INFECTION CONTROL

Community Acquired Infection

- Infection acquired outside of health care facilities
Nosocomial Infection
 an infection acquired in a hospital by a patient who was admitted for a reason other than that infection.
Most Common Types of Nosocomial Infections
 Urinary Tract Infection (UTI)
 Lower Respiratory Tract Infections (Pneumonia)
 Bloodstream Infection (Septicemia)

INFECTION CONTROL -- breaking the chain of infection

Aseptic

Technique

 Asepsis = absence of pathogens

 Sepsis = presence of pathogens
 2 types:
a. Medical asepsis
- Clean Technique
- Based on maintaining cleanliness to prevent the spread of pathogenic
microorganisms and to ensure that the environment is as free of microbes as
possible.
b. Surgical asepsis
- Sterile Technique
- Requires strict adherence to ordered and specific procedures which render an
area free from all microorganisms including spores.

Aseptic Techniques

1. Handwashing
2. Cleaning, Disinfection, Sterilization
3. Personal Protective Equipment (PPE) and other barriers
 Masks
 Caps & shoe coverings
 Gloves
 Goggles
 Private rooms
 Waterproof disposable bags for linen & trash
 Labelling & bagging contaminated equipment & specimens
 Control of airflow into the sterile areas & out of contaminated areas
 4. Equipment & Refuse Handling
 Categories of Institutional wastes:
a. Infectious wastes
b. Injurious wastes
c. Hazardous wastes
5. Isolation Systems

Masking

 Masks should fit tightly to the face, covering the nose and the mouth.
 Masks lose their effectiveness if they are wet, worn for long periods, and when they are no changed after
caring for each client.

MEDICAL HANDWASHING

Hand washing is the act of cleansing the hands with water or another liquid, with or without the use of
soap or other detergents, for the sanitary purpose of removing dirt and/or microorganisms. This is the most
basic yet effective way to prevent the spread of communicable diseases.

The main purpose of washing hands is to cleanse the hands of pathogens (including bacteria or viruses)
and chemicals which can cause personal harm or disease. This is therefore done to prevent spread of
communicable diseases (www.wikipedia.com).

When is medical handwashing done?

Unless there is an emergency, medical handwasing is done:
Before
 Invasive procedures
 Caring for susceptible individuals such as newborns and immunocompromised
 Handling wounds
After
 Handling wounds
 Handling contaminated items such as bedpans or wet linens
 Caring for infected clients
 Removing gloves
Between
 Caring for individual clients
(Potter & Perry, 2007)

Requisites:
 Soap, foam, benzalkonium chloride-based or alcohol gel sanitizer
 Warm running water / running tap water
 Paper towels
 Orange wood stick (optional)
 Soap disk (for bar soap)

1. Assess the hands

 Nails should be kept short. (Short, natural nails are less likely to harbor microorganisms, scratch a client
or puncture gloves).
 Check hands for breaks in the skin, such as hangnails or cuts (A nurse who has open sores may require a
work assignment with decreased risk for transmission of infectious organisms).

2. Remove all jewelry. (Microorganisms can lodge in the settings of jewelry and under rings. Removal
facilitates proper cleaning of the hands and arms).

3. Assemble all equipment.

4. Stand in front of the sink but do not allow the uniform to touch the sink or become wet.

5. Turn on the water, and adjust the flow. Adjust the flow so that the water is warm. (Warm water removes less
of the protective oil of the skin than hot water.)
6. Wet the hands thoroughly by holding them under the running water. Hold the hands lower than the elbows so
that the water flows from the arms to the fingertips. (The water should flow from the least contaminated to the
most contaminated area; the hands are generally considered more contaminated than the lower arms.)

7. Apply soap to the hands. If the soap is liquid, apply 2-4 ml (1 tsp.). If it is bar soap, granules, or sheets, rub
tem firmly between the hands. After washing, rinse the bar and return it to the soap dish.

8. Thoroughly wash the hands.

 Use firm, rubbing and circular movements to wash the palm, back, and wrist of each hand. Interlace the
fingers and thumbs, and move the hands back and forth. Continue this motion for 10 seconds. (The
circular action helps remove microorganisms mechanically. Interlacing the fingers and thumbs cleans the
interdigital spaces).
 Rub the fingertips against the palm of the opposite hand. (The nails and fingertips are commonly missed
during handwashing).
9. Use fingernails of the other hand or an orange wood stick to clean under the fingernails

10. Rinse thoroughly under running water with the fingers pointed downward.

11. Dry hands and arms thoroughly with a paper towel (Moist skin becomes chapped readily; chapping
produces lesions.)

12. Discard the paper towel in the appropriate container.

13. Turn off the faucet. Use a new paper towel to grasp a hand-operated control. (This prevents the nurse from
picking up microorganisms from the faucet handles.)

14. Apply lotion or moisturizer to your hands. (Moisturizing the skin with lotion after hand washing between
clients can help protect the skin from excessive drying).

Applying and Removing Sterile Gloves

Purpose: prevent transfer of microorganisms from hands to sterile objects or open wounds.

Principles:
1. Objects below waist level are considered contaminated.
2. Inner surface of wrapper is considered sterile.
3. Contamination occurs if ungloved hand contacts gloved hand.
4. Wash gloved hands first before removing.
5. Use “glove-to-glove”, “skin-to-skin” technique when removing gloves.
6. Wash hands before and after removing gloves to prevent contamination of hands.