BAY AREA COLLEGE OF NURSING

Module 6: Principles of Asepsis

I. Terminology A. Asepsis B. Athletes Foot C. Bacteria D. Barriers E. Biohazard Symbol F. Center for Disease Control and Prevention (CDC) G. Chain of Infection H. Communicable I. Contamination J. Disinfection K. Disorientation L. Disposable M. E-coli N. Excretion O. Exposure Incident P. Flora Q. Fungus R. Hepatitis A, B, C S. Herpes Zoster T. HIV (Human Immunodeficiency Virus) U. Host V. Infections W. Infectious Agent X. Influenza Y. Isolation Z. Lice AA. Microorganisms BB. MRSA (Methicillin-Resistant Staphylococcus Aureus) CC. Nausea DD. Non-intact EE.Nosocomial FF. Pneumonia GG. OSHA HH. Pathogens II. PPE (Personal Protective Equipment) JJ. Reservoir KK.Scabies

LL. Standard Precaution MM. Sterilization NN. Streptococcus OO. Transmission-based precaution: 1. Airborne 2. Contact 3. Droplet PP. Tuberculosis QQ. VRE (Vancomycin Resistant Enterococcus) II. Common infectious agents and discuss the diseases they cause A. Types of infectious agents and common diseases they cause: a) b) c) a) b) c) d) e) 1. Bacteria (microorganism): Streptoccoccus E. Coli Tuberculosis 2. Virus (microorganism): HIV (AIDS virus) Hepatitis A,B,C Common cold Influenza Herpes Zoster 3. Fungi (microorganism) a) Tinea pedis b) Candida albicans 4. Insects: a) Lice b) Scabies 5. Antibiotic resistant bacterial infections (microorganisms): a) Methicillin resistant staphylococcus auerus (MRSA) infection. b) Vancomycin resistant enterococcus (VRE) infection III. A. B. C. D. E. Five conditions necessary for infectious agents to grow Food Source Moisture Oxygen or lack of oxygen Warmth Darkness

IV. The six parts of the chain of infection 1. Causative agent 2. Reservoir

3. 4. 5. 6. V.

Portal of exit Method of transmission Portal of entry Susceptible host

Four lines of defense against infection in the body: 1. 2. 3. 4. Normal flora Skin Mucous membranes Immune system

VI.

The signs and symptoms of infection

VII. Asepsis and sterile technique A. Asepsis/clean techniques: 1. Handwashing 2. Disinfection B. Surgical asepsis/sterile technique 1. Use of equipment, which has been sterilized 2. Use of barriers to prevent transmission of infectious agents. VIII. The roles of CDC and OSHA in the prevention of infections. A. Roles of agencies: 1. CDC Center for Disease Control and Prevention a) Located in Atlanta, Geogia b) Under the Department of Health and Human Services (a federal agency) c) Makes non-regulatory recommendations for disease control. d) Introduced categories of precautions in 1996 called standard precautions and transmission-based precautions. 2. OSHA Occupational Safety and Health Administration a) State regulatory agency which publishes and endorses rules to keep workers safe includes an infection control. b) Requires written documentation and follow-up on exposure incidents. IX. Standard precautions procedures and related terminology A. Standard precautions (asepsis) - they are designed to reduce the risk of transmission of microorganisms from moist body fluids - they include the following: 1. Blood

2.

3. 4. B. Contamination

All body fluids, secretions and excretions except sweat. Non-intact skin. Mucous membranes.

C. Methods of prevention 1. Hand washing 2. Sharps disposal

3. Personal protective equipment (PPE) a) Gloves are required when: 1. In contact with blood, body fluids, dressings, tissues or surfaces contaminated with blood or body fluids. 2. Wear gloves when in contact with non-intact skin or mucous membrane. 3. Remove gloves when contact is completed and wash hands. 4. If gloves become punctured or torn they should be removed. 5. Change gloves between residents. 6. Do not reuse gloves. b) Double gloves are required when necessary and according to facility policy. c) Gowns or aprons: 1. Wear moisture resistant gowns or aprons when the possibility of soiling with blood or body fluids might occur. 2. Remove when procedure is complete and prior to leaving the room. d) Facial protection 4. Environmental controls a) Use Environmental Protection Agency (EPA) registered disinfectant on solid surfaces including floors, furniture, bathrooms and utility rooms. b) Reusable equipment must be cleaned or disinfected before reuse. c) Mouthpieces for resuscitation should be available. d) Wastes and soiled linen should be placed in plastic bags and disposed of according to agency policy. e) Use separate containers for regular wastes and biohazardous wastes (blood and body fluids which contain blood). f) Wipe up body fluid spills immediately. g) Do not eat, drink, apply cosmetics or handle contact lens in contaminated area h) Labeling: 1. biohazard symbol 2. laboratory specimens and specimen containers X. Transmission-based precautions and related terminology

A.

Transmission based precautions:

1. Transmission based precautions used for pathogen infections which can be transmitted by:

a) b) c) d)

Airborne Droplet Contact Contaminated surfaces

2. Isolation 3. Transmission based precautions used in addition to standard precautions. 4. Isolation precautions 5. Guidelines by CDC indicate specific precautions and barriers to be used. 6. Consult agencys guidelines for identification of pathogen and related barriers. XI. Psychological effects of standard precautions and transmission based precautions. A. Placing the resident in isolation may interfere with following basic needs as defined by Maslow: 1. 2. 3. 4. Safety needs Love, belonging, affiliation needs Self-esteem Self-actualization

B. Methods of assisting the resident to meet these needs: 1. Explain the reason for the isolation to the resident. 2. Frequently check on the residents condition. 3. Provide the resident with newspapers, books and magazines, if appropriate. 4. Instruct the family and visitors on the details of the isolation technique to make it easier for them to visit the resident. 5. Make sure the necessary equipment for the isolation technique is available. 6. Place the call bell within the residents reach and be sure he/she knows now to use it. Respond to the call bell promptly. 7. Talk with the resident while in the room giving care.