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Module E OBJECTIVES
PRINCIPLES AND PRACTICES OF • Describe the principles and practice of asepsis
ASEPSIS
• Understand the role of hand hygiene in asepsis
Statewide Program for Infection Control and Epidemiology • Understand the role of the environment in disease
(SPICE)
UNC School of Medicine transmission
DEFINING ASEPSIS MEDICAL ASEPSIS
Medical asepsis, also known as “clean
Medical Asepsis Surgical Asepsis technique” is aimed at controlling the
Definition Clean Technique Sterile Technique number of microorganisms and is used for
all clinical patient care activities.
Emphasis Freedomfrom most Freedomfrom all pathogenic Necessary components of medical asepsis
pathogenic organisms organisms
include:
Purpose Reduce transmission of Prevent introduction of any • Knowing what is dirty versus clean versus
pathogenic organisms from organism into an open
one patient‐to ‐another wound or sterile body cavity sterile
• How to keep the first three conditions
separate
(Free from disease producing microorganisms) • How to remedy contamination immediately
PRINCIPALS OF MEDICAL ASEPSIS SURGICAL ASEPSIS
SURGICAL ASEPSIS PRINCIPLES OF SURGICAL ASEPSIS
Surgical asepsis, also known as “sterile • The patient should not be the
technique” is aimed at removing all source of contamination
microorganisms and is used for all • Healthcare personnel should not
surgical/sterile procedures. be the source of contamination
Necessary components of surgical asepsis • The hand scrub should be done
include: meticulously
• Knowing what is and what is not • Recognize potential environmental
sterile
• How to keep the first two conditions contamination
separate • Keep door closed
• How to remedy contamination • Keep traffic to a minimum
immediately
KNOWLEDGE CHECK ROLE OF HAND HYGIENE
Which of the following is True?
1. Surgical asepsis should be used for all patient care
activities
2. “Clean technique” is used for all procedures done in
ambulatory care
3. Clean and dirty equipment can be stored together as
long as they are not touching
4. The goal for medical asepsis is freedom from all
pathogenic organisms
WHAT IS HAND HYGIENE? THE ROLE OF HAND HYGIENE
• Handwashing with soap and water
• Antiseptic handwash
• Alcohol‐based hand rub
• Surgical antisepsis
THE ROLE OF HAND HYGIENE THE ROLE OF HAND HYGIENE
Present on the Transferred to 34 STUDIES: 1981-2000
skin or near by healthcare workers • Mean baseline rates:
objects hands 5%-81%
• Overall average:
< 40%
Survive for Compliance
several Hand Hygiene
minutes omitted or Direct contact
inadequate with patients or
equipment
REASONS FOR NONCOMPLIANCE POTENTIAL ADVANTAGES
ALCOHOL‐BASED HANDRUBS
• Inaccessible hand hygiene supplies • Requires less time than hand washing
• Skin irritation • Acts quickly to kill microorganisms on hands
• Too busy • More effective than hand washing with soap and water
• Glove use • More accessible than sinks
• Didn’t think about it • Less irritating to skin than soap and water and can even
• Lacked knowledge improve condition of skin
WHEN TO PERFORM HAND HYGIENE HOW TO HAND RUB
The 5 Moments Consensus recommendations Video Clip: To start video click on image.
WHO CDC Guidelines on Hand Hygiene in healthcare, 2002
1. Before touching • Before and after touching the patient
a patient
2. Before clean / • Before donning sterile gloves for central venous catheter insertion; also for insertion of
aseptic other invasive devices that do not require a surgical procedure using sterile gloves
procedure • If moving from a contaminated body site to another body site during care of the same
patient
3. After body fluid • After contact with body fluids or excretions, mucous membrane, non-intact skin or
exposure risk wound dressing
• If moving from a contaminated body site to another body site during care of the same
patient
• After removing gloves
4. After touching • Before and after touching the patient
a patient • After removing gloves
5. After touching • After contact with inanimate surfaces and objects (including medical equipment) in the
patient immediate vicinity of the patient
surroundings • After removing gloves
HOW TO HAND WASH
HOW TO HAND RUB Video Clip: To start video click on image.
• The use of an
alcohol based hand
rub is preferential to
hand washing when
hands are not
visible soiled:
HOW TO HAND WASH HAND HYGIENE PROGRAM
ADDITIONAL ELEMENTS
• Hand washing with CDC GUIDELINE FOR HAND HYGIENE IN HEALTHCARE SETTING
soap and water should • Involve staff in evaluation and selection of hand hygiene
be used when hands products
are visible soiled or • Provide employees with hand lotions/creams compatible
contaminated with with soap and/or ABHRs
blood and/or body • Do not wear artificial nails when providing direct clinical
fluids and after care
providing care for • Provide hand hygiene education to staff
patients with diarrhea: • Monitor staff adherence to recommended HH practices
SUMMARY OF HAND HYGIENE KNOWLEDGE CHECK
Hand hygiene must be performed exactly where you are delivering healthcare
to patients (at the point‐of‐care).
During healthcare delivery, there are 5 moments (indications) when it is True or False:
essential that you perform hand hygiene. Hand washing with soap and water is always
To clean your hands, you should prefer hand rubbing with an alcohol‐based the preferred method of hand hygiene
formulation, if available. Why? Because it makes hand hygiene possible right at
the point‐of‐care, it is faster, more effective, and better tolerated.
You should wash your hands with soap and water when visibly soiled.
You must perform hand hygiene using the appropriate technique and time True False
duration.
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