BY HAFIZ

WHAT IS ASEPSIS
y Asepsis is the freedom from disease. y The nurse s effort to minimize the spread of infection

are based on the principle of aseptic technique.

There 2 type of Asepsis

y Medical y Surgical

Medical Asepsis

Surgical Asepsis
y Refers to those practice that keep an area or object free

of all microorganism. y Used for all procedures involving the sterile area of the body.

Nasocomial Infection
y Infection that are associated with the delivery of

health care service in a health care facility. y Microorganism that cause Nasacomial infection can be originated from client themselves(endogenous) , hospital environment or hospital personnel (exogenous).

Latrogenic infection
y Direct result of diagnostic of therapeutic procedure e.g

intravenous line

Hand Washing
y Is the most important procedure for preventing

nasomial infection because hand is the important route of transsmision of infection.

Purpose
y To prevent cross infection of the patient. y To protect the nursing personnel from pathogenic

organism.

Hand Washing
y Use soap & warm water y Scrub your hand very well. y Wash between finger , wrist under fingernails , & back

of hands.

Social Hygienic hand washing

y The lathering time should no less than 30 second.

This hygienic hand washing should be done prior to :

y Giving medication y Before & after eating y After using toilet y When hand look dirty y After contact with patient

Social/hygiene/medical hand washing

y Avoid wearing ring. y Turn on tap with elbow. Allow water to run cotinuosly y y y y y y

along the procedure. Wet both hand under the running water. Apply soap onto hand. Rub both palms firmly with closed fingers. Place one hand into others. Spreads fingers interlaced & rub firmly. Rub back of fingers to opposing palm with finger interlaced.

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y Repeat for other hand. y Grasp the thumb with other hand & rub in circular y y y y y

motion. Repeat for the other hand. Rubs clasped fingers on right hand in left palm using circular movement. Repeat for other hand. Rinse both hands. Turn off tap with elbow.

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y Dry other hand with tissue using one part of towel. y Repeat to other hand. y Maintain both hands above the waist(pinggang) line.

Picture

Antiseptic/surgical Hand washing

y The lathering time should no less than 1 minutes

This should be done prior to :

y Before & after any procedure requiring an aseptic

technique. y After handling with contaminated material. y On entering & leaving all high risk infection areas.

Antiseptic/surgical hand washing

y Avoid wearing rings. Remove if wearing ring. y Like the social hand washing , wash fingertips untill

elbow.

Picture of hand washing

Disinfection
y A process of eliminates all microorganisms. y The process which is an antimicrobial agents are

applied to non-living object to destroy microorganisms.

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y Antibiotics destroy microorganisms within the body. y Antiseptic destroy microorganisms on living tissue.

Type of Disinfection
y Alcohol y Halogens y Chlorine y Hypochlorite y Iodine y Oxidizing agents

Alcohol
y Wipes over benches skin & allowed to evaporated for

quick disinfection.

Halogens
y Chloramines used in drinking water treatment

instead of chlorine. y Chlorine used to disinfect swimming pools & is added in a small quantity to reduce waterborne disease.

Hypochlorite
y Often in form of common household bleach , used to

disinfect toilet & drains.

Iodine
y Antiseptic for skin cut.

Oxidizing agents
y Act by oxidizing the cell membrane result in liss of

structure & leads to cell lysis & death.

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y Hydrogen peroxide used in hospital to disinfect

surface. y Acetid acid y Potassium permanganate

Sterilization
y Is the complete elimination of all microorganisms

including spores. y Use steam under pressure. y Ethylene oxide gas (ETO). y Hydrogen peroxide plasma & chemical.

Antiseptic
y An antimicrobial substance that applied to living

tissue or skin to reduce the possibility of infection.

Some antiseptic are true

y Germicides capable of destroying microbes. y Bacteriostatic only prevent their growth. y Antibacterial are antiseptic that only act against

bacteria.

Common Antiseptic
y Alcohol used to disinfect the skin before injection are

given. y Boric acid used in suppositories to treat yeast of the vagina. y Hydrogen peroxide solution to clean & deodorize wounds & ulcer.

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y Iodine used in alcohol solution (as pre & post-

operative antiseptic) y Sodium chloride used as a general cleanser. Also used an antiseptic mouthwash. y Chlorhexidine used as skin antiseptic.

Barrier System Defense

y Body s organ system have unique defenses against

disease. y The skin , respiratory tract & gastrotestinal tract.

Universal/Standard Precaution
y Technique of infection control : y - proper hand washing y - the use of barrier (gloves) y - appropriate disposal of waste product & needles. y - proper care of spills.

All blood & body fluid like .

y y y y y y y y y

Blood Spinal fluid Vaginal secretion Semen Pericardial fluid Breast milk Amniotic fluid Peritoneal fluid *all blood & body fluid is considered potential infectious.

Personnel protective
y Gown y Mask y Protective eyewear y gloves

Primary reason for gowning

y To prevent soiling clothes during contact with the

client. y Protect health care personnel & visitor from coming in contact with infected material & blood or body fluid. y Can be disposable & reusable.

