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Aseptic Technique


Aseptic Technique By Group 1 Droplet Precautions Mask Should be worn when working within three feet of the patient or upon entering room Patient Transport Should be ... – PowerPoint PPT presentation

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Title: Aseptic Technique

Aseptic Technique
  • By Group 1

  • Define Infection Control and Aseptic Technique
  • Discuss the 3 elements of transmission of
  • List the 5 means of transmission of infectious
  • Describe the five modes of transmission of
    infectious microorganisms
  • Define isolation and discuss isolation
  • List and describe the five crucial areas,
    according to the C.D.C., for maintaining
    isolation precautions and their implementations
  • Describe Standard precautions, including who is
    responsible for implementation, when to
    implement, and methods of implementation
  • Demonstrate proper procedure for donning a
    sterile gown
  • Demonstrate proper procedure for removal of
    contaminated gloves
  • Recognize when the guidelines for a sterile field
    are violated and how to act appropriately
  • Describe the purposes, types, materials, and
    methods of wound dressings

  • Infection Control
  • Program of disease surveillance, designed to
    investigate, prevent, and control the spread of
    infections and their causative microorganisms
  • Aseptic Techniques
  • Are the methods and procedures used to create and
    maintain a sterile field

Infection Control
  • Prevention of disease in hospitals is a major
  • Transmission of infection requires three elements
  • A source of infecting microorganisms
  • A susceptible host
  • A means of transmission for the microorganism

Sources of Infection
  • Humans Sources
  • Include
  • patients
  • personnel
  • visitors
  • Can be
  • Carrying an acute disease
  • In the incubation period of a disease
  • Colonized by an infectious agent
  • Chronic carriers of an infectious agent

Other Sources
  • Pts own Endogenous Flora (internal microbes
    useful to the body)
  • Contaminated Objects
  • Equipment
  • Medications

Susceptible Host
  • Resistance among persons to pathogenic
    microorganisms varies greatly
  • Person may,
  • Be immune
  • Resistant to colonization
  • Become asymptomatic carriers
  • May develop clinical disease
  • Host factors may include, but not be limited to
  • Age
  • Underlying diseases
  • Certain treatments with immunodepressive agents
  • Antimicrobials
  • Corticosteroids
  • Irradiation
  • Breaks in the first line of defense mechanisms
    caused by
  • Surgical operations
  • Anesthesia
  • Indwelling catheters

Means of transmission
  • Microorganisms are transmitted in hospitals by
    several routes
  • The same microorganism may be transmitted by more
    than one route
  • The five main routes of transmission are
  • Contact
  • Droplet
  • Airborne
  • Common vehicle
  • Vectorborne

Contact Transmission
  • The most important and frequent mode of infection
  • Divided into two subgroups
  • Direct contact transmission
  • Direct body to surface contact
  • Physical transfer of microorganisms between a
    susceptible host and an infected or colonized
  • Indirect contact transmission
  • Contact of a susceptible host with a contaminated
    intermediate object, usually inanimate

Droplet Transmission
  • Droplets are generated from a source person by
  • Coughing
  • Sneezing
  • Talking
  • Performance of certain procedures
  • Suctioning
  • Wound care
  • Transmission occurs when droplets containing
    microorganisms generated from the infected person
    are propelled a short distance through the air
    and deposited on a hosts conjunctivae, nasal
    mucosa or mouth
  • Droplets do not stay suspended in air

Airborne Transmission
  • Occurs by two modes of dissemination
  • Airborne droplet nuclei
  • Are evaporated droplets containing the infectious
  • Remain suspended in air for long periods of time
  • Dust particles containing the infectious agent
  • Dispersed widely by air currents
  • Inhaled by a susceptible host

Common Vehicle Transmission
  • Applies to microorganisms transmitted by
    contaminated items such as
  • Food
  • Water
  • Medications
  • Devices
  • Equipments

Vectorborne Transmission
  • Occurs when vectors transmit microorganisms
  • Vectors are vermin such as
  • Mosquitos
  • Flies
  • Rats
  • This method is of less significance in hospitals

