asepsis

By
Mehvish Ashraf
Instructor con RYK
 Introduction(ASEPSIS)
The nurse who understands how to control or prevent
the spread of infection is making a significant
contribution to safe patient care.
This applies to the care of patients both who are at risk
& those already acquired infection & how to minimize
spread of those infection.
 Asepsis(definition)
• Reducing the number of microbes to an irreducible
number.
• Asepsis means to make free from disease producing
organism.
• The purposeful prevention of the transfer of
microbes from one person to another.
• It can be defined as the absence of micro organisms
 Types of asepsis
• Surgical asepsis:
it is a sterile technique which eliminates all micro
organism including viruses & spores.
• Medical asepsis:
it is a clean technique which is used to prevent the
spread of micro organism against pathogenic &
non pathogenic organisms.
Difference b/w surgical & medical asepsis.
Surgical
• Sterile technique
• Complex procedure
• It eliminates all micro
organism including viruses
& spores.
• Protect from environment
Medical
• Clean technique
• Simple procedure
• It is used to prevent the
spread of micro organism
against pathogenic & non
pathogenic organism
• Protects environment from
patient.
 Infection cycle
• The life cycle of pathogens frequently describe as an
uninterrupted chain of events. For organism to
spread disease, they must grow, reproduce & move
from one source to another
 Link of infection cycle
• Etiologic agent:
(bacteria,virus,fungi,protozoa)
• Resiorvior:
( human, animals).
• portal of exit:
(Res.tract,GI tract, Open lesions, blood).
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• Mode of transmission:
(direct, indirect contact,vehicles,water,food,drugs,
blood, air)
• Portal of exit:
(Resp.tract,GI.tract,skin,Mucus membrane).
• Susceptible host:
(age,sex,status,general,health,disease).
 Infectious agent
• 1st link in the chain of survival is the microbial agent,
which are bacteria,virus,fungi,& protozoa.
• The ability of the infectious agent to cause a disease
depend upon :The pathogenicity , virulence,
invasiveness.
 Source/reservoir
• The source of organism, also called reservoir, are
elements in the environment. Organism can find the
nourishment or lie dormant & survive.
• Portal of exit: The portal of exit provide a means
for the micro organism to leave the source.
• Mode of transmission
mode of transmission refers to the way in which the
organism moves or is carried from the portal of exit.
The main 5 routes are:
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• Direct transmission: touch the patient body
secretions e.g.urine,feces,sputum,blood etc.
• Indirect contact: touching the objects that are
used on the patients e.g. instruments.
• Droplet spread:sneezing,coughing,talking etc.
• Vector borne :living animals such as rates, insects
that carry pathogens.
• Air borne:dust particles in air.
• Vehicle transmission: contaminated
food,water,blood
 PORTAL OF ENTRY
• It permits the organism to gain entrance into the
host. They can find their way through
• Broken skin
• Mucus membrane
• During medical examination
• Through the use of invasive devices
• By eating
• Through breathing etc.
 Susceptible host
• A host is a person whose own body defense
mechanisms which exposed are unable to with stand
the invasion of pathogens.
• There are two types of risk factors:
⮚ intrinsic
⮚ extrinsic
 Susceptible host
Intrinsic risk factors Extrinsic risk factors
• Age of the patient. • Skin trauma/chronic lesion
• Diabetes. • Antibiotic
• Malnutrition • Immunosuppressive
• Substance/drug abuse therapy.
• Respiratory disorders • Invasive devices
• Blood disorders • Surgery anesthesia
• Infection with blood • Hospital environment
borne viruses e.g.HIV/
AIDS.
 Nosocomial infection
• It refers to hospital acquired infection or
infection acquired in other health care
delivery system.
• MRSA:
Methicillin resistant staphylococcus aureus. The
transmission of organism is direct (person) or
indirect (fomite) contact, or through the air.
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• MARO: multiple
antibiotic resistant organism, these are gram negative
rod, resistant to two or more classes of antibiotics i-e
