene before handling food, eating, after eliminating, and after touching infectious material
• Factors Increasing Susceptibility to Infection:

  • Age: children and older persons are at greater risk due to reduced defenses
  • Heredity: some people have a susceptibility to infectious diseases
  • Cultural practices, healthcare beliefs, and practices can influence susceptibility to diseases
  • Nutrition: inadequate nutrition can make a person more susceptible to illness
  • Physical and emotional stressors affect the body's ability to protect against microbes
  • Altered rest and exercise patterns, unhealthy habits decrease protective mechanisms
• • Physiological abnormalities can influence normal defenses, making a person susceptible to infection
  • Environment exposing individuals to hazards and toxins increases the risk of infection
  • Immunization history
• Course of an Infection:

  • Incubation period: time between entrance of causative agent and beginning to have symptoms
  • Prodromal Stage
  • Full Stage or acute period
  • Convalescence Stage
• Terminologies related to infection are those acquired as a result of a health care delivery system
• Medical Handwashing:

  • Purpose: to reduce the number of microbes, risk for transmission, cross-contamination, and the risk of transmission to oneself
• Nursing Process Applied to Asepsis and Infection Control:

  • Assessment
  • Nursing Diagnosis: Risk for/Actual Infection, Potential complication of Infection: Fever
  • Planning/Outcome Criteria: Client will manifest positive understanding of measures to control/prevent infection
  • Nursing Interventions:
  • Perform medical handwashing
  • Render personal hygiene and change linens of the client
  • Clean surroundings (bed and bedside table)
  • Evaluation
• Performing Open Gloving:

  • Gather and prepare gloves
  • Open the outside wrapper of the gloves
  • Perform handwashing
  • Open the wrapper of the gloves
  • Manipulate and adjust the gloves to fit
• • Cleaning should follow topmost first and bottom last
• Performing Environmental Care:

  • Purposes: to leave a clean polished surface, remove dust, dirt, breeding places of microorganisms, maintain articles ready for use, and maintain aesthetic factors
  • Principles of Dusting:
  • Scrubbing is the best way to physically remove dirt, debris, and microorganisms
  • Dry sweeping, mopping, and dusting should be avoided
  • Routine cleaning is necessary
  • Cleaning products should be selected based on use, efficacy, and cost
  • Bacteria grow in dark, moist, and unclean places
  • Exposure to sunlight destroys some bacteria
• Purpose of Handwashing:

  • Reduce the number of microbes, risk for transmission, cross-contamination, and the risk of transmission to oneself
• Steps in Handwashing:

  • Gather equipment: liquid soap with push button, paper towel
  • Remove jewelry and watch
  • Assess the hands: nails should be kept short, check for breaks in the skin like hangnails or cuts
  • Open the faucet and adjust the flow
  • Apply soap and lather hands for at least 20 seconds
  • Rub hands palm to palm, right palm over left dorsum with interlaced fingers and vice versa, palm to palm with fingers interlaced, interlock fingers and rub the back of the fingers, rub thumb in a rotating manner, rub fingertips on palm, rub wrist in a rotating manner
• • Rinse with running water flowing towards the fingertips
  • Close the faucet using a tissue
  • Dry hands and arms thoroughly with a paper towel
  • Discard the used paper towel appropriately
• Purpose of Open Gloving:

  • Method of wearing gloves used when not wearing a gown to protect hands from fluids and prevent contamination of sterile equipment
• Materials Needed for Open Gloving:

  • Sterile gloves, tray with lining
  • Gather equipment
• • Place fingers of the gloved hand under the cuff of the partially gloved hand and unfold the cuff down, ensuring gloved fingertips do not touch bare forearm or wrists
  • Manipulate and adjust gloves to fit
• Steps for Open Gloving:

  • Open the outside wrapper of the gloves and place them on a clean space or tray with lining
  • Perform handwashing and ensure hands are thoroughly dried
  • Open the wrapper of the gloves, keeping the inside wrapper and gloves sterile
  • Using the dominant hand, pick up the cuff of the opposite glove and slide hand into the glove until a snug fit is achieved
  • Slide fingertips into the folded cuff of the glove on the non-dominant hand
  • Use the gloved hand to pick up the folded cuff of the opposite glove and pull the glove up
• Purpose of Environmental Care:

  • Leave a clean polished surface to prevent accumulation of dirt and potential infection or contamination
  • Remove all dust, dirt, and breeding places of microorganisms with minimal disturbance to the client
  • Prolong the life of articles and keep them ready for use at any time
  • Maintain aesthetic factors
• • Bacteria grow in dark, moist, unclean places, sunlight exposure destroys some bacteria
• Principles of Dusting and Scrubbing:

  • Scrubbing is the best way to physically remove dirt, debris, and microorganisms
  • Friction aids in mechanical cleaning, use a brush for grooved surfaces
  • Avoid dry sweeping, mopping, and dusting to prevent dust, debris, and microorganisms from spreading
  • Dust clings to moist surfaces, so use a damp duster or oiled cloth for dusting
  • Routine cleaning is necessary to maintain cleanliness
  • Albuminous materials should be removed with cold water
  • Cleaning products should be selected based on use, efficacy, and cost
• Disinfectant Selection:

  • Consider intended use, efficacy, acceptability, safety, and cost
  • Follow the topmost first and bottom last rule in cleaning