  • One means of infection control is isolation
  • Isolation is the separation and placement of
    patients in environments that reduce the
    potential for transmission of infectious
  • When a patient is placed in isolation
  • Signage is posted outside the patients room
    indicating specifically required isolation
  • A request is posted for visitors to see the
    patients nurse prior to entering the patients

Isolation Precautions
  • There are two levels of isolation precautions
  • Standard precautions
  • Designed for the care of all patients in
    hospitals regardless of diagnosis or suspected
    infection status
  • Is the primary strategy for successful nosocomial
    infection control
  • Transmission precautions
  • Based on the concept of avoiding infection by
    limiting the potential for transmission of
  • Are designed only for the care of specified
    patients who are known or suspected to be
    infected by epidemiologically important pathogens

Standard Precautions
  • Apply to
  • All patients receiving care in hospitals
    regardless of diagnosis or presumed infection
  • Blood
  • All body fluids, secretions, and excretions
    except sweat
  • Non-intact skin
  • Mucous membranes
  • Are designed to reduce the risk of transmission
    of microorganisms from both recognized and
    unrecognized sources of infection in hospitals

Transmission Based Precautions
  • Designed for patients documented or suspected to
    be infected with highly transmissible pathogens
    for which additional precautions, beyond standard
    precautions, are needed
  • There are three types of transmission based
  • Airborne
  • Droplet
  • Contact
  • Are used in addition to standard precautions
  • can be used in any combination

  • The C.D.C. stands for Center for Disease Control
  • It is the federal agency responsible for
    developing and issuing guidelines for aseptic
    techniques and isolation systems.

  • The C.D.C.
  • Recommends isolation procedures based on 7
  • Strict isolation
  • Respiratory isolation
  • Protective isolation
  • Enteric precautions
  • Wound and skin precautions
  • Discharge precautions
  • Blood precautions
  • Requires that guidelines
  • Have a basis that is epidemiologically sound
  • Emphasize the importance of all body fluids,
    secretions and excretions of nosocomial pathogens
  • Contain precautions for infections transmitted by
    airborne, droplet, and contact routes of
  • Be simple to understand and use
  • Use terms to avoid confusion with existing

CDC Contd
  • The C.D.C. deemed five areas crucial to
    maintaining isolation precautions in hospitals
  • Administrative controls
  • Standard precautions
  • Airborne precautions
  • Droplet precautions
  • Contact precautions

Administrative Controls
  • Include
  • Education
  • Developing systems to ensure that patients,
    personnel and visitors are educated about the use
    of precautions and their responsibility to adhere
    to them
  • Adherence to precaution
  • Periodic evaluation of adherence to precautions
  • Use of findings to direct improvements

Standard Precautions
  • Include
  • Handwashing
  • Gloves
  • Mask and eye protection
  • Gown
  • Patient care equipment
  • Environmental control
  • Linen
  • Occupational health and bloodborne pathogens

  • Hands should be washed
  • Immediately after touching,
  • Blood
  • Body fluids
  • Secretions
  • Excretions
  • Contaminated items
  • Immediately after gloves are removed
  • Between tasks and procedures on the same patient
  • Plain soap should be used
  • Procedures
  • Should last a minimum of 15 seconds
  • Involves vigorous rubbing together of all
    surfaces of lathered hands
  • Followed by rinsing under a stream of water
  • In the case of specific circumstances such as
    control of outbreak or hyperendemic infections,
    an antimicrobial agent may be used

  • Clean gloves should be worn when
  • Touching
  • Blood
  • Body fluids
  • Secretion
  • Excretions
  • Contaminated items
  • Mucous membranes
  • Non-intact skin
  • Gloves should be changed in between tasks and
    procedures on the same patient
  • Gloves should be removed promptly after use

