ASEPSIS. PRPD/CIN2/2007. ASEPSIS. The term asepsis means the absence of disease-producing microorganisms. Concept of Asepsis. The nurse’s efforts to minimize the onset & spread of infection are based on the principles of aseptic technique .
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Medical asepsis & Surgical asepsis.
- Disposable object has to be discarded.
- Reusable objects must be cleansed thoroughly before disinfection
When cleaning equipment that is soiled by organic material such as blood, fecal matter, mucus or pus, the nurse applies a mask, protective eyewear, & waterproof gloves.
needed for cleaning.
Sterilization – is the process of eliminating and destroying all microorganisms, including spores & viruses.
1. Physical - boiling
2. Chemical - disinfectants
A) Types of microorganisms
Certain strains of bacteria are more resistant to destruction than vegetative forms.
B) Number of microorganisms present on articles
The more heavily contaminated the articles are, the harder for destruction.
- Cleanliness of items
- Unlocking all locked instruments
- Complete immersion of articles
Indications for use of Hospital Disinfectants:
1. Disinfection of skin & mucous membranes.
2. Disinfection of instruments & other items.
3. Decontamination of the inanimate environment.
1. Phenolics -
a) clear soluble fluids, e.g., 2% Printol. 1% Sudol
b) Hexachlorophene e.g., Phisohex, Gamaphene
- for wide range of antibacterial activity.
2. 70% - 75% Ethyl or Isopropyl Alcohol - for wide range of antibacterial activity, most active against TB.
3. Halogens - for inactivation of viruses and anti bacterial activity except TB. a) Chlorine (hypochlorites) e.g., Milton, Eusol. b) Iodine.
4. Glutardehyde, e.g., Cidex - wide range of antibacterial activity, very effective against Hepatitis B virus. Best for heat sensitive instruments.
5. Quaternary ammonium compounds e.g., Cetrimide (Cetavlon) - good detergent (more active against gram +ve organisms).
6. Diguanides, e.g., Chlorhexidine (Hibitane)
Chlorhexidine + detergent (Hibiscrub, Savlon) - useful skin ‘disinfectant’. Very active against gram +ve organisms.
-moist heat (Autoclave)
- dry heat (Hot Air Oven)
- in solution, e.g., Ethicon Fluid, Glutaraldehyde
- vapour, e.g., Formaldehyde
- gas, e.g., Ethylene Oxide
-ultra violet light
- gamma rays/cobalt 60
-applicable to pharmaceutical laboratory where it is used in combination with ultra violet light.STERILIZATIONThis process can be carried out by 4 methods:-
Gloves– The purpose of wearing gloves is both to protect the hands from contamination by micro-organisms and to prevent the transfer of micro-organisms already on the hands.
e.g., IV lines & buckets.
SEXUALLY TRANSMITTED DISEASES(STDs)
Wash hands before touching pts, before scrubbing & any time hands have been soiled.
- put on clean gloves just before contact with mucous membranes & non intact skin.
- wear appropriate gloves any time hands likely to have contact with moist body substances.
- remove gloves immediately after task is completed.
Wear any time it is likely that clothing or skin will be soiled.
- wear in OR / sterile area
-wear when working directly over large areas of open skin.
- wear when it is likely that nasal & oral mucous membranes will be spattered with moist body substances.
- Discard in rigid, puncture-resistant containers.
- Do not recap used needles by hand.
- Be particularly careful when manipulating small devices such as heparin locks.
- Assign patient with infectious disease to an individual OR or last on surgical list.
- Bag all soiled trash & linen securely.
- Discard according to facility policy.
- Wear gloves & protective garments when handling soiled linen & trash.
- Clean all rooms on regular schedule.
- Clean articles, equipment & furniture soiled with moist body substances immediately. Wear gloves.
- Handle all laboratory specimens with equal care. Special precautionary labels are required.
- Develop programme to ensure that health care workers comply with the infection precautions system.
(Florence Nightingale, 1859)