1. ASEPTIC MEASURESASEPTIC MEASURES
SHAHEENA MASOODI
HICN
SKIMS

2. ASEPSISASEPSIS
Definition
Asepsis means those practices that decrease
or eliminate infectious agents, their
reservoirs, and vehicles for transmission.

3. ASEPTIC TECHNIQUEASEPTIC TECHNIQUE
Purpose
 absence of pathogenic organisms in the
clinical setting.
Goal
to protect the patient from infection.

4. Chain of InfectionChain of Infection
Pathogen
Reservoir
Portal of
ExitMode
of
Transmission
Portal of
Entry
Susceptible
Host
Why Isolation?.. because transmission isWhy Isolation?.. because transmission is
easier to control than the source / host!easier to control than the source / host!

5. CROSS INFECTIONCROSS INFECTION
METHODS
Direct contact: transmitted from person to
person. (droplets, sexual contact, hands)
Indirect contact: through fomites,
contaminated food, insects, dusts, carriers.

6. PREVENTION OF CROSSPREVENTION OF CROSS
INFECTIONINFECTION
well ventilated hospitals
General cleanliness in hospitals
Safe food and water supply(kitchen
protected from flies)
Safe disposal of excreta (urine, stool
&sputum)
Safe disposal of refuse (dressing &
garbage)
Destruction of rodents and insects.

7. PREVENTION OF DIRECTPREVENTION OF DIRECT
CONTACTCONTACT
Respiratory
isolation: masks
and gowns are
worn.

8. Enteric isolation:
Recommended to wear
gloves and gowns
while handling soiled
articles.
Thorough hand
washing by patient &
staff.
Soiled linen to be
disinfected

9. Wound and skin isolation
Use of gowns and gloves
Safe disposal of dressings and discharges
Articles must be kept separate in case of
tetanus, gas gangrene, scabies

10. BLOOD ISOLATIONBLOOD ISOLATION
Equipment that comes in contact with the
client’s blood must be carefully disinfected
before touching another patient.

11. ISOLATION PRECAUTIONS:ISOLATION PRECAUTIONS:
TWO TIERSTWO TIERS
Standard: used routinely for the care of all
patients regardless of diagnosis or presumed
infection status and organism
These precautions apply to
– airborne
– droplet
– contact transmissions

12. ContdContd
Transmission-based: designed for
patients documented or suspected to be
infected or colonized with organisms that
require additional precautions beyond the
standard precautions necessary to interrupt
transmission.

13. Standard PrecautionsStandard Precautions
Hand Hygiene Wash/Decontaminate hands:
•After touching bodily fluids or contaminated items
•After removing gloves
•Between (before and after) patient contacts
Gloves •Wear gloves when touching bodily fluids or contaminated items
•Put on clean gloves before touching mucous membranes or non-intact skin
•Change gloves between "dirty" and "clean" tasks on the same patient
•Remove gloves promptly after use (before going to another patient); wash hands immediately
Mask, Eye Protection, Face
Shield, Gown
•Use personal protective equipment (PPE) as necessary to protect against splashes or sprays of bodily fluids
•Facial protection including eye, nose, and mouth protection is essential when there is any aerosolized-generating
procedures being performed
•Prescription eyeglasses are NOT considered personal protective equipment
Patient-Care Equipment &
Linens
•Equipment and linens soiled with bodily fluids should be handled in a way that avoids cross-contamination
•Clean and reprocess reusable equipment appropriately before use on another patient
•Discard single-use items appropriately

14. Environmental Care Environmental surfaces should be cleaned and disinfected on a routine basis and when visibly
soiled/contaminated.
Bloodborne Pathogens •Use sharps (needles, scalpels, etc.) carefully and appropriately. For example, do not bend or recap needles
•Take care to prevent accidental sticks
Patient Placement Patients who contaminate the environment should be placed in private rooms.
Disposal of Waste Regulated Medical Waste includes:
•Infectious cultures and stocks of infectious agents
•Bulk blood/blood products
•Pathological wastes/body parts
•Sharps
•Animal carcasses/bedding
Handling of Medical
Waste
•Must be collected, stored and shipped in leak-proof containers
Specimen collection All specimens are considered biohazardous and should be handled using gloves. All specimens must be placed
in zip lock specimen bags with the universal biohazard symbol on the front. Specimens must go inside the zip
lock, and the requisitions must be placed in the pouch in front of the zip lock.