Gloving Procedures
  • Glove pack is opened
  • Sterile wrapping containing gloves should be
    opened on a sterile surface with cuffs toward
    person gloving
  • Sterile portion of a glove pack is opened by
    grasping the folds of the paper enclosing the
  • Grasp the left glove with your right hand by its
    cuff on the non-sterile portion and work your
    left hand into it.
  • Once left is in place, place the first two or
    three fingers of the left hand inside the sterile
    side of the cuff of the other glove
  • He lift the right glove using the fingers inside
    the cuff only
  • Then work the right hand into the glove pulling
    the sleeve over the gown
  • Now place the right fingers on the inside of the
    left glove cuff and pull that over the gown
  • Once gloved both hands must remain above waist

Removal of Gloves
  • One hand grasps the cuff of the other glove
  • The glove that is grasped is turned inside out as
    it is removed
  • The glove that is removed is compacted into the
    other glove
  • The thumb of the ungloved hand is hooked inside
    the remaining glove
  • The remaining glove is pulled towards the fingers
    while being turned inside out
  • Both gloves are removed with contaminated sides
  • Do not snap the gloves
  • Dispose the gloves in the appropriate container

Mask and Eye Protection
  • Are worn to protect mucous membranes of the eyes,
    nose mouth of health care providers
  • Should be worn when performing procedures and
    patient care activities that are likely to
    generate splashes or sprays of blood, body
    fluids, secretions and excretions

  • A clean sterile gown can protect the skin and
    prevent soiling of clothing of health care
  • Should be worn when performing procedures and
    patient care activities that are likely to
    generate splashes or sprays of blood, body
    fluids, secretions and excretions
  • Should be removed promptly after procedure

Gowning Procedures
  • Open sterile pack
  • Grasp gown with hands above waist at all times
  • Shake open gown so it unfolds
  • Locate the neck and armholes of the gown
  • Without touching the outside, work both arms into
    the sleeves
  • Have a nurse or other personnel tie the gown at
    the back and neck

Patient Care Equipment
  • Used patient care equipment that is soiled in
    blood, body fluids, secretions or excretions
    should be handled in a manner that prevents skin
    and mucous membrane exposure, contamination of
    clothing, and transfer of microorganisms
  • Ensure that equipment is not used for another
    patient until it is cleaned appropriately
  • Ensure that single use items are discarded

Environmental Control Linen
  • Ensure that hospital protocols are in place
    regarding routine care, cleaning, disinfection of
    environmental surfaces, beds, bedrails, bedside
    equipment and other frequently touched surfaces
  • Handle, transport, and process linen soiled with
    blood, body fluids, secretions, and excretions in
    a manner that prevents skin and mucous membrane
    exposures and contamination of clothing

Occupational Health Bloodborne Pathogens
  • Disposable syringes and needles, scalpel blades
    and other sharp items should be
  • Handled with care
  • Disposed of in proper puncture proof containers.
  • Never
  • Recap used needles
  • Manipulate them using both hands
  • Direct the point of a used needle toward any part
    of the body
  • Remove needles from disposable syringes by hand
  • Bend, break, or manipulate used needles by hand
  • Mouthpieces, resuscitation bags other devices
    should be used as an alternative to mouth to
    mouth rescusitation

Airborne Precautions
  • Respiratory Protection
  • Such as an, N95 respirator, should be worn when
    entering room
  • Patient Transport
  • Movement should be limited to essential purposes
  • Surgical Mask should be worn by the patient

Droplet Precautions
  • Mask
  • Should be worn when working within three feet of
    the patient or upon entering room
  • Patient Transport
  • Should be limited to essential purposes only
  • Patient must wear a surgical mask

Contact Precautions
  • Gloves
  • Should be used as outlined under standard
  • Must be changed constantly during the course of
    patient care
  • Must be removed before leaving patients room
  • Handwashing
  • Must use an antimicrobial agent
  • Gown
  • Must be removed before leaving room
  • Patient transport
  • Should be limited to essential purposes only
  • Patient Care Equipment
  • Use of this equipment should be limited to a
    single patient only

Sterile Field
  • Another aseptic technique is to provide and
    maintain a sterile field.
  • A sterile field is most commonly required in an
    operating room
  • There are 8 requirements for providing and
    maintaining a sterile field.

