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Nursing Assistant
Principles of Asepsis
Common infectious agents
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Microorganisms – tiny organisms that can be
disease causing that can only be seen with
assistance of a microscope
– Bacteria –
• Streptococcus – strep throat, pneumonia
• E coli – urinary tract infections
• Tuberculosis – lung disease
– Virus –
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HIV – acquired immune deficiency syndrome
Hepatitis A, B, C – liver disease ( Hep B – 3 shots)
Common cold – respiratory infection
Influenza – fever, chills, body aches
Herpes zoster - shingles
Microorganisms
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Fungi –
– Tinea pedis – athlete's foot
– Candida albicans – yeast infection
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Insects
– Lice – body, head, pubic, causes itching
– Scabies – skin rash
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Antibiotic resistant bacterial infections
– Methicillin resistant staphylococcus aureus
(MRSA)
– Vancomycin resistant enterococcus (VRE)
Conditions necessary for
infectious agent growth
Food source
 Moisture
 Oxygen or lack of oxygen
 Warmth
 Darkness
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Six parts of chain of infection
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Causative agent – bacteria, fungi, virus,
insects
Reservoir – resident, health care worker,
environment, equipment
Portal of exit – excretions, wound drainage,
urine, feces, blood, saliva
Method of transmission – airborne, droplet,
contact, food/water, animals or insects
Portal of entry – non-intact skin, mucus
membranes, respiratory tract, urinary tract,
reproductive tract
Susceptible host – resident, health care
worker, families, visitors
Chain of infection
All parts of the chain are linked
 To stop the spread of infection, BREAK
THE CHAIN AT ANY LINK!!!!
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4 lines of defense against
infection
Normal flora
 Skin
 Mucus membranes
 Immune system – immunity & vaccines
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– Hepatitis B immunizations very important
for HCP
Signs & Symptoms of infection
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Appetite loss
Pain
Diarrhea
Drainage
Fatigue
FEVER
Nausea, vomiting
Rash
Redness
Swelling, tenderness
Asepsis vs sterile technique
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Medical asepsis/clean techniques
– Free from microorganisms carrying disease
– Handwashing
– Disinfection – process of destroying pathogens
utilizing soap/water or disinfectants
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Surgical asepsis/sterile technique
– Use of sterilized equipment – all microorganisms
have been destroyed
– Use barriers to prevent transmission of infectious
agents
Role of CDC & OSHA
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CDC – Center for Disease Control &
Prevention
– Located in Atlanta, GA
– Under DHHS (fed)
– Makes non-regulatory recommendations for
disease control
– Introduced standard precautions & transmissionbased precautions in 1996
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OSHA – Occupational Safety & Health
Administration
– Publishes & endorses rules to keep workers safe,
including infection control (state
– Requires written documentation & follow-up on
exposure accidents
Standard Precautions
Noscomial infections – hospital acquired
infection
 Standard Precautions – used for the care of
all residents regardless of diagnosis or
presumed disease status
 Designed to reduce risk of transmission of
microorganisms from moist body fluids
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– Blood
– All body fluids, secretions, excretions except
sweat
– Non-intact skin
– Mucus membranes
Standard Precautions
Contamination – process by which an object,
person, or area becomes unclean
 Methods of prevention
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– Handwashing
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Beginning & end of shift
Between residents
After using bathroom
Before handling food
After removing gloves
After covering mouth, nose when coughing or sneezing
When providing toothbrushes, drinking glasses, towels,
washclothes
• Prior to handling raw fruit & vegies before serving
• May substitute alcohol foams/gels during procedures
involving mutiple resident contacts. Not recommended if
soiled by blood/body fluids
Standard Precautions
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Sharps disposal
– Needles are never bent, broken, or recapped by
hand
– Dispose in appropriate Sharps containers
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Personal Protective Equipment (PPE)
– Gloves are required:
• Contact with blood, body fluids, dressings, tissues, or
contaminated surfaces
• Contact with non-intact skin or mucus membranes
• Remove gloves when contact complete & wash hands
• If gloves are torn/punctured, remove them
• Change gloves between residents
• Don’t reuse gloves
Personal Protective Equipment
Double gloves – required when necessary &
according to policy
 Gowns or aprons
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– Need moisture resistant gowns when possibility of
soiling with blood or body fluids
– Remove when procedure complete & prior to
leaving room
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Facial protection
– Wear – masks, goggles, face shields to protect
eyes, nose, mouth
Environmental Controls
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Use EPA registered disinfectant on solid surfaces
including floors, furniture, bathrooms, utility rooms
 Reusable equipment must be cleaned or disinfected
before reuse
 Mouthpieces for resuscitation necessary
 Wastes & soiled linen should be placed in plastic
bags & disposed of according to policy
 Wipe up body fluid spills immediately, disinfect
 Don’t eat, drink, apply make-up, or handle contacts
 Label- biohazard for sharps & blood
 Watch for lab specimens, label & transport
Transmission-based precautions
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Used for residents known or suspected to be
infected with pathogens transmitted by
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Airborne
Droplet
Contact
Contaminated surfaces
Isolation needed to separate resident to
prevent spread of microorganisms
 Used in addition to standard precautions
 Type of precaution dependent on type of
organisms
 CDC guidelines to be used
Psychological effect of
transmission-based precautions
Interference with basic needs – safety, love,
self-esteem, self actualization
 Methods of assisting resident to meet needs
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– Explain reason for isolation
– Frequently check on resident & condition
– Provide resident with distractions – books, tv,
magazines
– Instruct family & visitors on isolation techniques
– Make sure equipment necessary is available
– Call light in reach & answered promptly
– Talk with resident when in room giving care
Skills
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Distributing ice & water
 Hand washing
 Gloving, Gowning, & masking
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Wash hands
Gown – top tie first, then bottom
Mask – top tie first, then bottom
Gloves
Do care
Remove Gloves, wash hands
Remove Mask – bottom tie first, then top
Remove gown – bottom tie first, then top
Wash hands