Full Face Protection

y Mask (topeng)

should be worn when working with a client placed on airborne or droplet precaution. y Surgical mask protect a wearer that travel short distance (3 feet).

Gloves
y Help to prevent the transmission of pathogen by direct

& indirect contact. y Non sterile gloves should be worn touching blood, contaminate item ,body fluid , secretion ,excretion.

Hand Washing
y Should washed hand immediately after & before

physical contact with client (e.g diapers change) y Blood or body fluid y After contact with used equipment (e.g. stethoscope & gloves) y After removing protective equipment such as gloves or clothing.

Isolation Technique
y To prevent spread of infectious microorganisms to

health personnel , client , & visitors.

Category
y Specific isolation enteric precaution y Drainage or secretions precaution y Blood or body fluids precaution

Specific Isolation Precaution

y For specific disease.

- use private rooms with special ventilation.

1. Airborne Precaution
y Disease droplet nuclei smaller than 5um ,measles

,chickenpox, disseminated zoster ,pulmonary or laryngeal TB.

y Barrier Protection

private rooms ,negative-pressure airflow ,mask or respiratory devices.

2.Droplet Precaution
y Disease pharyngeal , rubella , pharyngitis ,

pneumonia ,mumps ,pertussis.

y Barrier Protection

private rooms ,cohort client s

mask.

3.Contact Precaution
y Disease - direct client or environment contact

infection with multidrug resistant organisms wound infections , herpes simplex ,scabies , varicella zoster.
y Barrier Protection

private or cohort client s gloves,

gown.

Negative Pressure Isolation Rooms

y Pressure differential of 2.5 Pa. y Clean to dirty airflow in the direction is from the

outside adjacent space.(e.g. corridor) y Personal protective equipment. y Windows do not open.

Positive Pressure
y Pressure differential of 2.5

8 Pa , preferable 8 Pa. y Airflow from the room to the outside adjacent space. y Protect client from getting infection by bacteria , viruses, or fungus that maybe in the environment or carried by staff & visitors.

General/Domestic Waste
y Is a waste that not contaminated with any hazardous

chemicals , infectious ,radioactive or other physical agents.

Clinical Waste
y Is classed hazardous waste that can cause harm to

individual person & the environment.

Group A Disposal
y All human tissue soiled dressing & swabs including

waste that is contaminated with blood or body fluids must be placed into yellow clinical waste bag. y When 2/3 full the bag must be securely tied.

Group B Disposal
y Syringes , needles , contaminated broken glass. y When sharp bin container 2/3 full the lid, it must

closed closely.

Group C
y Laboratory waste.

Group D (A)
y Pharmaceutical waste

include all medicine products for internal & external use ,vaccines ,disinfection & their container. These should be disposed as follow :

1. Stock item empty stock item & treated as clinical waste group A. 2. unwanted or expired stock item should be returned to pharmacy.

Controlled Drug (B)

y Empty pack of controlled drugs & treated as clinical

group B.

- used or empty syringes IV bags for infusion which have contained control drugs should be treated as group B item.

Cytotoxic Drugs
y All equipment used for their administration including

sharps , apron & gloves must be disposed separately into cytotoxic waste container.

Vaccines(B)
y Expired vaccines or used vaccines containers treated as

Group B item.

Group E
y Item used for disposal of urine & other body secretion

must be treated as clinical waste in the hospital.

Bins (tong sampah)

y Yellow clinical waste y Red plastic beg

linen that contaminated with blood. y Green plastic beg linen that contaminated with feaces & urines. y Black/Blue plastic bag other rubbish

Sterile Technique
y An object is sterile when is free from all

microorganism. y Is practiced in operating room & special diagnostic areas.

Procedure
y Perform hand washing. y Open sterile item. y Work area is always above (atas pinggang) waist level. y Letakkan item di atas tempat kerja. y Remove the sterilazation tape. y Grasp (pegang dgn ketat) the outer surface of the tip of

the outermost flap.

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y Open the outer flap away from the body, keeping the

arm outstretched & away from the sterile field. y Hold the outside surface of the first side flap. y Open the side flap , keep the arm to the side & do not allow the flap of the spring back over the sterile content.

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y Open all the outside surface & the innermost flap. y Stand away from the sterile package &pull the flap

back.

Adding sterile Item

y Use the inner surface of the package as a sterile pack to

add additional sterile item.

Pouring Solution To Sterile Area

y Held it label in the palm of hand to prevent the

possibility of the solution wetting & fading(tumpah) the label. y The edge (hujung) of the bottle & container is kept away.

y Pour the solution slowly to avoid splashing

(tertumpah). y The bottle should be held outside the edge of the sterile field.

Equipment
*Surgical face mask

Procedure
y Find top of mask. It has thin metal trip along edge. y Ties the top string above the ears. y The two lower ties snugly (comfortable) around neck

with mask well under chin.

Removal of Surgical Mask

y Remove mask by handling only the ties. y Untie the bottom (bawah) , the untie the top (atas) tie. y Remove the mask from your face. y Properly dispose the mask by touching only the ties. y Change the mask if wet or contaminated.