CMP INFECTION CONTROL.docx
- 1. ASEPSIS AND INFECTIONS CONTROL Introduction A lot of lives are lost every year due to the spreads of infections in hospitals. Health care workers are therefore required to take steps to prevent the spreads of these diseases within and outside the health facilities. Definition: Asepsis is defined as the state of being free from disease-causing contaminant (such as bacteria, viruses, fungi and parasites) Infection control is simply defined as a discipline concerned with preventing nosocomial infection (health associated infection), infection control can be achieved by ensuring that all medical and surgical procedures are performed using aseptic techniques. Medical Asepsis is any procedure intended to limit the number, growth and transmission of microorganisms Surgical asepsis is any procedure /practices that destroy all micro-organisms and their spores. JOSEPH LISTER is the founder of aseptic techniques. Definition of terms Sterilization: is the process of total destruction of microorganism and their spores ( both pathogenic and non –pathogenic ) Disinfection: this is the process of destruction of most pathogenic microbes (excluding bacterial spores) on inanimate object. Antiseptics: these are substances that destroy or inhibit the growth of microorganism on living tissue or reduce the possibility of infection. Examples are Dettol, Savlon, iodine, hydrogen peroxide and etc. Disinfectant: these are chemicals that destroy microorganism that are found on non-living objects e.g. Izal, chlorine, formaldehyde High level disinfection: this is destructions of all microbes, but spores may survive if initially present in large numbers usually through the use of drastic method such as the use of concentrated chemicals (e.g. formaldehyde), very high temperature or intense radiation. Decontamination: this is the process of removing foreign material such as blood, body fluids or radioactive substances from the objects, tissue or surfaces. It does not eliminate microbes completely, but it is a necessary
- 2. step before disinfection or sterilization. Its significance is to make something safe for handling by health workers. Principles of asepses in health care settings I. Only sterile object should touch sterile object II. Always hold sterile object above the waist III. Avoid talking, coughing, sneezing or reading over sterile field or object IV. All items brought in contact with broken skin or used to penetrate the skin in order to inject substances into the body or normally enter sterile cavities should be sterile V. Used dry sterile forceps always VI. Consider an object contaminated if you have any doubt as to its sterility VII. Any sterile package that is tempered with (e.g., syringe are considered contaminated) hence should not be used Signs of localized infection 1. Localized swelling 2. Localized redness 3. Pain or tenderness with palpation or movement 4. Loss of function of body part affected Signs of systemic infections 1. Fever 2. Increase pulse and respiratory rate if the fever is high 3. Malaise and loss of energy 4. Anorexia, nausea and vomiting 5. Enlargement and tenderness of lymph nodes that drain the area of i nfection Course of infections 1. Incubation period The time between the initial contact with infectious agent and appearance of first sign and symptoms
- 3. 2. Prodromal stage: the time period from the onset of non-specific symptoms to appearance of specific symptoms related to causative organism 3. Full stage : manifestation of specific signs and symptoms of infectious agent refer to as acute stage 4. Convalescence: time period that the host takes to return to pre-illness BBstage Method of sterilization and disinfection 1. Physical method: this includes i. Use of steam: applying high temperature and high pressure to destroy microorganism. Common example is autoclaving use to sterilize metal instrument, gowns, mask etc Disadvantage: plastics and rubber devices are damage by autoclaving. It also requires light. ii. Boiling water: this method is simple and inexpensive; just boil items for at least 10minutes from the time the water start boiling. Disadvantage: it is insufficient to destroy all microbes and it should be use where there is no autoclave iii. Dry heat: used for metal items. Heat with very high temperature for specified time. Disadvantage: Not very common iv. Radiation: used for drugs, foods, plastics and other heat sensitive items. Disadvantage: posed risk to personnel v. Chemical method: chemical solution is mostly used for disinfection and decontamination. Examples are sodium hypochlorite (JIK), alcohol, beta-dine etc. Disadvantage: it does not destroy all spores and may cause corrosion on metal surfaces. UNIVERSAL PRECAUTIONS Universal precautions are guideline to ensure prevention of transmission of blood borne diseases to and from health workers, the patient and the environm ent. Thorough these guidelines, all equipments are disinfected before and after use and are disposed of properly. The guidelines are as follows: The use of protective barrier (glove, mask, Google, etc)
- 4. Hand washing using antiseptic solutions and water Proper disposal and management of medical waste Injection safety Disinfection of instrument with 0.5% chlorine solution (common chlorine solution used in Nigeria are JIK, parazone and hypo Steps of universal precaution using chlorine solution Step 1. Decontamination: completely immerse all soiled instruments into the 0.5% chlorine solution. Make sure instrument are open, tubes are flushed allow to stand for 10minutes. Step 2. Cleaning: thorough cleaning with detergent and brush, Make sure all stains are removed. Step 3. Rinsing in clean water Step 4. High level disinfectant (HLD) Boiling: boil washed instruments for 20minutes, start counting from when water starts boiling. Remove for use or store. Remove instruments from solution using HLD cheatle forceps Rinse with boil water Place instrument on HLD tray or in HLD container then allow to dry Use of personal protective equipments PPE are equipment used by health workers to protect them from contacting infection from others/environment or spreading infection to others. They includes Masks Surgical and latex disposable gloves Gown Apron Boot Goggles
- 5. Masks protects contact of infection that are airborne, droplet infection, poisonous gasses etc eg TB exposure Surgical gloves: protect the health worker from contact with body fluid (e.g. blood, other body secretions) wound etc Gown: also protect the worker and the patient e.g. during surgery or conduct of delivery. Gown must be sterile Apron: protect worker from contact with body fluids e.g. blood. Always disinfect Boots: also worn by nurses, midwives and doctors especially in bloody areas eg labour room, theatre, accidents and emergency ward Goggle: worn over the eyes to protect it from splashes of body fluids e.g. blood, amniotic fluid etc