Requirement 1
  • All items used within the boundary of a sterile
    field must be sterile
  • Single use items are preferred
  • Packages are considered sterile only when
  • Initial packaging was performed properly
  • Package was stored in a proper manner
  • Package was not mishandled during distribution
  • Shelf life data has not been exceeded

Requirement 2
  • Once a package is opened, the edges are not
    considered sterile
  • Care in opening sterile packages is required to
    avoid having edges touch the contents of the
    package, or having the edges touch the gloved
    hands or sterile gown

Requirement 3
  • Once donned properly, sterile gowns are
    considered sterile in the front from the shoulder
    level to table top level, including the sleeves
  • Hands should be held above table top level, in
    front of body during and after scrubbing, gowning

Requirement 4
  • Only the top surface of a table is considered
  • Any surface above the level of the instrument
    table, or above waist level, whichever is higher,
    is a sterile surface as long as it is draped
  • Undraped or improperly draped surfaces, or
    surfaces below the top level of the instrument
    table or waist, are considered unsterile

Requirement 5
  • Only sterile items and personnel in sterile
    attire may enter the field or touch items in a
    sterile area.
  • Forceps can be used to transfer items into a
    sterile area, but are considered contaminated
    after one use.

Requirement 6
  • Activity in a sterile area cannot be allowed to
    render the area unsterile.
  • Movement within the sterile area must be measured
    and careful to avoid contact between sterile and
    unsterile surfaces.
  • Any contamination of a sterile area must be
    pointed out immediately by any personnel present
    for the protection of the patient

Requirement 7
  • Penetration of a sterile barrier is considered to
    cause contamination of a sterile field.
  • Penetration can be via
  • Liquid (most likely)
  • Airflow

Requirement 8
  • Sterile areas and fields should be prepared as
    close to the time of use as feasible
  • They should not be left unattended
  • Where there is doubt about the sterile quality of
    an area, a field, or an item, it should be
    considered unsterile.

Wound Dressings
  • Two factors may dictate the type of dressing
    applied or the method of application of a wound
  • The location of the wound
  • The underlying pathologic conditions
  • No dressing should ever be applied that impedes
  • When non institutional care is appropriate, a
    patient or patients family must be instructed
    carefully in proper wound care

Purpose of Wound Dressings
  • The purposes of wound dressings are to
  • Protect physically the site of injury
  • Prevent contamination of a wound
  • Prevent transmission of infection from a wound
  • Promote healing

Evaluation of the Wound
  • Documentation of wound characteristics is
    necessary for
  • Appropriate selection of dressing materials and
    protective agents
  • Monitoring progress in wound healing
  • Evaluation of the wound is necessary to
  • Cause
  • Location
  • Area
  • Depth
  • Whether the wound is wet or dry
  • Whether wound is infected
  • Source of infection
  • Mechanism of infection
  • Microorganism of infections
  • Wounds can be measured with a ruler
  • Wounds can be documented by photograph.

Types of Dressings
  • Five methods of dressing applications for wound
    management are
  • Dry to dry
  • Application of a dry absorbent or non absorbent
    dressing to cover the wound
  • Damp to damp
  • Application of a gauze pad moistened with saline
  • Damp to dry
  • Application of a moistened dressing that is
    allowed to dry before removal
  • Occlusive dressing
  • Applied to provide a semipermeable barrier to air
    and moisture penetration
  • Rigid dressing
  • Provides physical protection to a wound and the
    adjacent area

  • Choice of materials for, and method of
    application of dressing depends on
  • Cause of the wound
  • Whether wound is clean or infected
  • If infected, what microorganism caused the
  • The type of dressing
  • The type, if any, of microbial agent to be
  • The site, area depth of wound
  • Whether a trained professional, the patient, or
    the patient's family will be responsible for
    monitoring and changing the dressing

