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Interactive Training CD for Medical Students Reproductive System Module : Infection Prevention: A- and Antiseptic Techniques. Reproductive System, Medical School of Universitas Padjadjaran, Bandung 2005 MIR-C Corporate. in Surgical Setting. Production Team:.

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reproductive system medical school of universitas padjadjaran bandung 2005 mir c corporate

Interactive Training CD for Medical Students

Reproductive System

Module :

Infection Prevention: A- and Antiseptic Techniques

Reproductive System,Medical School of Universitas Padjadjaran, Bandung2005MIR-C Corporate

in Surgical Setting

production team
Production Team:
  • Director : Kiki Lukman, MD, MSc, FINACS (Dig.)
  • Script writer : Kiki Lukman, MD, MSc, FINACS (Dig.)
  • Main contributors : Kiki Lukman, MD, MSc, FINACS (Dig.)

Yayat Ruchiyat, MD, FINACS (Dig.)

Warko Karnadihardja, MD, FINACS (Dig.)

Nurhayat Usman, dr., SpB-KBD

Lisa Hasibuan, MD

Nina K. Poetri T., SKp,

Dadang Sunarya AMK

Dedy Rusnadi AMK,

Alia Rahmi AMK,

  • Editorial Team : Kiki Lukman, MD, MSc, FINACS (Dig.)
  • Casting : Kiki Lukman, MD, MSc, FINACS (Dig.)
  • Artistic : MIR-C Corporate
  • Productions : Medical School of Universitas Padjadjaran

Bandung

credits
Credits
  • Special thanks to:
  • Central Operating Theatre Unit of Hasan Sadikin General Hospital
infection prevention module
Infection Prevention Module

Introduction

Infection control

Antiseptic techniques

Operating Theater

Aseptic techniques

introduction

Introduction

Description

Objectives

description
Description
  • Infection Prevention in Surgical Setting is one of important preventive methods in order to achieve infection control in clinical and surgical practices.
objectives
Objectives
  • The aims of this method are :
    • To minimize surgical site infection
    • To protect health personnel
    • To improve wound healing
    • To minimize disability, morbidity, & mortality
    • To reduce the cost of hospital care
specific learning objectives
Specific Learning Objectives :
  • To describe the definition and history of sterilization, disinfection, decontamination, anti and a - septic techniques.
  • To describe six methods of sterilization.
  • To describe three categories of surgical instruments
  • To describe 6 rules of aseptic techniques
specific learning objectives1
Specific Learning Objectives :
  • To perform aseptic techniques correctly, including (P5):
    • Applying surgical attire
    • Hand washing
    • Surgical scrubbing
    • Gloving
    • Surgical Gowning
definition
Definition:
  • Sterilization : Processes by which all pathogenic & non pathogenic microorganisms, including spores, are killed.
  • Disinfection: Chemical or physical process of destroying all pathogenic microorganisms, except spore bearing ones; used for inanimate objects, but not on tissues.
definition1
Definition:
  • Decontamination : Process or method by which all contaminated materials that can cause diseases are removed.
  • Aseptic techniques : Methods by which contamination with microorganisms is prevented.
  • Antiseptic techniques: Prevention of sepsis by the exclusion, destruction, or inhibition of growth and multiplication of microorganisms from body tissues and fluids.
historical backgrounds
Historical backgrounds :
  • Ignas Sammelweis (1818 - 1865)
    • Puerperal fever  increased maternal mortality
    • Hand scrub with chlorinated-lime solution prior to examination.
    • Father of nosocomial infection.
  • Louis Pasteur (1860)
    • Discover the process of fermentation by microorganisms
    • Germ theory: against spontaneous generation theory.
historical backgrounds1
Historical backgrounds :
  • Joseph Lister (1865)
    • Use carbolic acid solution on surgical dressing in the operating room  mortality  (Listerization)
    • Father of modern surgery (Antiseptic technique)
  • Ernst Von Bergmann (1886)
    • Introduced “steam sterilizer”
    • Basic of sterilization  aseptic technique
    • Later: “pressure & vacuum steam sterilizer” was developed
methods of infection control
Methods of Infection control
  • Anti septic techniques
  • Design and traffic patterns of the operating theatre
  • Aseptic techniques
sterilization
Sterilization
  • The objective of modern surgery
  • For inanimate objects
  • Problem :
    • Some items are not heat resistance
techniques of sterilization
Techniques of Sterilization
  • Physical:
    • Heat
    • Radiation/ ultraviolet ray
    • Boiling water
    • Ultrasound
  • Chemical:
    • Liquid
    • Gas
heat sterilization
Heat Sterilization
  • Dry :
    • Commonly cause damage
    • For powder, oils, and jelly
  • Moist :
    • Steam
    • High pressure   spores 
    • Vacuum  constant temperature
    • Autoclave
chemical sterilization
Chemical Sterilization
  • Generally as disinfection
  • Mechanism of action :
    • Protein coagulation
    • Enzyme denaturation in cells
    • Lysis
  • Depend on : number of microorganisms, soiling, concentration, and temperature.
solutions
Solutions
  • Jodium and Jodophor
    • Good bactericide, but irritant
    • Mixture : povidone-jodine 10%
  • Alcohol Solution of 70% or 90%
  • Glutaraldehyde (Formaldehyde Sol. in Alcohol 2%)
    • Spores are killed within 3 hours
solutions1
Solutions
  • Hexachloropene (Halogenated phenol)
    • Bacterio-static, particularly Gram (+) bacteria
    • For scrubbing
  • Chlorhexidine gluconate
    • Bactericide : Gram (+) & (-).
    • Good for antiseptic
gas sterilization
Gas Sterilization
  • Formaldehyde
  • Ethilene-oxide
  • - propionolactone
boiling water
Boiling Water
  • Mild boiling
  • Vigorous boiling
  • More active, if 2% sodium-carbonate or 0,1 % sodium-hydroxide being added
the operating theater
The Operating Theater

