🔴 Nosocomial Infection & Asepsis: Hand Washing Tips for Nursing Students

Learn nosocomial infection prevention, asepsis techniques, and essential hand washing tips for nursing students. Improve patient safety and hygiene.

Health Care-Associated Infection (Nosocomial Infection)

What is Nosocomial Infection?

• Nosocomial infections are infections acquired in hospitals or healthcare settings.
• Also called Hospital-Acquired Infections (HAIs).
• Occurs 48 hours after hospital admission or within 30 days after discharge.
• Caused by antibiotic-resistant organisms.

Who is at Risk?

• All hospitalized patients, but higher risk for:
  • Young children and elderly
  • Patients with weak immune systems
  • Long hospital stays
  • Use of catheters and medical devices
  • Poor hand hygiene by healthcare workers
  • Overuse of antibiotics

Why are Nosocomial Infections Common?

• Hospitals have many sick people with weak immune systems.
• Frequent movement of staff between patients spreads infections.
• Some medical procedures bypass the body’s natural protection.
• Unclean hospital environments and equipment.

How are Nosocomial Infections Spread?

• Direct Contact (Patient to patient, Staff to patient, Patient to visitors)
• Indirect Contact (Contaminated medical instruments, Hospital equipment)
• Through Air (Aerosols)
• Through Vectors (Flies, insects)

Common Sites and Causes of Nosocomial Infections

1. Urinary Tract Infections

• Caused by catheter use, poor hand hygiene, contaminated equipment.
• Reflux of urine from the bag to the bladder.

2. Surgical Wound Infections

• Caused by improper sterilization, poor handwashing, unclean dressing materials.

3. Bloodstream Infections

• Due to contaminated IV fluids, needles, or improper care of insertion sites.

Prevention of Nosocomial Infections

1. Hand Hygiene: Wash hands properly for at least 20 seconds with soap and water.
2. Use of Protective Equipment: Wear gloves, gowns, masks, and face shields when necessary.
3. Proper Cleaning and Disinfection:
   • Clean hospital rooms and equipment with disinfectants regularly.
   • Linens should be sanitized and changed daily.
4. Infection Control Policies:
   • Identify high-risk patients.
   • Isolate contagious patients.
5. Education and Training:
   • Healthcare workers should receive infection control training regularly.
6. Safe Medical Practices:
   • Proper use and care of catheters and IV lines.
   • Avoid overuse of antibiotics.

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Asepsis

Asepsis is the absence of disease-causing microorganisms. It helps prevent infections, especially during medical procedures.

Types of Asepsis

1. Medical Asepsis (Clean Technique)
   • Reduces the number of microorganisms and prevents their spread.
   • Examples: Handwashing, wearing gloves, cleaning surfaces.
2. Surgical Asepsis (Sterile Technique)
   • Eliminates all microorganisms, including spores.
   • Used in surgeries and invasive procedures.

Aseptic Techniques

Aseptic techniques help prevent infections by maintaining cleanliness.

Aims of Aseptic Technique

• Prevent infections in patients.
• Stop the spread of microorganisms.
• Protect healthcare workers from infections.

Indications for Aseptic Technique

Used during procedures like:

• Wound care and suturing.
• Inserting catheters, IV lines, and tubes.
• Surgical procedures and biopsies.

Principles of Medical Asepsis

• Wash hands before and after patient contact.
• Wear gloves and masks when needed.
• Keep soiled items separate from clean ones.
• Dispose of waste properly to prevent contamination.
• Avoid touching face, nose, or mouth while handling sterile items.

Principles of Surgical Asepsis

• Only sterile objects can touch other sterile objects.
• Open sterile packages carefully to avoid contamination.
• Use sterile drapes to create a sterile field.
• Do not talk, cough, or sneeze over a sterile field.
• Never turn your back on a sterile field.
• Consider the outer 1 inch of a sterile field contaminated.

Differences Between Medical and Surgical Asepsis

Medical Asepsis (Clean)	Surgical Asepsis (Sterile)
Reduces microorganisms	Eliminates all microorganisms
Prevents the spread of germs	Used in surgeries & invasive procedures
Uses clean techniques (e.g., handwashing)	Uses sterile techniques (e.g., surgical dressing)
Gloves protect the worker	Sterile gloves protect the patient

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Hand Hygiene

Hand hygiene is the most effective way to prevent infections and stop the spread of harmful germs. It includes hand washing with soap and water and the use of hand rubs (sanitizers).

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Hand Washing

Definition:
Hand washing is the process of rubbing hands with soap and water to remove dirt, germs, and microorganisms.

Purpose:

• Removes harmful germs from the hands.
• Prevents infections in patients and healthcare workers.

When to Wash Hands? (as per Gamer and Favero, 1985)

1. Before touching patients.
2. After patient contact.
3. After exposure to body fluids.
4. Before invasive procedures (e.g., injections).
5. Before and after wound care.
6. After handling contaminated equipment.
7. Between contacts in high-risk areas.
8. After removing gloves.

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Hand Washing Procedure

Materials Required:

✅ Running water (preferably warm)
✅ Antimicrobial or regular soap
✅ Clean towel

Steps for Hand Washing:

1️⃣ Wet hands under running water. Keep hands lower than elbows.
2️⃣ Apply soap and rub palms together in circular motions.
3️⃣ Rub the back of each hand with interlaced fingers.
4️⃣ Interlock fingers and rub between them.
5️⃣ Rub the back of fingers against opposite palms.
6️⃣ Rub thumbs in the opposite hand using a rotating motion.
7️⃣ Rub fingertips in circular motions on opposite palms.
8️⃣ Rub wrists, then rinse hands under running water.
9️⃣ Dry hands with a clean towel.

💡 Wash hands for at least 15-20 seconds as recommended by the CDC.

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Surgical Hand Washing

Surgical hand washing is a more thorough process to eliminate all microorganisms, including spores and pathogens.

Materials Required:

✅ Antimicrobial soap/antiseptic solution
✅ Running warm water
✅ Nail brush
✅ Sterile towels

Procedure:

1️⃣ Remove jewelry and roll up sleeves.
2️⃣ Check hands for cuts or wounds.
3️⃣ Wet hands and forearms under running water.
4️⃣ Apply antiseptic soap and scrub hands, nails, and arms up to elbows.
5️⃣ Use a nail brush to clean under nails.
6️⃣ Rinse hands under running water, keeping hands above elbows.
7️⃣ Dry hands with a sterile towel, using separate sides for each hand.
8️⃣ Avoid touching anything before wearing sterile gloves.

💡 Key Points:
✔ Always wash from least contaminated (elbows) to most contaminated (hands).
✔ Keep hands above elbows to prevent contamination.
✔ Do not touch the faucet after washing.

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Use of Hand Rub (Hand Sanitizer)

💡 When soap and water are unavailable, use an alcohol-based hand rub.

Steps:

1️⃣ Apply a small amount of sanitizer (at least 60% alcohol).
2️⃣ Rub palms together.
3️⃣ Rub the back of hands and between fingers.
4️⃣ Rub thumbs and fingertips.
5️⃣ Continue rubbing until hands are dry.

✔ Quick and effective for killing germs.
❌ Does not remove visible dirt or grease.

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