Group 6

Medical Asepsis /
Infection Control

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Topic:
01 Hand Washing
02 Cleaning and Proper
Waste Disposal
03 Disinfection

04 Sterilization

05 Aseptic VS Sterile
Techniques
Method of maintaining medical asepsis
INTRODUCTION
Method of maintaining medical asepsis

is concerned with world have forced all

eliminating the spread of
microorganisms through
facility practices.
Medical
Asepsis
health care workers to be
more vigilant in the
practice of infection
control in order to
protect themselves and
others from acquiring
infectious diseases

the state of being free
from disease causing
microorganisms
increasing incidence of
tuberculosis and various
forms of hepatitis in the
United States and
throughout the
. This makes the practice
of infection control
measures a necessity for
all who are working in,
being treated in, or
visiting health care
settings.
INFECTION CONTROL PRACTICES IN HEALTH CARE SETTINGS:

Dress in the Hand Gloves

Workplace Hygiene

Eye
Hair Protection
 Removing the Gloves:
Step 5
Wash your hands.
Steps
Step 1
With the gloved right hand,
take hold of the upper,
outside portion of the left
glove and pull it off, turning
it inside out as you do so
Step 4
Drop the soiled gloves
into a receptacle for
contaminated waste.
Step 3
With the clean, bare index and
middle fingers, reach inside
the top of the soiled glove and
pull it off, turning it inside out
and folding the first glove
inside it as you do so. Be
careful to touch only the inside
of the glove.
Step 2
Hold the glove that you
have just removed in the
palm of the remaining
gloved hand.
HAND WASHING

Hand Washing
Hand washing, also known as hand hygiene, is the act
of cleaning hands or the purpose of removing soil, dirt,
and microorganism.

Hands are the primary carriers of dirt,

viruses, and bacteria, as they can come into
contact with so many different surfaces
throughout the day.

Without proper hand washing, this could

easily lead to something harmful entering
the body, spreading elsewhere, or causing
cross-contamination
This technique must not be confused with the surgical aseptic scrub procedure described
later in this text. The medically aseptic hand-washing procedure is as follows:

1. Approach the sink. Do not lean against the sink or allow clothing to touch the sink because it is
considered to be contaminated. Remove any jewelry except for a wedding band.

2. Turn on the tap. A sink with foot or knee control is most desirable but is not always available. If the
faucet is turned on by hand, use a paper towel to touch the handles and then discard the towel.

3. Regulate the water to a comfortable warm temperature.

4. Regulate the flow of water so that it does not splash from the sink to one’s clothing.

5. During the entire procedure, keep hands and forearms lower than the elbows. The water will drain by
gravity from the area of least contamination to the area of greatest contamination.

6. Wet hands and soap them well. A liquid soap is the most convenient.

7. With a firm, circular, scrubbing motion, wash your palms, the backs of your hands, each finger,
between the fingers, and finally the knuckles. Wash to at least one inch above the area of contamination.
If hands are not contaminated, wash to one inch above the wrists. Fifteen seconds should be the
minimum time allotted for this.
8. Rinse hands well under running water. If hands have been heavily contaminated, repeat steps 6, 7,
and 8.

9. Clean fingernails with a brush or an orange stick carefully once each day before beginning work and
again if hands become heavily contaminated. Scrubbing heavily contaminated nails with a brush is
recommended.

10. Rinse fingers well under running water.

11. Repeat washing procedure as described above after cleaning nails.

12. Turn off the water. If the handles are hand- operated, use a paper towel to turn them off to avoid
contaminating hands.

13. Dry arms and hands using as many paper towels as necessary to do the job well.

14. Use lotion on hands and forearms frequently. It helps to keep the skin from cracking and thereby
prevents infection.
Mode of
Transmission
The mode (means) of transmission
is the route or method of transfer
by which the infectious
microorganism moves or is carried
from one place to another to reach
the new host.
Microorganisms are transmitted in the
following ways and in combination:

• Direct contact

• Indirect contact

• Droplet particles

• Airborne particles

• Common vehicle

• Vector borne
Direct contact transmission: Direct contact transmission
occurs when microorganisms are transferred by direct
physical contact with an infected or colonized individual.
Direct contact is one of the most common modes of
transmission.