15. Standard PrecautionsStandard Precautions
Every Patient, Every Time,Every Patient, Every Time,
Every EncounterEvery Encounter
Foaming in and foaming
out.
Cleaning your
stethoscope with alcohol
pads.
 Cleaning all other
equipment with Sani-Cloth
between each patient
contact.

16. Medical asepsisMedical asepsis
those practices that confine or reduce the
numbers of microorganisms. Also called,
clean technique, it involves measures that
interfere with the chain of infection in
various ways.

17. Examples of medical asepticExamples of medical aseptic
practicespractices
using antimicrobial agents,
performing hand hygiene,
wearing hospital garments,
confining and containing soiled materials
appropriately,
and keeping the environment as clean as
possible.

18. 1. Using Antimicrobial Agents1. Using Antimicrobial Agents
Antimicrobial agents are chemicals that
destroy or suppress the growth of
infectious microorganisms
Examples are antiseptics, disinfectants, and
anti-infective drugs.

19. AntisepticsAntiseptics
Antiseptics: inhibit the growth of, but do
not kill, microorganisms. An example is
alcohol

20. DisinfectantsDisinfectants
Disinfectants, also called and , destroy
active microorganisms but not spores.
Phenol, household bleach, and
formaldehyde are examples.
Disinfectants are used to kill and
remove microorganisms from equipment,
walls, and floors

21. Anti-Infective DrugsAnti-Infective Drugs
Antibiotics
Antiviral

22. 2. Hand washing2. Hand washing
Hand washing is
an aseptic practice
that involves
scrubbing the
hands with soap,
water and friction.

23.  Hands should be washed:
– Before and after patient contact
– Before putting on gloves and after taking them off
– After touching blood and body substances (or contaminated
patient-care equipment), broken skin, or mucous membranes
(even if you wear gloves)
– Between different procedures on the same patient

24. Performing a Surgical ScrubPerforming a Surgical Scrub
A surgical scrub, a type of skin and nail
antisepsis, is performed before donning
sterile gloves and garments when the nurse
is actively involved in an operative or
obstetric procedure. The purpose is to
more extensively remove transient
microorganisms from the nails, hands, and
forearms.

25. Wearing Personal ProtectiveWearing Personal Protective
EquipmentEquipment
uniforms
scrub suits or gowns
masks
gloves
protective eyewear
Hair (caps) and Shoe Covers

26. Key Points About PPEKey Points About PPE
Don before contact with the patient,
generally before entering the room
Use carefully – don’t spread contamination
Remove and discard carefully, either at the
doorway or immediately outside patient
room; remove respirator outside room
Immediately perform hand hygiene

27. Sequence for Donning PPESequence for Donning PPE
Gown first
Mask or respirator
Goggles or face shield
Gloves

28. How to Safely Use PPEHow to Safely Use PPE
Keep gloved hands away from face
Avoid touching or adjusting other PPE
Remove gloves if they become torn;
perform hand hygiene before donning new
gloves
Limit surfaces and items touched

29. ““Contaminated” and “Clean”Contaminated” and “Clean”
Areas of PPEAreas of PPE
Contaminated – outside front
• Areas of PPE that have or are likely to have been
in contact with body sites, materials, or
environmental surfaces where the infectious
organism may reside
Clean – inside, outside back, ties on head
and back
• Areas of PPE that are not likely to have been in
contact with the infectious organism

