Asepsis and

Infection
Control
1
Components of the Infection Cycle
Infectious agent — bacteria, viruses, fungi
Reservoir — natural habitat of the organism
Portal of exit — point of escape for the organism
Means of transmission — direct contact, indirect
contact, airborne route
Portal of entry — point at which organisms enter a
new host
Susceptible host — must overcome resistance
mounted by host’s defenses
2
 Infectious Agents
Bacteria — most significant and most
prevalent in hospital settings
Virus — smallest of all microorganisms
Fungi — plantlike organisms present in air,
soil, and water

3
 Classification of Bacteria
Spherical (cocci), rod shaped (bacilli),
corkscrew shaped (spirochetes)
Gram positive or gram negative — based on
reaction to gram stain
Aerobic or anaerobic — based on need for
oxygen

4
Factors Affecting an Organism’s
Potential to Produce
Number of organisms
Disease
Virulence
Competence of person’s immune system
Length and intimacy of contact between
person and microorganism

5
 Possible Reservoirs for
Microorganisms
Other humans
Animals
Soil
Food, water, milk
Inanimate objects

6
 Common Portals of Exit
Respiratory
Gastrointestinal
Genitourinary tracts
Breaks in skin
Blood and tissue

7
Laboratory Data Indicating Infection
Elevated white blood cell count — normal is
5000 to 10,000/mm3
Increase in specific types of white blood cells
Elevated erythrocyte sedimentation rate
Presence of pathogen in urine, blood,
sputum, or draining cultures

8
 Aseptic Technique
Includes all activities to prevent or break the
chain of infection
Two categories
Medial asepsis — clean technique
Surgical asepsis — sterile technique

9
 Factors Predisposing Patients
to Nosocomial Infections
Use of invasive medical devices
Antibiotic-resistant organisms developed in
hospitals

10
 Measures to Reduce Incidence
of Nosocomial Infections
Constant surveillance by infection-control
committees and nurse epidemiologists
Written infection-prevention practices for all
agency personnel
Hand hygiene recommendations
Infection control precaution techniques
Keeping patient in best possible physical
condition
11
 Bacterial Flora
Transient — attached loosely on skin,
removed with relative ease
Resident — found in creases in skin, requires
friction with brush to remove

12
 Stages of Infection
Incubation period — organisms growing and
multiplying
Prodromal stage — person is most infectious,
vague and nonspecific signs of disease
Full stage of illness — presence of specific
signs and symptoms of disease
Convalescent period — recovery from the
infection
13
Body’s Defense Against Infection
Body’s normal flora
Inflammatory response
Immune response

14
Factors Affecting Host Susceptibility
Intact skin and mucous membranes
Normal pH levels
Body’s white blood cells
Age, sex, race, hereditary factors
Immunization, natural or acquired
Fatigue, climate, nutritional and general health status
Stress
Use of invasive or indwelling medical devises

15
 Factors Determining Use of
Sterilization and Disinfection
Methods
Nature of organisms present
Number of organisms present
Type of equipment
Intended use of equipment
Available means for sterilization and
disinfection
Time
16
 Personal Protective Equipment
Gloves
and Supplies
Gowns
Masks
Protective eye gear

17
Evolution of Specialized Infection

Early CDC Control

guidelinesPrecautions
Specific isolation techniques
Disease specific isolation
Universal precautions
OSHA regulations for universal precautions
Body substance precautions
Current CDC guidelines
18
 Current CDC Guidelines
Standard precautions — used in care of all
hospitalized patients
Apply to blood, body fluids, secretions,
excretions, non-intact skin, mucous membranes
Transmission-based precautions — used in
addition to standard precautions for patients
with suspected infection
Include airborne, droplet, or contact precautions
19
 Use of Surgical Asepsis
Operating room, labor and delivery areas
Certain diagnostic testing areas
Patient bedside
E.g., for procedures that involve insertion of
urinary catheter, sterile dressing changes, or
preparing and injectible medicine

20
 Patient Teaching for Medical
Asepsis at Home
Wash hands before preparing or eating food.
Prepare foods at high enough temperatures.
Use care with cutting boards and utensils.
Keep food refrigerated.
Wash raw fruits and vegetables.
Use pasteurized milk and fruit juices.
Wash hands after using bathroom.
Use individual care items.
21
 Evaluating Patient Goals
Use techniques of medical asepsis.
Identify health habits and lifestyle patterns
promoting health.
State signs and symptoms of an infection.
Identify unsafe situations in the home
environment.

22