Indirect contact transmission: Indirect contact

transmission involves transfer of microorganisms via an
object. Examples include, hands not washed between
residents, contaminated gloves, objects in the resident’s
bed space or environment, medical equipment, and/or
contaminated instruments. Indirect contact is also a
common mode of transmission.
Droplet transmission: Droplet transmission involves large droplets, ≥ 5
microns in diameter, that comes from the respiratory tract during coughing or
sneezing, or during aerosol generating procedures such as suctioning. These
droplets are propelled a short distance, through the air, and enter the nasal or
oral mucosa of the new host. Some microorganisms transmitted by this route.
Especially respiratory viruses, survive on objects in the immediate
environment of the resident. In these cases, droplets are also spread by direct
and indirect contact.

Airborne transmission: Microorganisms transmitted by this route are carried

by dust or other small particles floating in the air and are <5 microns in size.
Theses microorganisms remain suspended in the air and widely dispersed by
air currents. Susceptible hosts, who may be some distance away from the
source resident, even in different rooms inhale these microorganisms. Control
of airborne transmission is the most difficult, as it requires control of airflow
through special ventilation systems.
Common vehicle transmission: Common vehicle
transmission refers to transmission through a contaminated
source. Examples include food, medication, intravenous fluid,
or shared equipment that transmits infection to multiple
hosts. This transmission may result in a large-scale outbreak.

Vector borne transmission: Vector borne transmission refers

to infections caused by animals and insects. Examples of
these infections include, West Nile Virus and Dengue Fever.
Appropriate facility construction and maintenance, closed or
screened windows, and proper housekeeping prevent Vector
borne transmission. This type of transmission has not been
reported in Canadian hospitals.
Cleaning and Proper Waste Disposal

Not all disinfectants are Microorganisms . If such items

equally effective. Before a begin to grow in are used, they
disinfectant is chosen for disinfectant solutions should be
the diagnostic imaging left standing day changed and
department, it should be after day. This is also cleaned every
thoroughly studied by an true in liquid-soap 24 hours.
infection control consultant. containers
The following are guidelines for the disposal of waste or the cleaning of
equipment after each patient use in the diagnostic imaging department:

1. Wear a fresh uniform each day. Do not place your uniform with other clothing in your
personal closet. Shoes should be cleaned and stockings should be fresh each day.

2. Pillow coverings should be changed after each use by a patient. Linens used for drapes
or blankets for patients should be handled in such a way that they do not raise dust.
Dispose of linens after each use by a patient.

3. Flush away the contents of bedpans and urinals promptly unless they are being saved
for a diagnostic specimen.

4. Rinse bedpans and urinals and send them to the proper place (usually a central supply
area) for resterilization if they are not to be reused by the same patient.

5. Use equipment and supplies for one patient only. After the patient leaves the area,
supplies must be destroyed or re-sterilized before being used again.
 6. Keep water and supplies clean and fresh. Use paper cups in the diagnostic imaging
department and dispose of them after a single use.

7. Floors are heavily contaminated. If an item to be used for patient care falls to the floor,
discard it or send it to the proper department to be recleaned.

8. Avoid raising dust because it carries microorganisms. When cleaning, use a cloth thoroughly
moistened with a disinfectant

9. The radiographic table or other imaging or treatment equipment should be cleaned with a
disposable disinfectant towelette or sprayed with disinfectant and wiped clean and dried from
top to bottom with paper towels after each patient use.

10. When cleaning an article such as an imaging table, start with the least soiled area and
progress to the most soiled area. This prevents the cleaner areas from becoming more heavily
contaminated. Use a good disinfectant cleaning agent and disposable paper cloths.
11. Place dampened or wet items such as dressings and bandages into waterproof bags,
and close the bags tightly before discarding them to prevent workers handling these
materials from coming in contact with bodily discharges. Place in contaminated waste
containers.

12. Do not reuse rags or mops for cleaning until they have been properly disinfected and
dried.

13. Pour liquids to be discarded directly into drains or toilets. Avoid splashing or spilling them
on clothing.

14. If in doubt about the cleanliness or sterility of an item, do not use it.

15. When an article that is known to be contaminated with virulent microorganisms is to be

sent to a central supply area for cleaning and re-sterilizing, place it in a sealed, impermeable
bag marked “BIOHAZARD.” If the outside of the bag becomes contaminated while the article
is being placed in the bag, place a second bag over it.
16. Always treat needles and syringes used in the diagnostic
imaging department as if they are contaminated with virulent
microbes. Do not recap needles or touch them after use. Place
them immediately (needle first) in a puncture-proof container
labeled for this purpose. Do not attempt to bend or break used
needles because they may stick or spray you in the process.

