Download Surgical Asepsis - Philadelphia University

Medical & Surgical Asepsis
Dr. Abdul-Monim Batiha
Assistant Professor
Critical Care Nursing
Philadelphia university
Learning objectives
Explain the concepts of medical and
surgical asepsis.
 Identify
types of microorganisms
causing infections.
 Identify types & signs of localized
and systematic infections.

Identify risks for nosocomial
infections.
 Explain chain of infection.
 Identify
factors influencing a
microorganism's capability to
produce an infectious process.
 Identify measures that break each
link in the chin of infection.

Asepsis
Asepsis is the freedom from
disease-causing microorganisms.
To decrease the possibility of
transferring
microorganisms
from one place to another,
asepsis is used.
There are two basic types
of asepsis
Medical & Surgical
asepsis.
1. Medical asepsis
Includes
all
practices
intended to confine a
specific microorganism to a
specific area, limiting the
number,
growth,
and
transmission
of
microorganisms.
In medical asepsis, objects are
referred to as clean, which
means the absence of almost all
microorganisms,
or
dirty
(soiled, contaminated, which
means
likely
to
have
microorganisms, some of which
may be capable of causing
infection.
2. Surgical asepsis or sterile
Technique, refers to keep an area
or
object
free
of
all
microorganism,
it
includes
practices
that
destroy
all
microorganisms
and
spores.
Surgical asepsis is used for all
procedures involving the sterile
areas of the body.
Sepsis is the state of
infection and can take
many forms, including
septic shock.

Types of
microorganisms
causing infections
1. Bacteria can live and be transported
through air, water, food, soil, body tissues
and fluids, and inanimate objects.
2. Viruses (causes the common cold)
hepatitis, herpes, and human
immunodeficiency virus.
3. Fungi include yeasts and molds. Candida
albicans
4. Parasites They include protozoa such as
the that causes malaria.
Types of infection

A local infection is limited to the
specific part of the body where
the microorganisms remain.

If the microorganisms spread and
damage different parts of the
body, it is a systemic infection.
When a culture of the person's
blood reveals microorganisms,
the
condition
is
called
bacteremia.
 When bacteremia results in
systemic infection, it is
referred to as septicemia.


Acute infections generally
appear suddenly or last a
short
time.
A
chronic
infection may occur slowly,
over a very long period, and
may last months or years.
Nosocomial infections

classified as infections that are
associated with the delivery of health
care services in a health care facility.
Nosocomial infections can either
develop during a client's stay in a
facility or manifest after discharge.

The
incidence
of
nosocomial infections is
significant. Major sites for
these infections are the
respiratory and urinary
tracts, the bloodstream,
and wounds.

Factors
that
contribute
to
nosocomial infection risks are
invasive
procedures,
medical
therapies, the existence of a large
number of susceptible persons,
inappropriate use of antibiotics, and
insufficient hand washing after
client contact and after contact with
body substances.
Chain of
infection
1
Etiologic agent
(microorgnanisms
)
6
Susceptible
host
2
Reservoir
(source)
5
Portal of entry
to the
susceptible host
3
Portal of exit
from reservoir
4
Method of
transmission
1. Etiologic agent
The any microorganism
is capable of producing
an infectious process
depends on the number
of
microorganisms
present.
2. Reservoir
There
are
many
reservoirs, or sources of
microorganisms,
common sources are
other
humans,
the
client's, plants, animals,
or general environment.
3. Portal of exit from
reservoir

Before an infection can
establish itself in a host,
the
microorganisms
must leave the reservoir.
4. Method of
transmission
There are three
mechanisms
1. Direct transmission
Involves immediate and direct
transfer of microorganisms
from person to person through
touching, biting, kissing, or
sexual intercourse. Droplet
spread is also a form of direct
transmission.
2. Indirect transmission

Material objects, such as toys,
soiled clothes, cooking or
eating
and
surgical
instruments,
or
dressing,
water, food, blood, serum, and
plasma. Animal or flying.
3. Airborn transmission
may involve
droplets or dust.
5. Portal of entry

Before a person can become
infected, microorganisms must
enter the body. The skin is a
barrier to infectious agents;
however, any break in the skin
can readily serve as a portal of
entry.
6. Susceptible Host
A susceptible host is any
person who is at risk for
infection. A compromised
host is a person at
"increased risk"
Factors Increasing
Susceptibility to Infection
1. Age influence the risk of
infection.
2. Heredity influences the
development of infection.
3. The nature, number,
and duration of physical
and emotional stressors
can
influence
susceptibility to infection.

Stressors
elevate
blood
cortisone.
Prolonged
elevation of blood cortisone
decrease anti-inflammatory
responses depletes energy
stores, lead to a state of
exhaustion, and decrease
resistance to infection.
4. Resistance to infection depends on
adequate nutritional status.
5. Some medical therapies predispose
a person to infection. For example,
radiation treatments for cancer,
some diagnostic procedures may
also predispose the client to an
infection.
6. Certain medication also
increase
susceptibility
to
infection.
Anticancer
medications may depress bone
marrow function, resulting
inadequate production of white
blood cells, anti-inflammatory
and antibiotics medications.
Cleaning, Disinfecting, and
Sterilizing
The first links in the chain of infection,
the etiologic agent and the reservoir, are
interrupted by the use of antiseptics
(agents that inhibit the growth of
some
microorganisms)
and
disinfectants (agents that destroy
pathogens other than spores) and by
sterilization.
Cleaning
Cleanliness inhibits the growth
of
microorganisms.
When
cleaning visibly soiled objects,
nurses must always wear gloves
to avoid direct contact with
infections microorganisms.
Disinfecting
A disinfectant is a chemical
preparation, such as phenol or iodine
compounds, used on inanimate objects .
 Disinfectants are frequently caustic
and toxic to tissues. An antiseptic is a
chemical preparation used on skin or
tissue .


Disinfectants
and
antiseptics often have
similar
chemical
components,
but
the
disinfectant is a more
concentrated solution .
When disinfecting articles,
nurses need to follow
agency protocol and
consider the following:
1. The type and number of
infectious organisms.
2.
The
recommended
concentration
of
the
disinfectant and the duration
of contact.
3. The temperature of the
environment.
4. The presence of soap. Some disinfectants
are ineffective in the presence of soap or
detergent.
5. The presence of organic materials, the
presence of saliva, blood, pus can readily
inactive many disinfectants.
6. The surface areas to be treated. The
disinfecting agent must come into contact
with all surfaces and areas.
Sterilizing

Sterilization is a process
that
destroys
all
microorganisms,
including spores and
viruses.
Four commonly used
methods of sterilization are
1. Moist heat
2. Gas
3. Boiling water
4. Radiation
Sterile Technique
The basic principles
of surgical asepsis
1. All objects used in a sterile field
must be strile.
2. Sterile objects become un-sterile
when touched by un-sterile
objects.
3. Sterile items that are out of
vision or below the waist level of
the nurse are considered unsterile.
4. Sterile objects can become
unsterile
by
prolonged
exposure
to
airborne
microorganisms.
5. Fluids flow in the direction
of gravity.
6. Moisture that passes through
a
sterile
object
draws
microorganisms from unsterile surfaces above or
below to the sterile surface by
capillary action.
7. The edges of a sterile
field are considered unsterile.
8. The skin cannot be
sterilized and is un-sterile.