Pencillin,cephalosporine,& aminoclycosydes.
• VRE:
Vancomycine resistance Enterococcus.It is a gram
positive bacteria that can no longer be treated with
vancomycine.transmission of VRE is from person to person
either via direct contact or indirect via the hands of
personnel or contaminated patient care
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• VHF:
viral hemorrhagic fever is caused by the Crimean
Congo virus & characterized by fever, low platelet,
counts & deranged coagulation.
• ESBL: Its
a gram negative strains, known as extended
spectrum beta lactamase. It is resistant to 3rd
generation cephalosporin.
 isolation
• It refers to the technique used to prevent or to limit
the spread of infection whether to protect a high risk
person from exposure to pathogens or prevent the
transmission of pathogens from an infected person
to others.
 Types of isolation
• Protective isolation:
It is used to protect patients from others.
• Strict Isolation:
it is used to prevent the transmission of
highly contagious or virulent infections that may be
spread by both air & contact with the blood & body
fluids. e.g. Diphtheria,pneumonia,plague,VHF.
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• Respiratory isolation
it is used to prevent droplet infection.e.g. Pulmonary
tuberculosis,diphtheria,small pox.
• Blood/body fluid precaution:
it is used to protect other patient from patients blood
& body fluid secretions. e.g.AIDS,Hepatitis c.
• Contact isolation:
it prevents the transmission of pathogens from an
infected person to others e.g MARO , MRSA, scabies .
 The card system of isolation
• Purpose of cards:
The category specific card system is designed
to give concise information about isolation
precautions for specific communicable diseases
based on their mode of transmission.
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Isolation colors of cards
• Blood/body fluid. • Red card
• Contact isolation • Orange card
• Strict isolation • Dull yellow card
• Protective isolation • Green card
• MARO,ESBL, • Yellow card
• MRSA • Yellow with red line
• VRE • Dark pink card
• Respiratory isolation • White card
 Isolation trolly
• Top shelf:
sharp containers
promote safety poster
clean masks container
dirty mask container
spirit swab
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Middle shelf Lower shelf
• Disposable gloves • Water soluble isolation bags
• Isolation category cards • Red plastic bags
• Medicines cups • Hamper bags
• Syringes\needles • Clean gowns for care givers
• Disposable plastic apron
• Patients linen if required
 Universal precaution
• Wash hands before and after every procedure.
• Wear mask to prevent the spread of droplet infection
• Wear gown & gloves when in contact with the body
secretions
• Dispose off sharps immediately in the danger box
• Never recap used needles.
• Use a Biohazards tickers on all infective specimen &
request forms
• All infected patients linen should be doubled bagged
as per policy.
 Nursing care of patients with mrsa,maro&
vre
• Isolation
• Hand washing
• Protective clothing
• Linen
• Labeling
• Transferring patient
• Terminal cleaning
Readmission of mrsa,vre positive patients

• On every readmission these patients should

be kept in isolation. Send 3 culture swabs of
nose, axilla & groins one week a part. If any
one culture is positive, patient will be kept in
isolation for six months duration.
• Same is with VRE except for culture, rectal
swab is taken.
 Viral hemorrhagic fever
• Viral hemorahgic fever is caused by Crimean,
Congo virus
• Contact history:
⮚ with tick or animals( cattle, sheep, goats)
⮚ Residence in a travel to Baluchistan,
Afghanistan.
⮚ Occupation (butchers, cattle farmers).
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• Clinical feature:
fever, low platelets count.
• Symptoms:
nausea, vomiting
sever headache
abdominal pain
• clinical sign:
conjunctivitis
petecial rash
epistaxis
hematemesis
 Nursing care of patients with VHF
• Isolation
• Hand washing
• Self protection
• Linen
• Labeling
• Transferring patient
 commemoration
To improve your patients
quality of life in terms of
care, it is essential to deliver
comprehensive knowledge
& skills to get maximum
out come in pts quality care.
thank you