Types of Materials
  • The most basic dressing is a Band Aid
  • Telfa pads are best for small wounds
  • Gauze is the most common material used or
  • Topical antimicrobial agents may be applied under
    the gauze portion of the dressing
  • Compression wraps are applied to control edema in
    a limb segment or to provide support to a join
  • Edges of lacerations can be approximated using
    Steri Strips
  • Tape used to secure an adhesive can be cloth
    adhesive or paper tape

Preparation of a Dressing
  • Supplies must be easily accessible during
  • Sterile fields, when required, must be prepared
  • Use appropriate application of aseptic techniques
  • Tape needs to be prepared before starting the
    application of a dressing
  • If tape is applied circumferentially on a limb
    segment, the ends should not overlap
  • The size of the dressing should cover the wound
  • In no case should adhesive portion of a dressing
    come in contact with a wound

Packing a Wound
  • Wound may be packed with gauze depending on the
  • Ensure that deeper layers of a wound heal before
    surface layers
  • Once packed, cover the wound and packing with
    additional dressing that is secured with a tape

Applying a Gauze Wrap
  • Lay portion of gauze roll against limb segment
    with the still rolled gauze away from the limb
  • Wrap gauze in a spiral wrap which means in a
    continuous spiral manner around the limb segment
  • Angle the roll of the gauze slightly to
    accommodate for sloping contour and to avoid
    creating a tourniquet
  • Unroll the gauze around the limb segment with
    each successive wrap overlapping the previous
    wrap by half
  • Secure the wrap with tape
  • When removing carefully use bandage scissors to
    cut gauze

Applying a Compression Wrap
  • Involves applying pressure when wrapping
  • The pressure should be more distal than proximal
  • Compression wraps may be applied as
  • Spiral wraps
  • Figure eight wraps
  • Same as spiral wrap except the direction of the
    wrap changes each time the wrap completes one
    loop of a figure eight

  • Infection Control and Aseptic techniques are
    programs and procedures put in place to limit or
    prevent the spread of infectious microorganisms
  • Transmission of infection requires three
    elements, a source of infecting microorganisms, a
    susceptible host and a means of transmission for
    the microorganism
  • The five modes of transmission of infections are
    contact, droplet, airborne, common vehicle and
  • Isolation is the separation and placement of
    patients in environments that reduce the
    potential for transmission of infectious
  • There are two tiers of isolation precautions
    standard precautions and transmission based
  • The five crucial areas for maintaining isolation
    precautions are administrative controls, standard
    precautions, airborne precautions, droplet
    precautions and contact precautions
  • Standard precautions include proper handwashing,
    gloving, face eye protection, gowning, managing
    of patient care equipment, environmental control,
    linen care, observance of procedures regarding
    occupational health bloodborne pathogens
  • Maintenance of a sterile field is usually applied
    for surgical procedures.
  • There are 8 requirements of maintaining a sterile
    field they are proper handling of opened
    packages, proper gowning, table sterility, only
    sterile items can enter field, activity cannot be
    allowed to render area unsterile, penetration of
    sterile barriers are considered contamination and
    sterile fields should be prepared as close to
    procedure time as possible
  • Wound care is designed to protect and prevent
    infection of wound and involves proper
    evaluation, type of, preparation and application
    of dressing

  • The most important and frequent mode of infection
    transmission is _________?
  • Contact transmission
  • __________ Precautions are designed for patients
    documented or suspected to be infected with
    highly transmissible pathogens for which
    additional precautions, beyond standard
    precautions, are needed
  • Transmission Based
  • The federal agency that is responsible for
    developing and issuing guidelines for aseptic
    techniques and isolation systems is the
    ___________ ?
  • C.D.C.
  • In healthcare when should standard precautions be
  • Always
  • When maintaining a sterile field, __________
    should be kept above waist level at all times.
  • Hands
  • No dressing should ever be applied that may
    impede ______________.
  • Circulation

  • Handout Aseptic Techniques

Thank You
  • Have A Great Day!