MEDICAL ASEPSIS

ASEPSIS: Efforts to minimize the onset and spread of infection are based on the principles of
aseptic technique. Aseptic Technique is an effort to keep the client as free from exposure to
infection- causing pathogens as possible. The term asepsis means the absence of disease-producing
micro-organisms. The two types of aseptic technique are :
1) Medical asepsis
2) Surgical asepsis

MEDICAL ASEPSIS: The nurse follows certain principles and procedures to prevent and control
its spread. Basic medical aseptic techniques are focused on breaking chain of infection. This can be
achieved by:

CONTROL OR ELEMINATION OF INFECTION AGENTS INCLUDING:

o Proper cleaning by water and mechanical action with or without detergents.
o Disinfection
o Sterilization of contamination objects. Sterilization and disinfection are physical processes,
involving the use of heat, radiation, chemical processes, etc. which use various solution or
gases.

MEASURES FOR CONTROL OR ELIMINATION OF RESERVOIRS OF INFECTION:

o Bathing will soap and water to remove secretion, drainage, perspiration etc.
o Frequent change of dressings
o Proper disposal of wastes and contaminated articles.
o Disposal of contaminated needles and syringes in moisture-resistant, puncture-proof
containers.
o Keep the patient’s bedside unit clean, dry and biologically safe.
o Bottled solutions should be placed with tight caps as per instructions.
o Keep drainage tubes and collection bags of the patient to prevent accumulation of serous
fluid under the skin surface of surgical wounds.
o Empty and dispose of drainage suction bottles according to agency policy.

CONTROLS OF PORTALS OF EXIT:

o Practise aseptic precautions
o Avoid talking directly into the client’s face to prevent droplet infections
o Wearing of masks is important once the nurse herself has infection or deals with clients
suffering from infections
o Careful handling of wastes like urine, faeces, emesis and blood is important
o Disposable gloves should be worn to prevent direct contact with wastes or infected
materials.

CONTROL OF TRANSMISSION OF INFECTION:

o Discourage sharing of bedpans, urinals, basins, eating utensils etc.
o Use separate thermometer for infectious patients.
o Damp dusting should be done to prevent scattering of dust, etc. in air.
o Protect own clothing from direct contact with infected materials.
o Practice hand washing technique. This is recommended in the following situation:
- Before contact with clients who are susceptible to infection.
- After caring for an infected client.
 - Before performing invasive procedures like administration of injections, suction,
catheterisation etc.
- After touching infected material.
- Before and after handling dressing or touching open wounds
- After handling contaminated equipment.
- Between contact with different clients in high-risk units.

CONTROL OF PORTAL OF ENTRY:

o Maintain integrity of skin and mucous membranes.
o Proper positioning of tubing’s, etc. may prevent injuries and skin breakdown.
o Regular skin care is essential with application of lubricants.
o Turning and positioning of debilitated clients will help in preventing a skin breakdown.
o Ensure personal hygiene of clients regularly.
o Dispose of contaminated syringes and needles properly to prevent accidents injuries to
hospital personnel as well as clients.
o Proper handling of catheters, drainage sets etc. is essential.
o Care should be taken while collecting and handling specimens.
o Regular wound care is to be institute properly to prevent infection.

PROTECTION OF SUSCEPTIBLE HOST:

This involves:
Protecting normal defence mechanism by:
o Regular bathing with adequate lubrication of skin.
o Regular oral hygiene
o Maintain an adequate fluid intake
o Encourage deep breathing and coughing exercises.
o Encouraging proper immunization of children and adults clients

Maintain healing processes:

This involves:
o Promotion of intake of a well balance diet containing essential proteins, vitamins, fats and
carbohydrates.
o Institution of measures to improve appetite of the patient.
o Promotion of the client’s comfort and sleep.
o Helping the clients to identify method to relieve stress.

ISOLATION PRACTICES

Isolation precaution controls the transmission of pathogens by prevention by prevention of direct

contact with the infected client. Barrier nursing or isolation technique is intended to confine the
micro-organism within a given and recognized area. There are various isolation techniques, which
are broadly classified two methods for implementation as given by Garner, Simmons, 1984.

These are:
o Disease-specific isolation method: certain practices are followed for each infectious disease,
e.g. chicken pox in which the client is placed in a private room with precaution to prevent
respiratory spread.
 o Category specific isolation: Diseases requiring similar isolation perceptions are grouped in
eight categories.

CATEGORY OF ISOLATION PURPOSE

Strict isolation Prevent transmission of highly contagious or
virulent infections spread by air and contact
Contact isolation Prevents transmission of highly transmissible
infections spread by close or direct contact that
do not warrant strict precautions.
Respiratory isolation Prevents transmission of highly transmissible
infections spread by close or direct contacts that
do not warrant strict precaution.
Enteric isolation Prevents infections transmitted by direct or
indirect contact with faeces.
Drainage and secretion precaution Prevents infections transmitted by direct or
indirect contact with purulent material or
drainage from an infected body site.
Universal blood and body fluid precautions. Prevents contact with pathogens transmitted by
(Blood Isolation) direct or indirect contact with infected blood or
body fluids containing blood.
Care of severely immuno-compromised clients. Protects the clients with lowered immunity and
resistance from acquiring infections organisms.

HAND WASHING

HAND WASHING is important in every setting, including hospitals. It is an effective infection

control measures, as it prevents spread of micro-organisms. For routine client care, the CDC
recommends a vigorous hand washing under a stream of water for at least 10 seconds using soap.

HAND WASHING SHOULD BE DONE:

o When there are known multiple resistant bacteria.
o Before invasive procedure.
o In special care unit, such as nurseries, ICUs and OTs.

