GROUP 6 Costa, Ezekiel Santiago Magbitang, John Carlo Mallorca, Aldrin Nino

Principles of Aseptic Technique 1.Only sterile items are used within sterile field 2.Sterile persons are gowned and gloved 3.Tables are sterile only at table level 4.Sterile persons touch only sterile items or areas; unsterile persons touch only unsterile items or areas 5.Unsterile persons avoid reaching over the sterile field; sterile persons avoid leaning over unsterile area 6.Edges of anything that encloses sterile contents are considered unsterile 7.Sterile field is created as close as possible to time of use 8.Sterile areas are continuously kept in view 9.Sterile persons kept well contact within the sterile area 10.Sterile persons keep contact with sterile areas to minimum 11.Unsterile persons avoid contact with sterile persons 12.Destruction of microbial barrier contamination 13.Microorganism must be kept to an irreducible minimum

Asepsis is the prevention of microbial contamination during invasive procedures or management of breaches in the skins integrity. Asepsis literally means without micro-organisms.
Aseptic technique ensures that only uncontaminated objects/fluids make contact with sterile/susceptible sites, minimizing the risks of exposure to potentially pathogenic micro-organisms. Clean technique is a modified aseptic technique where the basic principle of an aseptic technique is used and clean gloves, clean field and non sterile solutions are used.

Sterilization (or sterilisation) is a term referring to any process that eliminates (removes) or kills all forms of microbial life, including transmissible agents such as fungi, bacteria, viruses, spore forms, etc. present on a surface, contained in a fluid, in medication, or in a compound such as biological culture media.

Sterilization as a definition terminates all life; whereas sanitization and disinfection terminates selectively and partially. Both sanitization and disinfection reduce the number of targeted pathogenic organisms to what are considered "acceptable" levels - levels that a reasonably healthy, intact, body can deal with. An example of this class of process is Pasteurization

Brief background ancient time Heat (flame) sterilization of medical instruments is known to have been used in Ancient Rome, but it mostly disappeared throughout the Middle Ages resulting in significant increases in disability and death following surgical procedures.

In general, surgical instruments and medications that enter an already aseptic part of the body (such as the bloodstream, or penetrating the skin) must be sterilized to a high sterility assurance level, or SAL. Examples of such instruments include scalpels,hypodermic needles and artificial pacemakers. This is also essential in the manufacture of parenteral pharmaceuticals.

Disinfectants are substances that are applied to nonliving objects to destroy microorganisms that are living on the objects. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than sterilisation, which is an extreme physical and/or chemical process that kills all types of life.

Disinfectants are different from other antimicrobial agents such as antibiotics, which destroy microorganisms within the body, and antiseptics, which destroy microorganisms on living tissue.

An autoclave is a device used to sterilize equipment and supplies by subjecting them to high pressure saturated steam at 121 C for around 1520 minutes depending on the size of the load and the contents
Autoclaves are widely used in microbiology, medicine, tattooing, body piercing, veterinary science, mycology, dentistry, and prosthetics fabrication

A medical autoclave is a device that uses steam to sterilize equipment and other objects. This means that all bacteria, viruses, fungi, and spores are inactivated.

Cleaning methods that do not achieve sterilization This is a brief list of cleaning methods that may be thought to "kill germs" but do not achieve sterilization. Washing in a dishwasher: Dishwashers often only use hot tap water or heat the water to between 49 and 60 C (120 and 140 F), which is not hot enough to kill some bacteria on cooking or eating utensils. Bathing can not sterilize skin, even using antibacterial soap. Disinfectants (for non-living objects) or antiseptics (for living objects such as skin) can kill or remove bacteria and viruses, but not all. Pasteurization of food also kills some bacteria and viruses, but not all.

In 2003, the Department of Health published Winning Ways a strategy for reducing healthcare associated infections It stated that Clinical teams will demonstrate consistently high standards of aseptic technique An aseptic technique is used to help prevent contamination of wounds and other susceptible sites by organisms that could cause infection. It should be employed during any procedure that bypasses the bodys natural defences or when handling invasive equipment such as intravenous cannula and urinary catheters.

Providing Safe Surgical Instruments: Factors to Consider

April 1, 2008

There are many steps involved with the preparation of sterile surgical instruments. All of these steps must be performed correctly to ensure a safe product for the patient. When shortcuts are taken, a failure in the process can result.