17. Place specimens to be sent to the laboratory in solid

containers with secure caps. If the specimen is from a patient
with a known communicable disease, label the outside of the
container as such. Avoid contaminating the outside of the
container, and place the container in a clean bag. If a container
becomes contaminated, clean it with a disinfectant before
placing it in the bag. Specimens must be sent to the laboratory
immediately after collection for examination.

18. Medical charts that accompany patients to the diagnostic

imaging department must be kept away from patient care areas
to prevent contamination. Keep charts in an area where only
those directly involved in patient care may read them.
 Disinfection is a term
used to describe the
removal, by
mechanical and
chemical processes,
Disinfection of pathogenic
microorganisms, but
frequently not their
spores, from objects
or body surfaces.
 Things to Remember!
. If the patient is coughing and
sneezing, the patient must be
provided with tissues and a
place to dispose of them.
Instruct the patient to cough
and sneeze into the tissues
and then discard them safely.

In Radiology Department Patient w/ contagious disease

. Put on a mask and goggles, if

necessary. The patient should be cared
for and returned to his or her room or
discharged as quickly as possible. After
the patient has been cared for and
leaves the imaging department, wash
your hands thoroughly and then
disinfect the imaging table and anything
in the room that the patient has
touched.
• TRANSMISSION-BASED PRECAUTIONS (TIER 2)

Standard precautions to prevent spread

of infection are used daily for all
persons cared for in all health care
settings.

These precautions are presently called

transmission-based precautions or Tier
2 precautions and are designed to place
a barrier to the spread of highly
infectious diseases between persons
with such diseases and the persons
caring for them.
 Isolation precautions
are meant to
separate the
Airborne 01 04 patient who has
Isolation a contagious
illness from
Droplet other
02 05
Isolation hospitalized
patients and
from the health
Contact 03 06 care workers.
Isolation
 Airborne Isolation
•This method of
transmission occurs when
microbes are spread on
evaporated droplets that
remain suspended in air or
are carried on dust particles
in the air and may be
inhaled by persons in that
room or air space.
The following precautions are required:
• A private room, negative air-pressure
ventilation, and an N95 respirator mask
for health care workers; a surgical mask
for visitors; door closed
• Standard Precautions
• A surgical mask for a patient to be
transferred within the hospital
 Droplet Isolation
Transmission by droplets occurs
when droplets contaminated with
pathogenic microorganisms are
placed in the air from a person
infected with a droplet-borne
infection. This happens when a
patient sneezes, coughs, talks, or
deposits infection from his or her
eyes, nose, or mouth in other
ways, and these droplets are
inhaled or internalized in other
ways to an uninfected person.
The following are requirements for
precautions for disease spread by
droplet transmission:
• A private room or a room with
another person infected with the
same disease; door may be left open
• A mask for any procedure that
requires less than 3 feet in proximity
to the infected patient
• Standard Precautions
Contact Isolation
Two Types:
1. Direct contact occurs when a
susceptible person actually touches
an infected or colonized person’s
body surface in an area where
infectious microbes are present.
2. Indirect contact occurs when a
susceptible person touches or comes
into contact with an object that has
been contaminated with infectious
microorganisms.
The following are precautions to prevent
disease spread by contact:

• A private room or a room with another

person infected with the same disease if
the patient cannot be relied on to maintain
adequate precautions or is too young to do
so

• Gloves to be worn by health care workers

before entering the patient’s room and
removed before leaving it

• Wearing a gown if there is a possibility of

touching the patient or items in the room.
•Removing Contaminated Garments

65% 45% 80% 50% 90%

•Removing Contaminated Garments

65% 45% 80% 50% 90%

•Removing Contaminated Garments

65% 45% 80% 50% 90%

 Sterilizations
The process of killing
or removing bacteria
and other forms of
living microorganism.
Prevents the Growth of Diseases
In any Medical tool/device used,
bacteria comes onto it. If left
unchecked or not disinfected
properly, it is highly likely that
bacteria will grow.

-Prevents the Spread of

Diseases If surgical equipment is
not properly sterilized, patients
treated are exposed to a disease
the previous patient had.
Methods of
Sterilizations:
 Methods of Sterilizations:

Steam under Chemical Ethylene Oxide

Pressure Sterilization

Item are Referred to as Used for items

low-temperature that cannot
double- sterilization. withstand
wrapped An antimicrobial moisture and
and placed and sporicidal
high
agent must be
in an used.
temperatures
autoclave.
RULES FOR SURGICAL ASEPSIS
1. Know which areas and objects are sterile and
which are not.

