Surgical Asepsis

Poor hand hygiene - spread of germs from one patient to another or spread for hands to surfaces.

Hart (2004) states the principle of Aseptic Technique is to prevent the spread of micro organisms to wounds and to protects the nurse and patient from healthcare-associated infections (HCIA). The technique used for less invasive procedures such as intravenous drugs and wound care is the Aseptic No-touch Technique (ANTT) (Pratt et al 2007).

During this last visit, Dr. M made some mistakes which may have played a crucial role in Jacob acquiring an infection, or, in the least, contributed to negligence. After removing Jacob’s cast, Dr. M did not complete his examination of Jacob’s leg before he left the room to exam another patient, Sarah, in the room across the hall. Upon entering the room, he did not close the door. The most obvious mistake the doctor did was not washing his hands after his examination of Sarah, who has osteomyelitis, after which he returned to the first exam room to continue his examination of Jacob’s leg. Hand washing plays a major role in preventing cross-contamination when caring for patients. According to the Centers for Disease Control and Prevention (CDC, 2014), washing hands is an extremely important way to prevent the spread of infection from patient to patient or patient to health care professional. It is essential that all health care providers practice hand hygiene even if gloves are worn. There

This means aseptic technique and sterile gloves should be used for insertion and care of a CVC. Aseptic technique is critically important to protect patients from CLABSIs; infections are caused by either intrinsic (e.g. patients own flora) or extrinsic (e.g. surrounding environment) pathogens. Asepsis therefore removes patients skin flora and ensures flora picked up from either other patients or the surrounding environment is not introduced into the patient (Mollee et al., 2011).

Asepsis can be defined as the complete absence of bacteria, fungi, viruses or other microorganisms that could cause disease. Aseptic techniques refer to a set of skills that are used to ensure any environment being examined or dressed remains free from micro-organisms by not directly touching the wound or any other surface that might come into contact with the wound (McFerran and Martin 2008).

To prevent cross-transmission from one patient to another, health care workers must perform hand hygiene immediately before touching a patient or when entering a patient zone. The correct moment to perform hand hygiene before touching a patient is critical.5 Hand hygiene should be performed close to the site of care to avoid recontamination if hands come into contact with an object distant from the patient, such as a doorknob.4,5 Hand hygiene must be performed between the last hand-to-surface contact with an object located outside the patient zone and the first within the patient zone — ideally, immediately before touching the patient.5 Hand hygiene should also be performed just after leaving the patient and before touching any object located

Healthcare-associated infections (HAIs), also known as nosocomial infections, are any type of infection a patient develops while receiving treatment for another diagnosis. HAIs are considered the most frequent type of infections in healthcare. Healthcare-associated infections do not only appear in the healthcare setting, but can appear after discharge and while the patient is receiving treatment at home. Many of the HAIs occur when a patient needs an invasive procedure (catheter, central line, and surgery.) The risk of these infections can be decreased if the healthcare providers follow strict aseptic technique when needed, washes hands before and after any contact with a patient, and by monitoring the patient for the slightest sign of an infection.

8. Aseptic technique for invasive procedures: Aseptic technique aims to prevent pathogenic organisms, in sufficient quantity to cause infection, from being introduced to susceptible body sites by the hands of staff, surfaces or equipment. It protects patients during invasive clinical procedures by utilising infection prevention measures that minimise the presence of micro-organisms. Practicing aseptic technique, asepsis is ensured by performing a risk assessment before each procedure, identifying the key parts and key sites that are required to be kept sterile. This will ensure correct infection prevention measures are in place to perform aseptic technique safely and reducing the risk of a patient acquiring a healthcare associated infection. Infection prevention measures include: environmental controls, the use of personal protective equipment (PPE) , hand hygiene and non-touch technique. Generally, the more technically difficult (complex) procedures require more infection prevention measures.