Training and Policies It is recommended that policies and procedures be developed, in-serviced and implemented for all cleaning, packaging and sterilization processes. The policies and procedures should be based upon accepted standards

Cleaning Cleaning is the removalusually with cleaning agent and waterof adherent visible soil (i.e., blood, pus, tissue, etc.) from the surfaces, crevices, serrations, jaws and lumens of instruments, devices and equipment, by a manual or mechanical process that prepares the items for safe handling and/or further decontamination.

Why is cleaning important?

The process of disinfection or sterilization is dependent upon direct contact of the sterilant or disinfectant with the surface of the items to be sterilized. Soils (e.g., blood, mucous, tissue) left on items can be "baked on" during sterilization. Sterilization is a multi-step process and proper cleaning is the first step in that process.

Ineffective cleaning may result in endotoxin accumulation. Endotoxins are potentially toxic, natural compounds commonly associated with pathogens such as bacteria. Classically, an endotoxin is a structural component of the bacteria which is released mainly when bacteria are lysed

Universal Precautions All used supplies and equipment are considered contaminated. The soiled instruments and devices should be collected and transported to the soiled utility or decontamination area in a manner that minimizes potential contamination of staff, patients or the environment.

METHOD -Breaking or bypassing the principles of sterility

MAN - Manpower - Competence - Lack of trainings - Proper endorsement of items PROBLEM - HEALTH HAZARD - INFECTION -VIOLATION OF PATIENT BILL OF RIGHTS

MATERIALS - Lack of OR instruments

MACHINE - Autoclave machine exhausted / in use

Chain of Infection

The Organism: What is the organism? Bacteria, virus, protist, parasite, or fungi? The type of organism informs you of the types of disinfectants, antiseptics and antimicrobials to use. Is it aerobic or anaerobic? What are its virulence factors? Toxin production in particular effect the course of the infection. What is its target host tissue? The Reservoir: Where do you find the organism in between outbreaks? What is the continual source of the infection? A reservoir can be environmental, the hospital setting or the water supply, or in a living organism, a rodent, bird or even snail. Humans are the only reservoir for many human pathogens. Portal of Exit: How does the organism leave the reservoir? Does it leave in feces, blood or mucus; in contaminated water; or in the blood meal of an insect. Transmission: How is the organism transmitted from one host to the next host? Does it need a living vector like a mosquito or flea? Some organisms like malaria have complicated life cycles involving more than one species. Can it be passed human to human? When passed human to human, it is transmitted by respiratory droplets, blood contact, semen or other secretions? Is it transmitted on the hands of health care workers or the hospital ventilation system? Hand-to-mouth is a common mode for gastrointestinal pathogens.

Portal of Entry: How does the organism enter the body? Does it come through inhalation, a break in the skin or mucus membrane, an insect bite, contaminated food? The portals of entry would be through the nose, skin, or mouth. Portal of entry tells you what type of personal protective equipment (PPE) to use to keep health care workers, family and visitors safe.
Vulnerable Populations: Who is most vulnerable to this organism? Common vulnerable populations are the very young and the very old, and the immune suppressed (due to genetics, transplant drugs, malnutrition, or viral infection like HIV). Occupational exposure should be considered. For many human pathogens, all of the non-immune are vulnerable. The non-immune are everyone who has not been previously exposed and generated a specific immune response to the pathogen. Previous exposure comes from either a previous infection or vaccination, or rarely with infection of a similar species that gives cross-immunity.

To produce an infection, there has to be a microorganism capable of causing human disease, someone susceptible to the micro-organism and a way of that micro-organism getting into the susceptible person. Asepsis breaks the chain in two places sterile equipment eliminates one potential source of micro-organisms and using effective techniques minimizes the likelihood of transmission of organisms from the staff member or environment to the client.

Declaration of patient rights 1) Right of appropriate medical care and humane treatment 2) Right to informed consent 3) Right to privacy and confidentiality 4) right of information 5) The right to choose health care provider and facility 6) Right to self determination 7) Right to religious belief 8) Right to medical records 9) Right to leave 10) Right to refuse participation in medical research 11) Right to correspondence and receive visitors 12) Right to express grievances 13) Right to be informed of his rights and obligations as a patient

Recommendation : - time to time inventory - compliance to asepsis and its technique - invest equipments