Medical Aseptic Handwashing

Handwashing and Medical Asepsis

• Wash hands for at least 20 seconds, rinse with fingers pointed downward, and turn off the faucet with a paper towel for effective medical aseptic handwashing.
• Alcohol-based rubs are acceptable for rapid sanitation if there is no obvious soil on the skin and handwashing sinks are not readily available.
• Use gloves when there is any possibility of contact with body fluids.
• Clean and disinfect supplies to prevent the spread of micro-organisms.

Surgical Asepsis

• Surgical asepsis involves sterile gloves, supplies, and equipment; gowns; and drapes.
• Antiseptic skin preparation is mandatory with surgical aseptic technique prior to puncturing a patient's skin.
• Phlebotomists do not typically use surgical asepsis but need to know when to use medical vs. surgical aseptic techniques.

Cough Etiquette

• Cover the mouth and nose with a tissue when coughing or sneezing.
• Use facial tissues to contain respiratory secretions and dispose of them in the nearest waste receptacle.
• Perform hand hygiene after contact with respiratory secretions and contaminated objects or materials.
• Offer masks to anyone who is coughing or sneezing.
• Keep anyone who is coughing or sneezing 0.9 m (3 feet) away from others.

Types of Infections

• Acute infections: symptoms appear suddenly, and the body recovers within a few weeks with a well-functioning immune system and sometimes medical treatment. (Example: common cold)
• Chronic infections: linger, sometimes forever, and the person can transmit it to others. (Example: Hepatitis B)
• Latent infections: the person has periods of remission and relapse. (Example: herpes simplex)
• Opportunistic infections: occur when the person has a weak immune system, and micro-organisms that might not easily cause disease in a person with a fully functional immune system can result in serious infections. (Example: oral candidiasis in patients with AIDS)

Infection Cycle

• The infection cycle consists of six links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.
• Breaking any of these links can stop the transmission of infection.

Infection Control

• Standard precautions: apply to every patient, including using personal protective equipment (such as gloves) when handling body fluids, nonintact skin, or mucous membranes; practicing meticulous hand hygiene; and safely disposing of used equipment, needles, and other sharps.
• Airborne precautions: required for patients who have infections that spread via droplets that are smaller than 5 microns in diameter (e.g., varicella, tuberculosis, measles).
• Droplet precautions: required for patients who have infections that spread via droplets that are larger than 5 microns in diameter (e.g., rubella, meningitis, some respiratory infections).
• Contact precautions: required for patients who have infections that spread via direct contact or contact with the environment (e.g., herpes simplex, wound infections, some bacterial infections, scabies).

Stages of Infection

• Inflammatory response: the body's defense mechanism against infection, characterized by erythema, edema, pain, and heat.
• Inflammation: a series of protective mechanisms that defend the body against the invasion, involving histamine, kinins, and prostaglandins.
• Possible outcomes of infection: healing, spread to lymph nodes, or spread to the bloodstream, leading to septicemia.

Handwashing and Medical Asepsis

• Effective handwashing involves washing hands for at least 20 seconds, rinsing with fingers pointed downward, and turning off the faucet with a paper towel.
• Alcohol-based rubs are acceptable for rapid sanitation if there is no obvious soil on the skin and handwashing sinks are not readily available.
• Medical asepsis involves removing micro-organisms after they leave the body, with the goal of reducing their numbers and preventing transmission.

Surgical Asepsis

• Surgical asepsis is mandatory for invasive procedures and when there is a penetration of the patient's skin or mucous membranes.
• It involves the use of sterile gloves, supplies, and equipment; gowns; and drapes.
• Antiseptic skin preparation is mandatory with surgical aseptic technique prior to puncturing a patient's skin.

Cough Etiquette

• Cover the mouth and nose with a tissue when coughing or sneezing.
• Use facial tissues to contain respiratory secretions and dispose of them in the nearest waste receptacle.
• Perform hand hygiene after contact with respiratory secretions and contaminated objects or materials.
• Offer masks to anyone who is coughing or sneezing.
• Keep anyone who is coughing or sneezing 0.9 m (3 feet) away from others.

Types of Infections

• Acute infections: symptoms appear suddenly, begin with initial cell damage, and worsen quickly.
• Chronic infections: linger, sometimes forever, and can be transmitted to others.
• Latent infections: periods of remission and relapse, with an example being herpes simplex.
• Opportunistic infections: occur in people with a weak immune system, with an example being oral candidiasis in patients with AIDS.

Infection Cycle

• The cycle of infection involves a pathogen, a reservoir, a portal of exit, a mode of transmission, a portal of entry, and a susceptible host.
• Breaking the cycle of infection can occur through effective hand hygiene.

Isolation Precautions

• Standard precautions apply to every patient and involve using personal protective equipment, practicing meticulous hand hygiene, and safely disposing of used equipment.
• Airborne precautions are required for patients with infections that spread via droplets smaller than 5 microns in diameter.
• Droplet precautions are required for patients with infections that spread via droplets larger than 5 microns in diameter.
• Contact precautions are required for patients with infections that spread via direct contact or contact with the environment.

Stages of Infection

• When a person has an injury or exposure to a pathogen, the body reacts by activating the inflammatory response.