Aesepsis

• Infection control is one of the major concerns that healthcare workers in healthcare facilities and hospitals constantly address
• Chain of Infection


  How an individual acquires the infection agents and includes the infectious agent, the source of infection, or its reservoir, how the organism is transmitted, and the organism's portal of entry into the susceptible host
• Mode of Transmission


  The manner in which the infectious organism is acquired by the host
• Standard Precautions


  The specific measure used to prevent the spread of infection among all patients and healthcare workers, including measures to protect them from contaminated blood and other body fluids
• Contamination


  Denotes contact of a sterile or aseptic item with microorganisms
• Decontamination


  The process where physical or chemical means are used to remove, inactivate, or destroy pathogens on a surface or item making them safe for handling use and incapable of transmitting infectious agents
• Disinfection


  The process by using physical or chemical means to destroy pathogens excluding the spores
• Sterilization


  The process by which all pathogens are destroyed, including the spores
• Antiseptic


  A chemical solution that inhibits the growth of some microorganisms. Most antiseptics can be used directly on the skin (e.g. alcohol and iodine)
• Health-Associated Infection


  Any infection that is acquired during the time a patient is admitted in a healthcare facility. The most common healthcare-associated infection is the urinary tract infection (UTI)
• Iatrogenic Infection


  Infection that is acquired in the course of undergoing diagnostic tests or therapeutic procedure
• Occupational Exposure


  The acquisition or exposure to an infectious agent of a healthcare worker during the course of his/her work
• Personal Protective Equipment (PPE)


  Specialized equipment and attire used by healthcare workers to protect them from infections. These include gloves, masks, gowns, and goggles
• Asepsis


  A condition in which the individual and his/her surrounding environment are free of any microorganisms
• Sepsis


  The clinical condition where an individual develops a systemic reaction to a bacterial infection that starts from a localized infection in one part of the body
• The goal of asepsis are to protect the patient from a hospital-acquired or nosocomial infections and to prevent the spread of pathogenic microorganisms
• Factors that play role in the occurrence of infection among patients

  • Suppression of the immune system
  • Prolonged duration of illness
  • Procedures that patients undergo in the healthcare facility
• The most commonly occurring pathogenic microorganisms that lead to nosocomial infections

  • Escherichia coli
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • Candida albicans
  • Enterococcus
• Pathogens may be introduced to the patient through contact with hospital personnel, hospital environment, or hospital equipment such as respiratory machines, catheters, and intravenous lines or needles
• Situations that require aseptic measures are surgery and the insertion of intravenous lines, urinary catheters, and drains
• Medical or Clean Asepsis

  The infection control process that aims to reduce the spread of infection. It involves certain procedures to decrease the number of organisms and prevent their spread in the general clinical setting
• Surgical or Sterile Asepsis


  Procedures that aim to eliminate microorganisms from an area in the body where surgical procedures will be performed as well as the location where the surgical procedure will be carried out
• General Aseptic Procedures that help preserve and maintain a clean medical environment

  • Frequent handwashing of hospital personnel
  • Prompt and safe disposal of contaminated materials like bandages and needles
  • Regular checking and emptying of containers for surgical drains
  • Prompt cleaning of soiled or moist areas
  • Proper labeling of containers regarding the date and time of disposal
• Handwashing


  The most frequent source of microorganisms leading to outbreaks of infection in health institutions is the hands of the healthcare workers. It is the most basic means of preventing the spread of pathogenic organisms
• Reasons for Handwashing


  • Reduce the flora on the healthcare worker's skin
  • Protect the healthcare worker in the event that there is a break in his or her skin
  • Reduce risk of contact with infectious agents if gloves worn are punctured
  • Reduce the chances of disease transmission
• When should handwashing be done?