2. If the sterility of an object is questionable, it is not

to be considered sterile.

3. Sterile objects and persons must be kept

separate from those that are non sterile.

4. When any item that must be sterile becomes

contaminated, the contamination must be remedied
immediately.

5. When tabletops are to be used as areas for

creating a sterile field, they must be clean, and a
sterile drape must be placed over them.

6. Personnel must be clothed in a sterile gown and

sterile gloves if they are to be considered sterile.
RULES FOR SURGICAL ASEPSIS
7. Any sterile instrument or sterile area that is
touched by a non sterile object or person is
considered contaminated by microorganisms.

8. A contaminated area on a sterile field must be

covered by a folded sterile towel or drape of double
thickness.

9. If a sterile person’s gown or gloves become

contaminated, they must be changed.

10. A sterile field must be created just prior to use.

11. Once a sterile field has been prepared, it must

not be left unattended as it may become
contaminated and presumed to be sterile.

12. An unsterile person does not reach across a

sterile field.
RULES FOR SURGICAL ASEPSIS
13. A sterile person does not lean over an unsterile
area.

14. A sterile field ends at the level of the tabletop or at

the waist of the sterile person’s gown.

15. Anything that drops below the tabletop or sterile

person’s waistline is no longer sterile and may not be
brought up to the sterile tabletop. The only parts of the
sterile gown considered sterile are the areas from the
waist to the shoulders in front and the sleeves from 2
inches above the elbow to the cuffs.

16. The cuffs of the sterile gown are considered non

sterile because they collect moisture. Cuffs must
always be covered by sterile gloves.

17. The edges of a sterile wrapper are not considered

sterile and must not touch a sterile object.
RULES FOR SURGICAL ASEPSIS
18. Sterile drapes are placed by a sterile person.
The sterile person places the drapes on the area
closest to him first to protect his sterile gown.

19. A sterile person must remain within the sterile

area. He must not lean on tables or against the wall.

20. If one sterile person must pass another, they

must pass back-to-back.

21. The sterile person faces the sterile field and

keeps sterile gloves above the waist in front of his
chest. The sterile person must avoid touching any
area of his body.

22. Any sterile material or pack that becomes damp

or wet is considered unsterile.
RULES FOR SURGICAL ASEPSIS
23. Any objects that are wet with disinfectant
solution and are to be placed on a sterile field must
be placed on a folded sterile towel for the moisture
to be absorbed.

24. A wet area on a sterile field must be covered

with several thicknesses of sterile toweling or an
impervious drape.

25. When pouring sterile solution, place the lid face

upward and do not touch the inside of the lid or the
lip of the flask. Pour off a small amount of solution
before the remainder is poured into the sterile
container.

26. When a sterile solution is to be poured into a

container on a sterile field, the container is placed at
the edge of the sterile field by the sterile person.
Opening Sterile Packs
To move a sterile object to another sterile field or to pass a sterile
object to a sterile person, the procedure is as follows:

1. Open the package as directed in Figure 5-5A-D.

2. Grasp the underside of the wrapper and let the edges fall over
the hand.

3. Take the item to the next sterile field and, from a distance, drop
or flip it onto the field. Do not allow the edges of the wrapper to
touch the sterile field.

4. A sterile forcep may be used to pick up a sterile object and move

it to a second field. The forcep may be used for one transfer only.

5. To pass a sterile object to a sterile person, grasp the underside

of the wrapper as in Figure 5-6 and hold it forward to the sterile
person so that he may take it. Do this away from the sterile field.
THE SURGICAL SCRUB
 Although the radiographer is not often the “sterile person” in the OR or the special
procedures rooms, he must be able to perform the surgical scrub if the situation calls for it.

