Learning Objectives:
1. Differentiate between sepsis and asepsis
2. Distinguish between medical asepsis and surgical asepsis
3. Enumerate general aseptic procedures followed to maintain a clean environment
and prevent the spread of infectious diseases
4. Explain the various isolation precaution measures
5. Identify aseptic measures utilized in the operating room
6. Determine general measures that can be used to present the development of
infection in the community
Infection Control
One of the major concerns in healthcare facilities and hospitals
Learn the meaning of the following terminologies:
1. Chain of infection
2. Mode of transmission
3. Standard precautions
4. Contamination
5. Decontamination
6. Disinfection
Infection Control
Learn the meaning of the following terminologies (continued):
7. Sterilization
8. Antiseptic
9. Healthcare-associated infection
10. Iatrogenic infection
11. Occupational exposure
12. Personal protective equipment
Asepsis
Asepsis vs. sepsis
Definition
Goal of asepsis is to protect the patient from hospital-acquired or nosocomial
infections and to prevent the spread of pathogenic microorganisms
Vulnerability of patients in healthcare facilities to pathogenic infection
Factors that play a role in the occurrence of infection
Common pathogens that lead to nosocomial infections
Location of the infection
Vectors of infection: through personnel, hospital environment and equipment
Asepsis
Medical asepsis vs. surgical asepsis
Medical or clean asepsis as the absence of disease-producing
microorganisms
Surgical or sterile asepsis is the absence of all
microorganisms
How are each asepsis obtained?
Medical or clean sepsis
Surgical or sterile asepsis
General aseptic procedures that help preserve a clean
medical environment
Frequent handwashing of hospital personnel
Prompt and safe disposal of contaminated materials
Regular checking and emptying of containers for surgical
drains
Prompt cleaning of soiled or moist areas
Proper labeling of containers regarding the date and time of
disposal
Handwashing
Hands of healthcare workers are often the source of infection
Proper handwashing is the most basic form of preventing
infection
Four reasons for handwashing in a healthcare environment
Typical healthcare-acquired infections: MRSA, VRE, and
penicillin-resistant Streptococcus pneumoniae.
When should handwashing be done:
1. Beginning and end of each shift
2. When hands are visibly soiled
3. After contact with possible source of microorganisms
4. Before and after perfoming invasive procedures
5. Before removing gloves if they are visibly soiled and each time
after removing gloves.
Handwashing
Proper way of handwashing
At least 15 seconds with 10-second rinse
With vigorous scrubbing, paying special
attention to the areas around the nailbeds
and between the fingers
Fingernails should be kept clean and short
Use of sanitizers
Alcohol-based sanitizing antimicrobial
solutions or hand cleaners must not be
substitute for handwashing
Personal Protective Equipment (PPE)
Gloves
Most commonly used PPE
Two types of gloves
Benefits of using gloves
Hands must be washed thoroughly after
using gloves because use of gloves can
multiply organisms in the hands
WHO guidelines for the proper use of
gloves, when gloves should be used,
and guidelines on the removal of gloves
PPE: Masks
MUST cover mouth and nose, with
minimal gaps between the face and the
mask
AVOID touching the mask once worn
The moment the mask becomes damp, it
should be replaced with a clean and dry
one
They are SINGLE - USE items
Proper disposal of used face masks
Hands should be decontaminated by
washing with soap and water after masks
are disposed.
PPE: Sterile gown
When should we wear sterile gowns, sterile
aprons?
Considerations on the type of gown to be worn?
Fluid-resistant
Length of sleeves
Three Instances when fluid-resistant, single-use,
long-sleeved, full body gowns are to be worn.
Four Sterility parameters that must followed to
maintain a sterile field
Changing of gowns
When treating different patients
When contamination of the gown occurs at any point
General procedures and aid to the health worker
changing gown
Isolation Precautions
Quarantine, the process of separating individuals with infections
from the rest of the healthy population
Center for Disease Control (CDC) in US came-up with guidelines
Universal precautions are for handling patients with infection
from unknown pathogens, applied to all bodily fluids including
blood, skin and mucous membrane
1. Proper handwashing
2. Use of PPE
3. Proper handling and disposal of excretions including sweat
4. Proper handling and disposal of soiled linen and equipment
5. Environmental control
6. Prevention of injury from sharp devices
7. Patient placement
Transmission-based Precautions
Precautions based on the mode of transmission of
the infectious agents
1. Contact Precautions
a) Prevent transmission through contact and fomites
b) All must wear gowns and gloves
2. Droplet Precautions
a) Prevent infection caused by tiny droplets like
coughing and sneezing
b) All must wear surgical mask
3. Airborne Precautions
a) Prevent infection through the air from one person
to another
b) Use of negative air pressure and measures for
reverse isolation
Aseptic Measures in the Operating Room
Cleaning of the OR and the equipment to be used
Sterile surgical clothing and OR gowns for the doctors
and nurses during the operation
OR nurse assists the surgeon in donning of gloves and
gowns; and arranges surgical instruments to minimize the
risk of contamination
Use of sterile drapes
Unwrapping of instruments and/or equipment
Preparation of patients
Surgical scrub
Other precautions
Only scrubbed personnel are allowed in the sterile field
Personnel’s hands should remain within the sterile field
Only areas that can be seen by the surgeon are considered
sterile
Items not sterile should not pass over the sterile field
Talking, laughing, coughing or sneezing are not allowed
Preventing Infection in the Community
Public education on infectious diseases, especially on the various modes of
transmission
Infection control through
1. Sanitation techniques,
2. Improvement of health practices, and
3. Vaccination
