Asepsis and Infection Control PDF

Ministry of Higher Education Technical Institute of Nursing Sherbin Asepsis and infection control Prepared by Dr/Walaa Zahran  Definition of terms: Asepsis: Is a...

Ministry of Higher Education Technical Institute of Nursing Sherbin Asepsis and infection control Prepared by Dr/Walaa Zahran  Definition of terms: Asepsis: Is a freedom from disease-causing microorganisms. There are two basic types of asepsis; medical asepsis and surgical asepsis.  Medical asepsis or clean technique Procedures used to reduce the number of microorganisms and prevent their spread. Include;  Hand washing  Standard precautions  Transmission based precautions  Surgical asepsis or sterile technique ► Includes procedures used to eliminate microorganisms from an area. Sterilization destroys all microorganisms including spores & viruses.  Cleaning: ► Cleanliness inhibits the growth of microorganisms. ► Is the removal of all foreign materials such as soil & organic material from objects. ► Generally, cleansing involves use of water & mechanical action. ►. A brush, detergent or soap is needed for cleaning. ► Disinfection: process of eliminating pathogenic organisms on inanimate object with the exception of spores. ► Disinfectant: Is a chemical substance that is used for disinfecting only an inanimate object e.g. (phenol, chlorine). ► Antiseptic solution: Is a substance that is used on person's skin to inhibit the growth and activity of microorganisms, but not necessarily destroy them. ► Sterilizing: Is the process that destroyed all microorganisms, including spores and viruses. ► Contamination: The process by which something is rendered unclean or unsterile. ► Infection: An infection is an invasion of the body by pathogens, or microorganism capable of producing disease. ► Nosocomial infection: infections that are associated with delivery of health care services in a health care facility. ► Nosocomial infections either develop during a client's stay in a facility or manifested after discharge. ► Carriers; Are people or animals that show no symptoms of illness but that have pathogens on or in their bodies that can be transferred to others.  Types of microorganisms causing infection: Four major categories of microorganisms cause infection in humans: bacteria, viruses, fungi, and parasites. Bacteria are by far the most common infection causing microorganisms.  Types of infection: Local or systematic: local is limited to the specific part of the body where the microorganism remain. If microorganisms spread and damage different parts of the body, it is a systemic infection. Acute or Chronic infections: Acute generally appear suddenly or last a short time. A chronic infection may occur slowly, over long period, and May last month or years Infection process  Introduction This process, called the chain of infection, can only occur when all six links in the chain are intact. By breaking this chain at any of the links, the spread of infection is stopped.  Links in the chain of Infection and how to break: 1-Infectious Agent: These are the pathogens that are capable of causing communicable diseases. Most commonly these are bacteria, virus, fungior parasites. 2- Reservoir: The reservoir (source) is a host which allows the pathogen to live, and possibly grow, and multiply. Humans, animals and the environment can all be reservoirs for microorganisms. Sometimes a person may have a disease but is not symptomatic or ill (carrier or ‘colonized’. Examples of reservoirs are standing water, a person with a common cold or syphilis, or a dog with rabies.  Portal of exit: This refers to the route by which the infectious microorganisms escape or leave the reservoir. Portal of exit Breaking the Link Respiratory Tract  Wear a mask  Do not talk directly into patient’s face.  Stay home if you are sick.  Practice good cough etiquette (cover your coughs and sneezes).  Perform good hand hygiene.   Handle and dispose of bodysecretions Gastrointestinal Tract: (e.g. stool properly. and vomit).  Use personal protectiveequipment.  Perform good housekeeping.  Perform good hand hygiene.  Dispose of wounddressingsproperly. Skin: wound drainage or through  Use personal protectiveequipment (PPE). skin lesions.  Perform good hand hygiene.  Safe handling of sharps. Blood: Infection may occur when  Use gloves for procedures wherethere is risk of someone’s blood gets into another exposure toblood. person’s system.  Use care in obtaining,transporting and processing specimens.  Perform good hand hygiene 3- Mode of Transmission: Since microorganisms cannot travel on their own, they require a vehicle to carry them to other persons and places. 4- Portal or mode of Entry: Method by which the pathogen enters the person. (the reverse of the portal of exit).  