30. Sequence for Removing PPESequence for Removing PPE
Gloves
Face shield or goggles
Gown
Mask or respirator

31. Where to Remove PPEWhere to Remove PPE
At doorway, before leaving patient room
or in anteroom*
Remove respirator outside room, after door
has been closed*
 Ensure that hand hygiene facilities
are available at the point needed, e.g.,
sink or alcohol-based hand rub

32. Removing Isolation GownRemoving Isolation Gown
Unfasten ties
Peel gown away from
neck and shoulder
Turn contaminated
outside toward the inside
Fold or roll into a bundle
Discard

33. Removing a MaskRemoving a Mask
Untie the bottom,
then top, tie
Remove from face
Discard

34. Hand HygieneHand Hygiene
Perform hand hygiene immediately after
removing PPE.
• If hands become visibly contaminated during
PPE removal, wash hands before continuing
to remove PPE
Wash hands with soap and water or use an
alcohol-based hand rub

35. Keeping the Environment CleanKeeping the Environment Clean
Health agencies employ laundry staff and
housekeeping personnel to assist with
cleaning
Terminal disinfection is more thorough
than concurrent disinfection and consists
of measures used to clean the client
environment after discharge.

36. Surgical AsepsisSurgical Asepsis
means those measures that render supplies
and equipment totally free of
microorganisms. Sterile technique is those
practices that avoid contaminating
microbe-free items.

37. SterilizationSterilization
consists of physical and chemical
techniques that destroy all microorganisms
including spores.

38. 1. Physical Sterilization1. Physical Sterilization
Microorganisms and spores are destroyed
physically through radiation or heat
(boiling water, free-flowing steam, dry
heat, and steam under pressure).

39. RadiationRadiation
Ultraviolet radiation can kill bacteria,
especially the organism that transmits TB.

40. Boiling WaterBoiling Water
Boiling water is a convenient way to
sterilize items used in the home. To be
effective, contaminated equipment needs to
be boiled for 15 minutes at 212°F (100°C)

41. Free-Flowing SteamFree-Flowing Steam
Free-flowing steam is a method in which
items are exposed to the heated vapor that
escapes from boiling water.

42. Dry HeatDry Heat
Dry heat, or hot air sterilization, is similar
to baking items in an oven. To destroy
microorganisms with dry heat,
temperatures of 330°to 340°F (165° to
170°C) are maintained for at least 3 hours.

43. Steam Under PressureSteam Under Pressure
Steam under pressure is the most
dependable method for destroying all
forms of organisms and spores.
The autoclave is an example

44. 2. Chemical Sterilization2. Chemical Sterilization
Both gas and liquid chemicals are used to
sterilize invasive equipment.

45. Principles of Surgical AsepsisPrinciples of Surgical Asepsis
They preserve sterility by touching one
sterile item with another that is sterile.
Once a sterile item touches something that
is not, it is considered contaminated.
Any partially unwrapped sterile package is
considered contaminated.
If there is a question about the sterility of
an item, it is considered unsterile.

46. The longer the time since sterilization, the
more likely it is that the item is no longer
sterile.
A commercially packaged sterile item is
not considered sterile past its
recommended expiration date.
Once a sterile item is opened or uncovered,
it is only a matter of time before it
becomes contaminated.

47. sterile wrapper, if it becomes wet, wicks
microorganisms from its supporting
surface, causing contamination.
Any opened sterile item or sterile area is
considered contaminated if it is left
unattended.
Coughing, sneezing, or excessive talking
over a sterile field causes contamination.

48. Reaching across an area that contains
sterile equipment has a high potential for
causing contamination and is therefore
avoided.
Sterile items that are located or lowered
below waist level are considered
contaminated because they are not within
critical view.

49. Creating a Sterile FieldCreating a Sterile Field
A sterile field means a work area free of
microorganisms.

50. THANK YOUTHANK YOU