Asepsis

• Asepsis


  Freedom from disease-causing microorganisms
• Aseptic Technique


  Used to decrease the possibility of transferring microorganisms from one place to another
• Medical Asepsis


  • All practices intended to confine a specific microorganism to a specific area
  • Limiting the number, growth, and transmission of microorganisms
  • Objects are referred to as clean (the absence of almost all microorganisms) or Dirty (soiled, contaminated-likely to have microorganisms, some of which may be capable of causing infection)
• Surgical Asepsis or sterile technique


  • Practices that keep an area or object free of all microorganisms
  • Practices that destroy all microorganisms and spores
  • Used for all procedures involving sterile areas of the body
• Sepsis


  A condition in which acute organ dysfunction occurs secondary to infection
• Principles of Aseptic Technique


  • Only sterile items are used within sterile field
  • Sterile objects become unsterile when touched by unsterile objects
  • Sterile items that are out of vision or below the waist level of the nurse are considered unsterile
  • Sterile objects can become unsterile by prolong exposure to airborne microorganisms
  • Fluids flow in the direction of gravity
  • Moisture that passes through a sterile object draws microorganism from unsterile surfaces above or below to the surface by capillary reaction
  • The edges of a sterile field are considered unsterile
  • The skin cannot be sterilized and is unsterile
  • Conscientiousness, alertness and honesty are essential qualities in maintaining surgical asepsis
• Infection


  The growth of microorganisms (infectious agent) in body tissue where they are not usually found

  
• Asymptomatic or Subclinical Infection


  When the microorganism produces no clinical evidence of disease
• Disease


  A detectable alteration in normal tissue function
• Microorganisms vary in their virulence (their ability to produce disease)
• Communicable Disease


  When an infectious agent can be transmitted to an individual by direct or indirect contact or as an airborne infection
• Pathogenicity


  The ability to produce disease; thus, a pathogen is a microorganism that causes disease
• Types of Microorganisms that cause Infections


  • Bacteria
  • Viruses
  • Fungi
  • Parasites
• Colonization


  The process by which strains of microorganisms become resident flora
• Types of Infections


  • Local Infection
  • Systemic Infection
  • Acute Infection
  • Chronic Infection
• Nosocomial Infections


  Infections that originate in the hospital
• Sources of Nosocomial Infections


  • Endogenous (from the client themselves)
  • Exogenous (from the hospital environment and hospital personnel)
• The cost of nosocomial infection is great to client, facility and funding sources
• Most Common Nosocomial Infections and Causative Microorganisms

  • Urinary Tract (Escherichia Coli, Enterococcus species, Pseudomonas aeruginosa)
  • Surgical Sites (Staphylococcus aureus, Enterococcus species, Pseudomonas aeruginosa)
  • Bloodstream (Coagulase-negative staphylococci, Staphyloccocus aureus, Enterococcus species)
  • Pneumonia (Staphyloccocus aureus, Pseudomonas aeruginosa, Enterobacter species)
• Chain of Infection


  The elements that must be present to cause an infection from a microorganism

  
• Factors Influencing Microorganism's Capability to Produce Infection


  • Number of microorganisms present
  • Virulence and potency of the microorganisms (pathogenicity)
  • Ability to enter the body
  • Susceptibility of the host
  • Ability to live in the host's body

  
• How to Break the Chain of Infection


  • Correctly cleaning, disinfecting or sterilizing articles before use
  • Educating clients and support persons about appropriate methods to clean, disinfect, and sterilize article
  • Changing dressings and bandages when soiled or wet
  • Appropriate skin and oral hygiene
  • Disposing of damp, soiled linens appropriately
  • Disposing of feces and urine in appropriate receptacles
  • Ensuring that all fluid containers are covered or capped
  • Emptying suction and drainage bottles at end of each shift or before full or according to agency policy
  • Avoiding talking, coughing, or sneezing over open wounds or sterile fields
  • Covering the mouth and nose when coughing or sneezing
  • Wear medical grade mask
  • Proper hand hygiene
  • Instructing clients and support persons to perform hand hygiene before handling food, eating, after eliminating and after touching infectious material
  • Wearing gloves when handling secretions and excretions
  • Wearing gowns if there is danger of soiling clothing with body substances
  • Placing discarded soiled materials in moisture-proof refuse bags
  • Holding used bedpans steadily to prevent spillage
  • Disposing of urine and feces in appropriate receptacles
  • Initiating and implementing aseptic precautions for all clients
  • Wearing masks and eye protection when in close contact with clients who have infections transmitted by droplets from the respiratory tract
  • Wearing masks and eye protection when sprays of body fluid are possible
  • Using sterile technique for invasive procedures, when exposing open wounds or handling dressings
  • Placing used disposable needles and syringes in puncture-resistant containers for disposal
  • Providing all clients with own personal care items
  • Maintaining the integrity of the client's skin and mucous membranes
  • Ensuring that the client receives a balanced diet
  • Educating the public about the importance of immunizations
• Course of Infection


  • Incubation
  • Prodromal Stage
  • Full Stage
  • Convalescence
• How to break the chain of infection


  1. Maintaining the integrity of the client's skin and mucous membranes

  2. Ensuring that the client receives a balanced diet

  3. Educating the public about the importance of immunizations
• Incubation period


  The time between initial contact with an infectious agent until the first signs of symptoms; microorganisms are growing and multiplying during this stage
• Prodromal Stage


  The time period from the onset of nonspecific symptoms to the appearance of specific symptoms related to the causative pathogen; during this phase it is still possible to transmit the pathogen to another host

  
• Full Stage


  Manifestations of specific signs & symptoms of infectious agent
• Convalescence


  The time period that the host takes to return to the pre-illness stage; the host defense mechanisms have responded to the infectious agent and the signs and symptoms of the disease disappear; the host, however, is more vulnerable to other pathogens at this time
• Nonspecific defenses


  • Anatomic and physiological barriers
  • Inflammatory response
• Anatomic and physiological barriers


  • Intact skin and mucous membranes
  • Moist mucous membranes and cilia of the nasal passages
  • Alveolar macrophages
  • Tears
  • High acidity of the stomach
  • Resident flora of the large intestine
  • Peristalsis
  • Low pH of the vagina
  • Urine flow through the urethra
• Inflammation


  A local and nonspecific defensive response of the tissues to an injurious agent; it is an adaptive mechanism that destroys or dilutes the injurious agents, prevents further spread of the injury and promotes the repair of damaged tissue
• Signs of inflammation


  • Pain
  • Swelling
  • Redness
  • Heat
  • Impaired function of the part
• Inflammatory response


  1. Vasoconstriction

  2. Increase in vascular permeability

  3. Blood vessels dilate allowing plasma to escape into the injured tissue

  4. WBCs (neutrophils, monocytes, and macrophages) migrate to the area of injury and attack and ingest the invaders (phagocytosis)
• Specific response


  Involves the immune system
• Antigen


  A substance that induces a state of sensitivity or immune responsiveness (immunity); if the proteins originate in a person's own body the antigen is called auto antigen
• Components of the immune response


  • Antibody-mediated defenses
  • Cell-mediated defenses/cellular immunity
• Antibody-mediated defenses/humoral immunity


  The ability of the body to develop a specific antibody to a specific antigen (antigen-antibody response); B-lymphocytes provide humoral immunity by producing antibodies that convey specific resistance to many bacterial and viral infections
• Types of immunity


  • Active immunity
  • Passive immunity
• Active immunity


  Host produces antibodies in response to natural antigens or artificial antigens
• Natural active immunity


  Antibodies are formed in presence of active infection in the body; duration lifelong