Pathogens enter the body by:  Inhalation (e.g. respiratory tract)  Ingestion (e.g.GI tract)  Absorption (e.g. mucous membranes of eyes)  Break in skin (e.g. needle stick, cut)  Introduction by medical procedures (e.g. catheters)  Susceptible Host: Is the person who is next exposed to the pathogen. The microorganism may spread to another person but does not develop into an infection if the person’s immune system can fight it off. They may however become a ‘carrier’ without symptoms, able to then be the next ‘mode of transmission’ to another ‘susceptible host’. Once the host is infected, he/she may become a reservoir for future transmission of the disease.  Susceptible Hosts 1. Children who are very young. 2. People who are very old. 3. People on inadequate diets. 4. People who are chronically ill. 5. People receiving medical therapy such as chemotherapy or high doses of steroids. 6. People who are already ill. 7. People with open wounds.  Stage of infection Incubation Prodromal Full stage of Decline Convalescent period stage illness phase stage 1. Incubation period: is the interval between the invasion of the body by the pathogen and the appearance of the first symptoms of the infection, e.g.  Chicken pox 2-3 weeks,  Common cold 1-2 days,  Tetanus 2 to 21 days. Or Silence stage time between infection and the appearance of signs and symptoms of the disease. 2- Prodromal stage: The pathogens begin to invade tissues. It is an internal from onset of nonspecific signs and symptoms (malaise, low grade fever, fatigue) to more specific symptoms. During this time, microorganisms grow and multiply and client is more capable of spreading disease to others (most infectious period). 3-Full stage of illness or invasion stage: the individual experience the typical signs and symptoms of the disease they reach their great intensity. 4-Decline phase: host defenses 5-Convalescent stage: represents recovery from infection.; recovery may take several days to months.  Defenses against infection The body has normal defenses against infection through normal body flora that reside inside and outside of the body protect a person from several pathogens. Each organ system has defense, mechanism that minimize exposure to infectious microorganism.  ► The Blood: Increasing the number of certain types of white blood cells (neutrophils and monocytes), which engulf and destroy invading microorganisms. The increase can occur within several hours, largely because white blood cells are released from the bone marrow, where they are made.  Assessment: During assessing phase of the nursing process, the nurse obtains the client's history, conducts the physical assessment, and gathers laboratory data.  ► Physical Assessment: Signs and symptoms of infection vary according to the body area involved;  Localized swelling  Localized redness.  Pain or tenderness with palpation or movement.  Palpable heat at the infected area.  Loss of function of the body part affected, depending on the siteand extent of the involvement.  Fever  Increase pulse an respiratory rate, if the fever is high  Malaise and loss of energy  Anorexia and, in some situations, nausea and vomiting.  Enlargement and tenderness of the lymph node that drain the areaof infection. ► Laboratory data that indicate the presence of an infection include the following:  Evaluate the leukocyte count (4.500 to 11.000/ml is normal).  Elevated erythrocyte sedimentation rate (ESR).  Urine, blood, sputum, or other drainage cultures that indicate the presence of pathogenic microorganisms.  Standard precaution: Body Substance Isolation System (BSIS) 1.Hand hygiene:  2-Personal Protective measures: Glove use. Gowns or Plastic Aprons Mask, eye protection face shield  3- Needle stick prevention: The most important aspect of reducing the risk of blood borne infection is avoidance of percutaneous injury. Used needless should not be recapped they are placed directly into puncture resistance containers. Respiratory hygiene and cough etiquette:  Persons with respiratory symptoms should apply source control measures:  Health care facilities should: Place acute febrile respiratory symptomatic patients at least 1 meter (3 feet) away from others in common waiting areas, if possible. Post visual alerts at the entrance to health-care facilities instructing persons with respiratory symptoms to practice respiratory hygiene/cough etiquette. Consider making hand hygiene resources, tissues and masks available in common areas and areas used for the evaluation of patients with respiratory illnesses.  Miscellaneous guidelines:  Place used sharps, such as needles or scalpels, in a designated sharps disposal container.  Do not purposefully bend, break, or recap needles.  Place disposable wastes and articles contaminated with blood or large amounts of body fluids in a bio-waste container for a trash pickup.  Clean up spills of blood or body fluids per hospital protocol (i.e., blood spill kit).  Place all soiled linen in a laundry bag. Do not overfill the bag, to prevent contamination of the environment.  Miscellaneous guidelines:  For patients with diarrhea: Strongly recommend soap and water for hand hygiene.  For patients who are coughing: Wear a face mask if within 3 feet of patient and teach patient about respiratory hygiene.  Use private rooms for patients with communicable diseases