Download Principles of Asepsis - McGraw Hill Higher Education

PowerPoint® to accompany
Medical Assisting
Chapter 19
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
Principles of Asepsis
Objectives
19-1 Explain the historical background of infectious
disease prevention.
19-2 Identify the types of microorganisms that cause
disease.
19-3 Explain the disease process.
19-4 Explain how the body’s defenses protect against
infection.
19-5 Describe the cycle of infection.
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Principles of Asepsis
Objectives (cont.)
19-6 Identify and describe the various methods of
disease transmission.
19-7 Explain how you can break the cycle of infection.
19-8 Compare and contrast medical and surgical
asepsis.
19-9 Describe how to perform aseptic hand washing.
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Principles of Asepsis
Objectives (cont.)
19-10 Define Bloodborne Pathogens Standards and
Universal Precautions as described by the rules
and regulations of the Occupational Safety and
Health Administration (OSHA)
19-11 Explain the role of Universal Precautions in the
duties of the medical assistant.
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Principles of Asepsis
Objectives (cont.)
19-12 List the procedures and legal requirements for
disposing of hazardous waste.
19-13 Explain how to educate patients in preventing
disease transmission.
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Introduction
Our bodies are
amazing structures
that defend us
against infections
under normal
circumstances.
You will learn:



About disease causing
microorganisms.
How the body fights
against disease.
Ways infections occur
You can be instrumental in helping to break the cycle of
infection by practicing asepsis in the office and educating
patients in the prevention of disease transmission.
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History of Infectious Disease
Prevention
 Hippocrates – first attempt to
prevent infection. He believed:
 Environment and natural
forces play an important part
in role of disease and health
 Simple treatments, using
strong drugs and surgery
only as a last resort.
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Joseph Lister
 Discovered how to use
chemical antiseptics
to control surgery
related infections
 Used antiseptics to
disinfect surgical
equipment and
supplies
Microorganisms are simple forms of life commonly made
up of a single cell only seen with a microscope.
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Holmes and Semmelweis
Holmes
 Demonstrated that
puerperal fever was
carried from patient
to patient by
doctors.
Semmelweis
 Also concluded
puerperal fever
was a
communicable
disease.
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Microorganisms
Microorganisms live all around us.





Viruses – smallest infectious agent
Bacteria – single celled reproduced quickly
Protozoans – single celled found in soil (most
do not cause disease)
Fungi – complex cell structure (most do not
cause disease)
Parasites – cause disease
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Disease Process
 Begins with
 Damage is caused
microorganisms
by:
finding host
 Depleting nutrients
 Reproducing
 Grows with specific
themselves
requirements
 Making body cells
 Proper temperature,
the target of body’s
pH, and moisture level
own defenses

Produce toxins
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Body’s Defenses
 Immunity – resistant to pathogens and the
disease they cause
 If defenses are not functioning properly,
person will become susceptible to invasion and
infection.

Lines of Defense
 Skin
 Normal flora
 Staying healthy
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Defenses Against Disease
 Nonspecific Defenses
 Infection is the
presence of a
 Species resistance
pathogen in or on the
 Mechanical
body
barriers
 Nonspecific defenses  Chemical barriers
mechanisms to
 Fever
protect us against
 Inflammation
pathogens in general
 Phagocytosis
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Specific Defenses Against
Disease
 Lymphocytes and
macrophages are
Protects the body
the major cells
against very specific
pathogens
 Antibodies and
complement are
the major
proteins involved
in specific
defenses
 Immunity

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Apply Your Knowledge
What are three lines of defense against
microorganisms?
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Apply Your Knowledge -Answer
What are three lines of defense against
microorganisms?
Lines of Defense
 Skin
 Normal flora
 Staying healthy
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Types of Immunity




Naturally acquired active – naturally
exposed to an antigen (usually long
lasting)
Artificially acquired – being injected
with a pathogen (immunizations or
vaccines)
Naturally acquired passive – immunity
through his mother (short-lived)
Artificially acquired passive –
immunity when person is injected with
antibodies (short-lived)
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T Cells
Helper T cells

increase antibody formation, memory cell
formation, B cell formation, and phagocytosis
Memory T cells


memory cells “remember” the pathogen that
activated the original T cell
person is later exposed to the same pathogen,
memory cells trigger an immune response that
is more effective than the first immune response
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Cell-Mediated Immunity
Two major types of lymphocytes
B Cells and T Cells
Recognize antigens in the body
B cells:
Respond to antigens by
becoming plasma cell make antibodies
against the specific
antigen
T Cells:
Cell-mediated
bind to antigens
on cells and attack
them directly
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Cycle of Infection
A reservoir host –animal, insect or human body
where pathogen is growing (carrier, unaware of
presence of pathogen)
Means of exit – pathogen must exit the host
 Nose, mouth, eyes or ears
 Feces or urine
 Semen, vaginal fluid or other reproductive
discharge
 Blood or blood products
Click for Cycle of Infection
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Cycle of Infection (cont.)
Means of transportation – must spread to another host
by some means of transmission
Vectors – living organisms, insects or person
Fomites – inanimate objects such as clothing, water,
food





Airborne transmission
Blood-borne transmission
Ingested transmission
Touching
During pregnancy or birth
Click for Cycle of Infection
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Cycle of Infection (cont.)
Means of Entrance
Enter through any cavity lined with
mucous membrane