Before
entering, the r If the
adiographer m radiographer is
ust change int not to scrub,
o a scrub suit, If ear studs are he must
cover hair w/ a worn, they perform hand
Remove all
cap, cover sho must be washing for 3
jewelry
es, and place covered minutes using
a mask over m by the cap. an antiseptic
outh & nose. soap.
The procedure in this text is adequate for
most cases. It is as follows:
1. Any person, including the radiographer, who will be present and unable to
protect himself from radiation must worn a lead apron prior to beginning the
scrub. Arms should be bare to at least 4 inches above the elbow.
2. Approach the sink. Adjust the water temperature and pressure. Most surgical
scrub areas have either foot or knee pedals to regulate water flow.
3. Obtain a scrub brush. Brushes must be single-use and disposable. Many
have an antimicrobial agent permeated through them. The hands and forearms
are wet to approximately 2 inches above the elbow. Hands must be held up to
allow the water to drain downward toward the elbow from cleanest to dirtiest
area. Apply the antimicrobial agent.
4. Scrub hands and arms using a firm, rotary motion. Fingers, hands, and arms
should be considered to have four sides, all of which must be thoroughly
cleansed. Follow an anatomical pattern, beginning with the thumb and
proceeding to each finger. Next, do the dorsal surface of the hand, the palm, and
up the wrist, ending 2 inches above the elbow. Wash all four sides of the arm.
The surgical scrub always begins with the hands because they are in direct
contact with the sterile field. Rinse the soap from hands and arms and repeat the
procedure
The procedure in this text is adequate for
most cases. It is as follows:

5. When the scrub is completed, drop the brush into the sink or
a receptacle prepared to receive used brushes. Do not touch
the sink or the receptacle. Hold hands up above the waist and
higher than the elbows during the surgical scrub.

6. Proceed to the area where a sterile towel, sterile gown, and

sterile gloves have been prepared.

7. Pick up the towel, which is folded on top of the sterile gown,

by one corner and let it drop and unfold in front of you at waist
level. Do not let the towel touch the scrub suit.

8. Dry one hand and one arm with each end of the towel. Do not
go over areas already dried.
 Putting the Gloves:
Step 4
Pull the glove over your
hand and over the cuff
of the gown (if you are
wearing a sterile gown)
in one motion.
Steps
Step 1
. Open the wrapper as
directed for opening sterile
packs. Sterile gloves are
always packaged folded
down at the cuff and
powdered so they may be
put on more easily.
Step 3
When the glove is over the hand,
leave it and pick up the left glove
with the gloved right hand under
the fold.
Step 2
Glove the dominant hand first.
Assuming that the right hand is the
dominant hand, pick up the right
glove with the left hand at the
folded cuff and slide the right hand
into the glove, leaving the cuff
folded down .
Aseptic Techniques VS Sterile Techniques
 Aseptic technique
80% 40%
means using practices and
procedures to prevent
contamination from pathogens. It
involves applying the strictest
rules to minimize the risk of
infection. Healthcare workers use
aseptic technique in surgery
rooms, clinics, outpatient care
centers, and other health care
settings.
four chief aspects of the aseptic technique
Patient & Equipment
Barriers
Preparation
protect the patient from
the transfer of Healthcare providers also
use sterile equipment and
pathogens from a
B BARRIERS healthcare worker,
from the environment,
sterile instruments. To
further protect the patient,
Contact they apply cleansing and
Guidelines or from both. bacteria-killing
SWOT P preparations to the

C PATIENT &
Environmental Controls
Maintaining a sterile
environment requires keeping
patient’s skin before a
procedure.
Contact Guidelines
EQUIPMENT
Environmental PREPARATION
doors closed during an
Once healthcare
Controls
E operation. Only necessary
health personnel should be at
the procedure. The more
providers have on sterile
barriers, they should only
people present, the more touch other sterile items.
opportunities for harmful They should avoid
bacteria to cause touching nonsterile items
contamination.
at all costs
Sterile Technique

- is a set of specific practices and

procedures performed to make equipment
and areas free from all microorganisms and
to maintain that sterility.

is most commonly practiced in operating

rooms, labour and delivery rooms, and
special procedures or diagnostic areas. It is
also used when performing a sterile
procedure at the bedside, such as inserting
devices into sterile areas of the body or
cavities

In health care, sterile technique is always

used when the integrity of the skin is
accessed, impaired, or broken. Sterile
technique may include the use of sterile
equipment, sterile gowns, and gloves
Differences between Aseptic and Sterile Technique

Aseptic means something has been made

contamination-free, that it will not
reproduce or create any kind of harmful
living microorganisms. Sterile describes a
product that is entirely free of all germs.
Basically, one is the removal of anything
that could contaminate an area, whereas
the other doesn’t discriminate bacteria or
germs and has none at all.
Thank You