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ASEPSIS AND INFECTION CONTROL

Asepsis
Asepsis is the state of being free from disease-causing contaminants (such as bacteria, viruses,
fungi, and parasites) or, preventing contact with microorganisms. The term asepsis often refers to
those practices used to promote or induce asepsis in an operative field in surgery or medicine to
prevent infection.
Medical asepsis
1. Includes all practices intended to confine a specific microorganism to a specific area
2. Limits the number, growth, and transmission of microorganisms
3. Objects referred to as clean or dirty (soiled, contaminated)
Surgical asepsis
1. Sterile technique
2. Practices that keep an area or object free of all microorganisms
3. Practices that destroy all microorganisms and spores
4. Used for all procedures involving sterile areas of the body
Principles of Aseptic Technique Only sterile items are used within sterile field.
1. Sterile objects become unsterile when touched by unsterile objects.
2. Sterile items that are out of vision or below the waist level of the nurse are considered
unsterile.
3. Sterile objects can become unsterile by prolong exposure to airborne microorganisms.
4. Fluids flow in the direction of gravity.
5. Moisture that passes through a sterile object draws microorganism from unsterile surfaces
above or below to the surface by capillary reaction.
6. The edges of a sterile field are considered unsterile.
7. The skin cannot be sterilized and is unsterile.

8. Conscientiousness, alertness and honesty are essential qualities in maintaining surgical

asepsis
Infection
Signs of Localized Infection

Localized swelling

Localized redness

Pain or tenderness with palpation or movement

Palpable heat in the infected area

Loss of function of the body part affected, depending on the site and extent of
involvement

Signs of Systemic Infection

Fever

Increased pulse and respiratory rate if the fever high

Malaise and loss of energy

Anorexia and, in some situations, nausea and vomiting

Enlargement and tenderness of lymph nodes that drain the area of infection

Factors Influencing Microorganisms 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 hosts body

Anatomic and Physiologic Barriers Defend Against Infection

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

Interventions to Reduce Risk for Infection

Proper hand hygiene techniques

Environmental controls

Sterile technique when warranted

Identification and management of clients at risk

Chain of Infection
1. The chain of infection refers to those elements that must be present to cause an infection
from a microorganism
2. Basic to the principle of infection is to interrupt this chain so that an infection from a
microorganism does not occur in client
3. Infectious agent; microorganisms capable of causing infections are referred to as an
infectious agent or pathogen
4. Modes of transmission: the microorganism must have a means of transmission to get
from one location to another, called direct and indirect
5. Susceptible host describes a host (human or animal) not possessing enough resistance
against a particular pathogen to prevent disease or infection from occurring when

exposed to the pathogen; in humans this may occur if the persons resistance is low
because of poor nutrition, lack of exercise of a coexisting illness that weakens the host.
6. Portal of entry: the means of a pathogen entering a host: the means of entry can be the
same as one that is the portal of exit (gastrointestinal, respiratory, genitourinary tract).
7. Reservoir: the environment in which the microorganism lives to ensure survival; it can
be a person, animal, arthropod, plant, oil or a combination of these things; reservoirs that
support organism that are pathogenic to humans are inanimate objects food and water,
and other humans.
8. Portal of exit: the means in which the pathogen escapes from the reservoir and can cause
disease; there is usually a common escape route for each type of microorganism; on
humans, common escape routes are the gastrointestinal, respiratory and the genitourinary
tract.

Breaking the Chain of Infection

Etiologic agent

Correctly cleaning, disinfecting or sterilizing articles before use

Educating clients and support persons about appropriate methods to clean, disinfect, and
sterilize article

Reservoir (source)

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

Portal of exit

Avoiding talking, coughing, or sneezing over open wounds or sterile fields

Covering the mouth and nose when coughing or sneezing

Method of transmission

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

Portal of entry

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

Susceptible host

Maintaining the integrity of the clients skin and mucous membranes

Ensuring that the client receives a balanced diet

Educating the public about the importance of immunizations

Modes of Transmission
1. Direct contact: describes the way in which microorganisms are transferred from person
to person through biting, touching, kissing, or sexual intercourse; droplet spread is also a
form of direct contact but can occur only if the source and the host are within 3 feet from
each other; transmission by droplet can occur when a person coughs, sneezes, spits, or
talks.
2. Indirect contact: can occur through fomites (inanimate objects or materials) or through
vectors (animal or insect, flying or crawling); the fomites or vectors act as vehicle for
transmission
3. Air: airborne transmission involves droplets or dust; droplet nuclei can remain in the air
for long periods and dust particles containing infectious agents can become airborne
infecting a susceptible host generally through the respiratory tract