“5 Essential Principles of Medical and Surgical Asepsis: Isolation and Nursing Barriers for Infection Control”

Learn the 5 key principles of medical and surgical asepsis, isolation techniques, and nursing barriers for effective infection control. Guarantee patient safety with these essential practices in healthcare.

Medical and Surgical Asepsis

Types of Asepsis:

Medical Asepsis (Clean Technique):
A practice that confines microorganisms to a specific area to limit their growth and transmission. It prevents the spread of pathogenic micro organisms.

Principles of Medical Asepsis:

• Do not place soiled items on the floor.

• Avoid direct exposure of others to coughing or sneezing patients.

• Clean least soiled areas first

• Proper disposal of soiled materials.

• Avoid leaning on contaminated surfaces.

Components:

Hand washing.

Using gloves, gown, mask.

Disinfection of equipment.

Proper linen handling.

Surgical Asepsis (Sterile Technique):
Practices that keep areas free from all microorganisms, used for invasive procedures.

Principles of Surgical Asepsis:

• Sterile objects must only contact other sterile objects.

• Open sterile packages away from the body

• Avoid moisture on sterile fields.

• Hold sterile objects above waist level.

• Avoid talking or reaching over sterile fields.

• Do not leave sterile fields unattended.

• Use only sterile items in invasive procedures.

Components:

Surgical hand washing.

Sterile gloves and gowns.

Sterilization of tools.

Isolation and Precautionary Measures

Definition of Isolation:
Isolation is the practice of separating individuals with infectious diseases from healthy individuals. This practice prevents the spread of microorganisms to health personnel, patients, and visitors. It involves both voluntary and compulsory separation to control infections.

Types of Isolation Precautions:

Universal/Standard Precautions:

Aim to avoid contact with bodily fluids by using protective equipment like gloves, goggles, and face shields.

Transmission-Based Precautions:

Extra precautions based on the mode of infection transmission:

Contact Precautions: Prevents transmission through direct or indirect contact.

Droplet Precautions: Prevents transmission via close respiratory or mucous membrane contact.

Airborne Precautions: Prevents transmission of pathogens that stay airborne for long distances (e.g., tuberculosis, measles).

Types of Isolation:

1. Contact Isolation:
   Prevents the spread of infections through direct or indirect skin contact. Includes measures like wearing gloves and gowns.
2. Respiratory Isolation:
   Prevents airborne transmission of diseases over short distances. Masks are required for those near the patient.
3. Enteric Isolation:
   Prevents infections transmitted via contact with feces. Special handling of patient’s toilet articles and soiled linen is required.
4. Blood/Body Fluid Isolation:
   Prevents transmission of infections via contact with blood or bodily fluids, including precautions against needle-stick injuries.
5. Wound and Skin Isolation:
   Prevents transmission from purulent material or infected skin wounds (e.g., abscesses, burns).

Barrier Nursing:

1. A technique that confines microorganisms to a specific area using stringent infection control techniques. It includes standard precautions like hand hygiene. It also involves respiratory precautions. Safe injection practices are another key element. Additionally, the use of personal protective equipment (PPE) is essential.

These practices are crucial to controlling infection spread in healthcare settings.

Principles of Barrier Nursing in Infectious Diseases

1. Patient Room Setup:
   • The patient should be nursed in a single room equipped with a washbasin and a hot and cold water supply.
   • Surfaces should be washable, and cleaning protocols must emphasize thorough disinfection.
2. Hand Hygiene:
   • All personnel must wash their hands often and thoroughly before and after patient contact.
3. Restricted Access:
   • The number of people entering the room should be minimized. Those who do enter must use proper gown and mask techniques.
   • Specially assigned nurses should care for the patient to limit the risk of cross-infection.
4. Protective Clothing:
   • Visitors and healthcare personnel should wear disposable gowns, masks, and gloves to prevent contamination.
5. Dedicated Equipment:
   • Medical equipment (e.g., thermometers, sphygmomanometers) should stay in the patient’s room for the entire duration of their stay.
   • Patient charts should be kept outside the isolation room to prevent contamination.
6. Safe Disposal:
   • Toys for children must be washable or disposable, and there should be bins for incineration and for soiled linen.
   • Dressing, discharges, and contaminated items must be disposed of safely to prevent spread.
7. Room Cleaning:
   • Surfaces must be cleaned with antiseptic solutions, and vacuum cleaners should be disinfected. All cleaning materials used should be disposed of or incinerated.
8. Isolation for Specific Infections:
   • Strict isolation is required for patients with highly contagious conditions like boils, abscesses, gas gangrene, anthrax, or rabies. All patient-specific items must be kept separate.
9. Sterilization:
   • Nothing from the isolation room should be used outside without being sterilized. Staff should follow microbiology department guidelines for disinfecting equipment and surfaces.
10. Preventing Contamination:

• Nurses must avoid cuts or abrasions on their hands to reduce the risk of infection.

11. Disposable Items:

• Where possible, use disposable equipment (e.g., syringes, bedpans, towels) to reduce contamination risks.

12. Patient-Specific Items:

• Personal care items like towels, lotions, and creams must be used exclusively for the isolated patient. They must stay in the room throughout their stay.

Reverse Barrier Nursing:

Reverse barrier nursing is used to protect immunocompromised patients (e.g., post-transplant, leukemia patients, or those on cytotoxic drugs) from environmental microorganisms. It is also used in cases of head injury with dura mater damage. This damage can create a direct pathway between the environment and the brain.

Principles:

1. Filtered Air:
   • Air entering the room should be filtered and drawn from outside, not from internal corridors.
2. Thorough Cleaning:
   • The room should be thoroughly cleaned before the patient is placed in it.
3. Limited Access:
   • Only essential personnel should enter the room, and they must be in good health and keep strict hygiene.
4. Protective Gear:
   • All personnel must wear masks and protective gowns when entering the room.
5. Sterile Equipment:
   • All items and equipment used by the patient must be sterilized or brand new to prevent infection.

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COURSES

GNM

BSC NURSING

Read more: “5 Essential Principles of Medical and Surgical Asepsis: Isolation and Nursing Barriers for Infection Control”

“5 Essential Principles of Medical and Surgical Asepsis: Isolation and Nursing Barriers for Infection Control”

Aseptic Room Setup:
The medical and surgical asepsis process begins with isolating patients. They should be in a room with washable surfaces and access to water. All equipment should be designated for single-patient use.

Hand Hygiene:
Frequent hand washing is a cornerstone of asepsis. Both medical staff and visitors must adhere to strict hand-washing protocols to prevent contamination.

Proper Use of Protective Barriers:
The use of protective barriers like gowns, gloves, and masks is crucial in nursing barriers. This gear plays a significant role. Disposable protective gear reduces the risk of pathogen spread and maintains a sterile environment.

Restricted Access to Isolated Rooms:
The number of people entering the patient’s isolation room should be limited. Those entering must follow strict protocols. This isolation is a fundamental aspect of infection control.

Dedicated Equipment:
All medical equipment, from thermometers to syringes, should be dedicated solely to the patient in isolation. This prevents cross-contamination and maintains the aseptic environment.