Caregivers are trained to provide aseptic wound care, patients are closely monitored compared to their own home setting, and physicians are always nearby to reassess wounds as needed. So where do these infections come from? Literature reviews have opened the gateway to further questions and investigations in order to answer this question. Comparing multiple studies listed in table 1, there are still many unanswered questions as to where infections originate. Most studies are looking into various prevention methods and the organisms present postoperatively, but do not address the question of why these infections are occurring. Strengths and weaknesses in all studies show that one needs to evaluate the studies carefully before consideration for implementation as

The main priority in my workplace is to protect the patients, visitors and staff from the risk of acquiring a hospital-associated infection. Most of our patients are immune-compromised due to treatment or disease, so we introduced a zero tolerance approach to poor hand hygiene. It is universally recognized that the hands are the primary source of cross-infection and good hand washing techniques are the main factor to prevent infection (Weston, 2013). We have enforced good hand hygiene practice by ensuring that all staff members are up to date with the mandatory yearly training and observing the 5 moments of hand hygiene. Family/visitors of patients are

Many nosocomial infections are caused from pathogens in the hospital. Ironically, the healthcare facility can be viewed as the cause for nosocomial infections. Although direct contact is the primary cause of these infections, indirect contact with pathogens must be considered as well. Patients can be exposed to these pathogens in a number of ways, i.e. contact with other patients, improper sterilization of hospital equipment, as well as the lowered immunity the patients themselves present while healing. One-day procedures have become a common practice, especially for non-invasive procedures. While many are not fans of “drive-by surgery”, it has benefits of reducing patients’ exposure to these pathogens. The bedding, clothing, toys, handkerchiefs, and surgical instruments all can serve as vectors in the spread of infection (Hospital Acquired Infections and Prevention).

Handwashing has been clearly proven to prevent different diseases and is one of the most beneficial ways to protect others including oneself from infections. As simple as hand washing with plain or antimicrobial soaps appears, it has been projected that it can cut down hospital acquired infections. Hand hygiene can decrease the risk of respiratory infections by 16% (CDC, 2016). The CDC published in 2016, significant reduction at the national level close to all infections included compared to baseline data (CDC, 2016). Moreover, reductions in hospital on-site MRSA 13%, bacteremia and a 8% with C. difficile infections based on 2014, HAI Data and Statics (CDC, 2016). Again, the compliance rates when it comes to hand hygiene hospitals the law mandates to report their findings. In 2011 the statics showed, one in twenty-five hospital patients have had an HAI, with 772,000 HAI in the major acute hospitals in the United States (CDC, 2016). Various parameters are said to have an effect on hand hygiene compliance. Furthermore, it is estimated 30,000 deaths each year from nosocomial infections (CDC, 2016). According to CDC, one of them is said to be the time required for procedure education. The hospital personnel has been recommended to re-educate, provided with hand hygiene products that are effective. These entail the alcohol-based hand rubs. Alcohol sanitizers are antiseptic products with some level of alcohol ranging between 60 to 85 percent. This is meant to avoid the spread of pathogens (WHO, 2016). A shift in hand hygiene agent had been said to be beneficial for the hospitals which have not only exhibited a high workload, but also a great demand of for hand hygiene which can cause laziness and rush to wash their

at Sumter Surgical, says that one of the most important steps you can take to not spread germs is

Sterile surgical clothing or protective devices such as gloves, face masks, goggles, and transparent eye/face shields serve as barriers against microorganisms and are donned to maintain asepsis in the operating room. This practice includes covering facial hair, tucking hair out of sight, and removing jewelry or other dangling objects that may harbor unwanted organisms. This garb must be put on with deliberate care to avoid touching external, sterile surfaces with nonsterile objects including the skin. This ensures that potentially contaminated items such as hands and clothing remain behind protective barriers, thus prohibiting inadvertent entry of microorganisms into sterile areas. Personnel assist the surgeon to don gloves and garb and arrange equipment to minimize the risk of contamination.

1- Medical Asepsis:- the term medical asepsis mention those the use of practices to decrease the number, spread and growth of organisms. It is also called clean technique. In medical asepsis, objects are generally referred to as (clean) or (dirty), clean objects are considered that presence of many organisms that are usually not pathogenic. Common medical aseptic measures used for clean or dirty objects are hand hygiene, daily changing of linens, and daily cleaning of floors and hospital furniture(APIC, 2003).