Clean

Zone

S

C

R

U

B

S

U

I

T

Transitional

Zone

Sterile

core

Restricted area

Semi –

Restricted

Area

traffic patterns of operating theatre
Traffic patterns of Operating Theatre
  • The use of aseptic principles requires regulation of traffic and flow patterns of the personnel, patient, equipment, and supplies in operating theatre
  • Aims : to protect the safety and privacy of patients and the cleanliness and integrity of the environment.
unrestricted area
unrestricted area
  • Elevators
  • Corridors outside surgical suite
unrestricted area1
unrestricted area
  • Entrance
  • Reception desk
  • Patient suite
transitional zone video
Transitional Zone (Video)
  • Locker room
  • Dressing room
clean zone video
Clean Zone (Video)
  • Surgical suite and corridors
  • Sterile core
putting on surgical attire
Putting on surgical attire
  • In the semi & restricted area:
    • Scrub suit : shirt & trousers
    • Hair covering: surgical cap/hood
    • Masks : disposable/ re-useable
    • Goggle (optional): protective eyewear
    • Shoe covers

are compulsory

surgical attire
Male personnel

Female personnel

Personnel with veil

Surgical attire
surgical instruments in the operating theatre
Surgical Instruments in the Operating Theatre
  • Critical items :
    • Sterile, because of being used for penetrating skin or mucosa
  • Semi critical items :
    • In contact with skin or mucous membrane
  • Non critical items :
aseptic techniques1
Aseptic techniques
  • Rules at clean zone
  • Procedures in sterile area
  • Talk as necessary
  • Restrict unnecessary movements
  • Sterile instruments, remove non sterile one
  • Avoid & Replace wet surgical drapes/towels
hand washing
Hand washing
  • Indications:
    • Between patient contacts
    • Before performing or assisting with invasive procedures
    • Before taking care of particularly susceptible patients
    • Before and after touching wounds
    • Immediately after gloves are removed
hand washing1
Hand washing
  • Before and after performing sterile procedures
  • After contact with blood or body substances, mucous membranes, soiled linen, waste, or contaminated equipment.
  • Between tasks at different body sites on the same patient to prevent cross contamination
  • After taking care of infected patient
  • After touching contaminated inanimate sources
purposes
Purposes:
  • To remove debris and transient organisms from the nails, hands, and forearms.
  • To reduce the resident microbial count to a minimum.
  • To inhibit rapid rebound growth of microorganisms.
purposes1
Purposes:
  • To minimize the re-growth of microorganisms for the length of the procedure.
  • To reduce the numbers of microorganisms on hands
  • To reduce contamination of the operative site by recognized or unrecognized breaks in surgical gloves.
actual procedure strokes technique
Actual procedure: Strokes technique
  • Rinsing hands & arms
  • Scrubbing with antiseptic solution
  • Rinsing arms
  • Scrubbing with brush or sponge
  • Rinsing arms
  • Scrubbing with antiseptic solution
  • Drying arms
gowning
Gowning
  • The goal:
    • to ensure a safe, protective, and aseptic environment to the patient and the surgical team.
gowning closed gloving techniques
Gowning & closed gloving techniques
  • Drying hands with sterile towel
  • Applying gown
  • Closed gloving technique
slide53
The final step of the aseptic techniques before performing surgery.
  • Sterile gloves are worn to permit the wearer to handle sterile supplies or tissues of the operative wound.
slide54
Sterile gloves establish a shield that protects the patient from contamination by flora from the hands of health care workers.
skin preparation
Skin preparation
  • The goals:
    • to cleanse the skin and bring both the resident and transient bacterial counts to an irreducible minimum, therefore reducing the risk of wound contamination and subsequent surgical site infection.
  • performed just before the surgical incision has been performed.
skin preparation1
Skin preparation
  • Skin painting
  • Skin draping
gown and gloves removal
Gown and gloves removal

After surgery:

  • Gown, Gloves removal
  • Simultaneous removal