  • At the beginning and end of each shift
  • When the hands are visibly soiled
  • After contact with a possible source of microorganisms such as blood or body fluids, mucous membranes, non-intact skin, or contaminated objects
  • Before and after performing invasive procedures
  • Before and after using of gloves
• Proper hand washing


  Using friction and regular soap and water, thoroughly washing hands with vigorous scrubbing, special attention to the areas around the nail beds and between the fingers (high in bacterial load). Fingernails should be kept short and clean
• Alcohol-based sanitizing antimicrobial solutions or hand cleansers must not be used as substitute for proper handwashing. However, if no water and soap, one may use it
• Personal Protective Equipment (PPE)


  Specialized equipment and attire used in healthcare facilities to protect not only the healthcare workers but also the patients and visitors against infections. These include masks, gowns and goggles
• Gloves


  Among the various PPEs in use, gloves are the most commonly used. Examination gloves and surgical gloves (sterile) are the two most commonly used
• Gloves


  • Serve as a protective barrier when handling our touching open wounds, blood or body fluids
  • Protection from microorganisms and help prevent the spread of infectious agents from one person to another
  • Sterile, disposable gloves must be provided to all personnel in healthcare facilities, particularly those who have direct contact with patients
  • The gloves must be disposed of immediately after use
• WHO Guidelines for Proper Use of Gloves in Health Care Facilities

  • Gloves are not meant to replace observance of proper hand hygiene. The practice of hand hygiene must still be observed before and after wearing of gloves
  • Gloves must be worn if contact with blood or body fluids, mucous membranes, open wounds, or potentially infectious material is anticipated
  • Gloves must be removed and disposed of after caring for a patient. Healthcare workers must not wear the same gloves if caring for more than one patient
  • Gloves must be removed or changed if moving from a contaminated body site to another body site in the course of caring for a patient
  • Re-using of gloves after decontamination is not recommended
• Sterile, disposable gloves


  Must be provided to all personnel in healthcare facilities, particularly those who have direct contact with patients
• Gloves


  Must be disposed of immediately after use
• WHO Guidelines for Proper Use of Gloves in Health Care Facilities

  • Gloves are not meant to replace observance of proper hand hygiene. The practice of hand hygiene must still be observed before and after wearing of gloves.
  • Gloves must be worn if contact with blood or body fluids, mucous membranes, open wounds, or potentially infectious material is anticipated.
  • Gloves must be removed and disposed of after caring for a patient. Healthcare workers must not wear the same gloves if caring for more than one patient.
  • Gloves must be removed or changed if moving from a contaminated body site to another body site in the course of caring for a patient.
  • Re-using of gloves after decontamination is not recommended.
• Masks


  • The mask must cover the mouth and nose
  • It must be tied in a way that there should be minimal gaps between the face and the mask
  • The moment it becomes damp, it should be replaced with a clean, and dry one
  • Masks are supposed to be single-use items – disposed and discarded of as clinical waste
  • Hands are recommended to be decontaminated with soap and water after mask is disposed
• Sterile Gowns


  • Healthcare workers are recommended to wear gowns or aprons when there is probability of contact with blood, body secretions excluding sweat, or other body substances
  • Wearing gowns is recommended if the healthcare worker has close contact with patients, equipment, or materials that can introduce infectious agents to the healthcare worker's skin, uniform and or other clothing
  • Fluid-resistant apron or gown is recommended if there is a risk for body substances, blood or body secretions to contaminate the clothing or skin of the healthcare worker
  • Clean, non-sterile gowns or aprons are generally sufficient to protect the skin and prevent soiling of clothing during procedures or other in-patient activities that may lead to splashing or spraying of blood and body substances
  • Fluid-resistant gowns or aprons are always worn with gloves and other personal protective equipment
  • Healthcare workers must make sure that they change gowns or aprons in between treating different patients
• Critical Shortage!
• Isolation


  The process of separating an individual with an infectious disease from the rest of the healthy population to prevent the spread of the infection to other individuals
• Universal Precautions


  Geared towards handling of patients with an infection from an unknown pathogen to decrease the risk of transmission