Mouth, nose, vagina, rectum
Through ears, eyes, intestinal tract, urinary
tract, reproductive tract, breaks in the skin
Click for Cycle of Infection
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Cycle of Infection (cont.)
Susceptible Host determined by:






Age
Genetic predisposition
Nutritional status
Disease process
Stress levels
Hygiene habits
Click for Cycle of Infection
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Cycle of Infection (cont.)
Back
24
Apply Your Knowledge
What are fomites?
25
Apply Your Knowledge -Answer
What are fomites?
Fomites are inanimate objects such as
clothing, water, food that serve as a means of
transportation for microorganisms.
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Break the Cycle
 Asepsis – condition in which
pathogens are absent or controlled
 Maintain strict housekeeping standards
 Adhering to government guidelines to
protect against disease
 Educating patients in hygiene, health
promotion and disease prevention
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Medical Asepsis
Clean technique - based on
maintaining cleanliness to prevent
spread of microorganisms
Keep office clean:
 Reception room clean, well lit, and
ventilated
 Keep furniture in good repair
 Strict “no food or drink” policy
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Medical Asepsis (cont.)
Handwashing
 Beginning of day
 After breaks
 Before and after each
patient
 Before and after handling
equipment or specimens
 After blowing your nose or
coughing
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Medical Asepsis (cont.)
Sanitization – reduction of
the number of
microorganisms
Disinfection – destruction
of infectious agents on
an object
Sterilization – removal of
all microorganisms
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Surgical Asepsis
 Keep the surgical
environment completely
free of all
microorganisms.
 Sterile technique used
for even minor operation
or injections.
 Object is either sterile or
not sterile; if unsure then
it is not sterile.
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OSHA Bloodborne Pathogens
Standards
 Written OSHA Exposure Control Plan
must be created and updated annually
 Training must be provided to all
employees as mandated by the
standard that includes use of PPE.
 Employees must take hepatitis B
vaccine or decline in writing.
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Hazardous Waste Operation &
Emergency Response Final Rule
Hazardous waste products include:
 Blood and blood products
 Body fluids and tissue
 Cultures
 Vaccines
 Sharps
 Gloves
 Specula
 Inoculating loops
 Paper product contaminated with body
fluids
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Universal Precautions
Use universal blood and body fluid
precautions for:
 Blood and blood products
 Human tissue
 Semen and vaginal secretions
 Saliva from dental procedures
 Cerebrospinal, synovial, pleural and other
body fluids
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Standard Precautions
Combination of Universal Precautions and
rules to reduce the risk of disease
transmission.
Applies to:
 Blood
 All body fluids, secretions, and excretions except
sweat
 Nonintact skin
 Mucous membrane
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OSHA Routine Safeguards
Category I Tasks:
 Those that expose a worker to blood, body fluids,
or tissue or those that have a chance of spills or
splashes. (Always were specific protective measures)
Category II Tasks:
 Do not usually involve risk of exposure
Category III Tasks:
 Do not require special protection
36
Personal Protective Equipment
Employers must provide personal protective
equipment (PPE) at no charge to the
employee.
 Disposable, sterile, exam & utility gloves
 Masks and protective eyewear or face
shields
 Protective clothing
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Postprocedure Cleanup
OSHA required steps:
 Decontaminate all
exposed surfaces
 Replace protective
coverings on surfaces
or equipment
 Decontaminate
receptacles
 Pick up any broken
glass with tongs
 Discard all potentially
infectious waste
materials
38
Apply Your Knowledge
The physician is going to remove a small
growth from your patient’s back. In order to
prepare for this procedure what steps would
you take to prevent the spread of infection?
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Apply Your Knowledge -Answer
The physician is going to remove a small
growth from your patient’s back. In order to
prepare for this procedure what steps would
you take to prevent the spread of infection?
Use medical asepsis while preparing the patient and
then use surgical asepsis during the procedure.
Follow all CDC and OSHA rules for the prevention
of infection and disease.
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Exposure Incidents
 A worker has reason to believe that he has
come in contact with a substance that may
transmit infection
 Notify physician or employer
 Employer must offer free medical evaluation
 Testing for HBV if not immunized
 Postexposure evaluation with written report
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Educating Patients
 Stress basic principles
of hygiene and disease
prevention
 Handwashing
 Daily hygiene
 Use tissues when
coughing or sneezing
 Routinely disinfect
rooms at home
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Educating Patients (cont.)
You will teach patient about:
 Nutrition and diet
 Exercise and weight control
 Prevention of sexually transmitted disease
 Smoking cessation
 Proper use of medications
 Stress reduction techniques
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Your Role in Patient Education
Remember the following factors when
providing education:
 Psychological and lifestyle factors
 Patient’s age and family circumstances
 Disease and disorders
 Patient’s psychological condition
 Remind patient to eat healthfully
44
Apply Your Knowledge
What is the first step to take after you
have been stuck with a blood-tinged
needle?
45
Apply Your Knowledge -Answer
What is the first step to take after you
have been stuck with a blood-tinged
needle?
Notify the physician or employer.
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Summary
Medical Assistant
You must follow federal regulations related to
infection control and asepsis.
You need to know the how pathogens cause disease,
how disease is transmitted and how to prevent the
spread of infection.
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End of Chapter
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