PURPOSE:
o To remove transient and resident bacteria from fingers, hands and forearms.
o To prevent the risk of transmission of infection to patients.
o To reduce the risk of transmission of infection organisms to oneself.
o To prevent cross infection among clients.

EQUIPMENTS/ ARTICLES

ARTICLES RATIONALE
Soap in soap dish Soap contains antibacterial agents and has a

Nail brush
Running water
Towel
STEPS OF PROCEDURE
STEPS
File the nails short; ensure
that nails are free of nail
polish.
Remove all jewellery and
wrist watch.
Turn on the water to adjust
the flow so that water is
lukewarm.
MEDICAL ASEPSIS: wet
the hands thoroughly by
holding the hands above
elbow level during entire
procedure.
SURGICAL HAND
WASHING: wet hands and
forearm liberally, keeping
arms and hands above
elbow level during the entire
procedure.
Apply liberal amounts of
soap into hands and arms
using hand brushes.
Thoroughly wash and rinse
the hand using firm rubbing
and circular movements to
wash the palm, back and
wrist of each hand with six
lasting bacteria static effect.
To clean nails.
To rinse soap and thoroughly wash hands.
To dry hands
RATIONALE SCIENTIFIC NURSING
PRINCIPLES PRINCIPLES
Short nails are less likely to Microbiology Safety
harbour resident and
transient micro-organisms.
Micro-organisms can be -do- -do-
inside the settings of
jewellery and under rings.
Removal facilitates proper
cleaning of hands and
arms.
Warm water removes less Physics Comfort and
of the protective oil of the safety
skin than hot water.
It allows water to flows Microbiology Safety
from the least
contaminated area (elbow)
to more contaminated area
(hands).
Water run by gravity from Physics Safety
finger tips to elbows.
Keeping hands elevated
allows water to flow from
least to the most
contaminated area.
Soap emulsified the oil and Physics and Safety therapeutic
lowers the surface tension chemistry effectiveness
of water, facilitates the
removal of micro-organism
dust and oils. Brushes are
used to enhance
mechanical friction during
hand washing.
The circular action helps to Physics Safety
remove micro-organisms
mechanically. Running
water and friction used in
cleaning are the
steps of hand washing. Inter
lace the fingers during hand
washing.
Dry arms and hands
thoroughly from fingers to
wrist and forearms. Discard
the towel in a proper
container.
mechanical action of
cleaning.
Drying helps in removing Microbiology Safety
moisture, prevents Anatomy and
chapping and roughing of physiology
skin. Drying from cleaner
to least clean area prevents
contamination.

Turn off the water tap using Handle is contaminated. Microbiology Safety
a paper towel or using a Use of a paper towel or an
paper towel or using an elbow prevents
elbow. contamination of washed
hands.

SIX STEPS OF HAND WASHING:

LATEST NEWS RELATED TO HAND WASHING:

Newfoundland and Labrador's chief medical examiner says he believes the province has
experienced few deaths directly related to swine flu because people have been taking preventative
measures, such as washing their hands and getting vaccinations.

Health officials said Wednesday that 15 people who died in the province this fall were confirmed to
have contracted the H1N1 virus but a review of their cases by Dr. Simon Avis, the province's chief
medical examiner, found that influenza was only directly related to five of the deaths.

Earlier, it was believed that eight people had died from swine flu-related complications.

Avis said despite the lower number, people shouldn't think there has been an overreaction.
"Because we're not getting those deaths everyone's saying, 'Oh well, this is a dud, this is a false
alarm,'" Avis told CBC News. "Perhaps the reason we're not getting the deaths is because [of] what
public health has been doing," Avis said in reference to a health campaign urging people to wash
their hands properly.

"What the public has been doing in response, is working."

Avis said the H1N1 influenza has had a serious impact on the province, keeping intensive care units
at hospitals filled throughout the fall.

SUMMARIZATION:

o Definition of asepsis and medical asepsis

o The measures for control of transmission of infection and elimination of infectious agent.

o all the isolation techniques

o The hand washing procedure with all the articles used in it and with the rationale behind all
the steps.

o Latest news related to hand washing.

RSEARCH ABSTRACT RELATED TO HAND WASHING:

The effect of a soap promotion and hygiene education campaign on hand washing behaviour in
rural India: a cluster randomised trial.

Summary Objective: To investigate the effectiveness of a hygiene promotion intervention

based on germ awareness in increasing hand washing with soap on key occasions (after faecal contact
and before eating) in rural Indian households.
Methods Cluster randomised trial of a hygiene promotion intervention in five intervention and
five control villages. Hand washing was assessed through structured observation in a random sample of
30 households per village.
Additionally, soap use was monitored in a sub-sample of 10 households per village using
electronic motion detectors embedded in soap bars.
Observed hand washing with soap on key occasions was rare (6%), especially after faecal contact
(2%).
 Data from motion detectors indicated a significant but small increase in overall soap use in the
intervention arm. We cannot confidently identify the nature of this increase except to say that there was
no change in a key measure of hand washing after defecation.
Conclusion The intervention proved scalable and effective in raising hygiene awareness. There
was some evidence of an impact on soap use but not on the primary outcome of hand washing at key
times. However, the results do not exclude that changes in knowledge and social norms may lay the
foundations for behaviour change in the longer term.

M.M. COLLEGE OF NURSING

MULLANA (AMBALA)

PROCEDURE ON

TOPIC:
MEDICAL ASEPSIS
SUBMITED TO: SUBMITTED BY:
Mr. VIJAY GAUTAM Ms. Rashmi
LECTURER ( MED. SURG. NSG.) M. Sc. Nursing
M. C. O. N. Roll no- 04
Mullana (Ambala)