UNIVERSAL PRECAUTIONS

AND ASEPSIS

Leo Mercado BSN- RN

Orbis International
 THE INFECTIOUS CYCLE
• Agent: microorganisms that can spread a disease
• Reservoir: where an infectious agent can survive
but may or may not multiply.f
• Portal of Exit: path by which an infectious disease
leaves the reservoir(resp. tract, G.I., skin, mucous
membrane, blood).
• Mode of transmission: mechanism of transfer of
an infectious agent from a reservoir to a
susceptible host; direct contact, indirect contact,
droplet spread, airborne vector spread.
 THE INFECTIOUS CYCLE
• Portal of Entry: path by which an infectious
agent enters the susceptible host( resp. tract,
G.I., skin/mucous, transplacental,
parenteral)
• Susceptible host: person who can become
infected
UNIVERSAL PRECAUTIONS
The blood and body substances of any and
all persons may be colonized or infected
with any bacteria, fungi, virus or parasites.
Therefore, all blood and body fluids from
all persons must be considered potentially
infectious to all persons. Universal
precautions are intended to protect patients
from one another and health care workers
from patients and each other.
 UNIVERSAL PRECAUTIONS
• Placing a physical, mechanical or chemical
“barrier” between microorganisms and an
individual is an effective means of
preventing the spread of disease. Protective
barriers in infection prevention include:
• handwashing
• protective attire: wear and change of gloves
• sharps: proper disposal, safe handling (never recap)
 ASEPSIS
• Absence of microorganisms that can cause
disease
– Medical asepsis; refers to practices which reduce
the numbers of microorganisms and or/prevent,
or reduce transmission from one person(or place)
to another.
– Surgical asepsis; refers to practices designed to
render and maintain objects and areas maximally
free from micro-organisms, also referred to as
“sterile technique”.
 ASEPSIS
• Medical asepsis; reduces numbers of skin
microorganisms by hand washing or cleaning:
• use soap for routine care situations
• apply friction to increase amount of soil removed
• clean from areas------clean dirty
• clean environmental surfaces routinely with germicidal
detergent
• use of germicidal agent for clean up of blood and body
fluids
 ASEPSIS
• Medical asepsis; use barrier techniques to
reduce microbial transmission from patient
to health worker
• use “no touch” dressing technique or sterile gloves
to avoid contamination of sterile supplies
• wear gloves to avoid direct contact with infectious
materials
• separate patients according to illness
 ASEPSIS
• Surgical asepsis or aseptic technique can be
summarized in the following four simple
rules:
• know what is sterile
• know what is not sterile
• keep the two apart
• remedy contamination immediately
 ASEPSIS
• Every individual who participates in the care of the
patient in the operating room has a responsibility
to provide quality care in a safe, comfortable
environment. A constant awareness of the basic
fundamentals of aseptic technique is required.
• Strict aseptic technique is needed at all times in the
operating room.
• First and most important method is by education,
training and supervision of operating room
personnel.
 ASEPSIS
• Principles of Aseptic Technique;
• Supplies:
– All articles prior to sterilization should be free of
blood, soil, dirt, etc.
– All materials should be sterilized before it comes in
contact with the sterile area.
– Dressings and supplies once removed from the sterile
field are considered contaminated.
– If in doubt as to the sterility of an article, it should be
considered unsterile.
 ASEPSIS
• Supplies cont’d:
– Wrappers on sterile package should be double thickness
and have indicators inside out.
– The edges of anything that enclosed sterile contents are
considered unsterile.
– Tables are sterile at table level ONLY.
– Wet areas are considered contaminated.
– Sterile drapes or towels should not be removed once in
place.
– Equipment should not be transferred from one case to
another.
 ASEPSIS
• Personnel:
– Clean clothing should be worn by all OT personnel,
e.g.scrub attire, hat, clothing should not be worn
outside the OT.
– Gowns are considered sterile only from the waist to
shoulder level in front, and the sleeves to 2” above
the elbow.
– Persons who are sterile touch only sterile items or
areas.
– Unsterile persons avoid reaching over a sterile field
and vice versa, keep one foot away.
 ASEPSIS
• Personnel cont’d:
– sterile persons keep well within the sterile area,
never turn your back to sterile field, back to back or
front to front technique.
– Skin cannot be sterilized, should be as clean as
possible, eye prep, hands and arms scrub, MUST
wear sterile gown and glove to be considered sterile.
– Sterile persons keep contact with the sterile areas to
a minimum, do not handle instruments or supplies
unnecessarily.
 ASEPSIS
• Environment:
– Environmental surfaces routinely cleaned with
germicidal detergent, OR tables and beds should be
cleaned between patients.
– Windows shut at all times.
– Traffic control in OT area, exclude visitors and
unnecessary personnel.
– Avoid cleaning activities in the area during surgical
procedures.
– Garbage should be empty after each case.
 SKIN ANTISEPSIS

• Hand washing is the single most important

way to prevent spread of infection
• The ten most important carriers of infection
are your fingers!!!
 SKIN ANTISEPSIS
• Wash your hands:
– before and after patient contact
– after removing a pair of gloves
– after touching anything contaminated with
blood or body fluids
– after touching the floor and picking up garbage
– before and after handling food
– after visiting the toilet
 SKIN ANTISEPSIS
• Hand washing: 15-30 seconds done before
and after patient contact, urinating, eating
or touching anything that is contaminated
with blood or body fluid.
• Surgical hand scrub: 5 minutes procedure
before every surgical procedures.
Antiseptic solution should be used, if not
available, use plain soap and alcohol 70%
(spirit), let dry for 2 minutes.
 SKIN ANTISEPSIS
VERY IMPORTANT
• Scrubbing longer than 5 minutes will bring
resident organisms up to the skin’s surface,
and therefore result in more organisms on
the surface than prior to the scrub.
• A vigorous friction might cause damage to
the skin and enhance growth of
microorganisms.
 RECOMMENDED SKIN
ANTISEPTICS
• Chlorhexidine Gluconate 4% (Savlon,
Hibiscrub, Hibiclens) do not use on face or
head
• Iodophor 2% or povidone iodine (Betadine,
Acu-Dyne)
• Isopropyl Alcohol 70%
• Tincture of iodine (iodine with alcohol in it)