|
Std./Reg.: JCAHO:
IC.2
|
Approved by:
|
I)
PURPOSE:
To delineate basic concepts
underlying the practices of asepsis
II)
POLICY:
Microorganisms are capable of
causing illness in humans and can be transmitted by direct or indirect
contact. Illness caused by microorganisms can be prevented by
interrupting the transmission of microorganism from reservoir to
susceptible host.
III)
DEFINITIONS:
A)
Asepsis is defined as the absence of pathogenic
(diseased-producing) microorganisms.
B)
"Cleaning" is the physical removal of soil or organic
material from objects using water and mechanical action with or without
detergent; cleaning removes rather than kills microorganisms.
C)
"Sterilization" is the process of complete destruction of
all forms of microbial life (bacteria, fungi, spores, and viruses) by
chemical or physical processes (e.g., steam under pressure, dry heat,
ethylene oxide gas, liquid chemicals).
D)
"Disinfection" falls between the processes of physical
cleaning and sterilization as the elimination of disease producing
microorganisms, but not spores, from inanimate objects via pasteurization
or liquid chemicals.
E)
Chemical germicide and chemical sterilants.
1)
A germicide is a disinfectant that can be used on living tissue as
well as on inanimate objects.
2)
"Chemical sterilant" is a disinfectant or germicide that
is used to destroy all forms of microbiologic life, including spores
(fungal and bacterial).
3)
Note: Dependent upon exposure or contact, some types of
germicides can be used for either disinfection or sterilization.
F)
"Decontamination" is the process of removing pathogenic
(disease-producing) microorganisms from objects, thus
rendering them safe to handle.
IV)
PROCEDURE:
A)
"Clean technique" refers to practices that reduce the
numbers of microorganisms or prevent or reduce transmission from one person
(or place) to another.
1)
Reduce numbers of skin microorganisms by hand washing or cleaning.
a)
care situations .
b)
to increase the amount of soil removed.
c)
Clean from areas of clean to areas that are less clean.
2)
Use barrier techniques to reduce microbial transmission from
patient to personnel.
a)
Use "no-touch" dressing technique to avoid contamination
of sterile supplies (or sterile gloves for dressing for application).
b)
Wear clean gown of apron to minimize contamination of clothing.
c)
Wear clean gloves to avoid direct contact with infectious
materials.
d)
Select room placement for patients according to transmission risk
(e.g., private room, room with negative pressure, cohorting).
3)
Provide environmental controls to reduce microbial transmission.
a)
Use negative-pressure rooms for patients with infectious agents
spread by the airborne route.
b)
Clean the environment routinely.
1)
Use clean equipment and supplies: Mops, water, cleaning
cloths.
2)
Use detergent for removal of soil.
3)
Use germicidal agent for cleanup of blood or body fluids.
B)
"Surgical technique" refers to practices designed to
render and maintain objects and areas maximally free from microorganisms.
1)
Provide maximum reduction of skin microorganisms without damaging
tissue.
a)
Use soap product initially to remove soil.
b)
Use antimicrobial agent; may leave residual to continue microbial
suppression effect.
c)
Apply friction with scrub brush or gauze sponge, as required for
the procedure or area of the hospital where the procedure is being
performed.
d)
Prepare patient skin before invasive procedure.
2)
Use antiseptic agent.
3)
Remove hair, when necessary Note: When hair removal is
necessary, it should be done with a depilatory or, less desirably, by
clipping, rather than by shaving with a razor, and should be done
immediately before the procedure.
4)
Use barrier techniques to decrease transmission of microorganisms
from personnel to patient.
a)
Maintain area of sterile field with sterile gloves, gowns and
drapes.
b)
Wear appropriate attire as indicated by risk of procedure and area
of hospital where the procedure is performed.
5)
Provide environmental controls to maximize reduction of
microorganisms during surgical procedures.
a)
Use special treatment rooms of operating room.
b)
Control activity to reduce airborne transmission if procedures are
done at the bedside.
1)
Keep doors closed during procedure; use physical barriers such as
screens to divert traffic.
2)
Exclude visitors and unnecessary personnel.
3)
Avoid cleaning activities in the area during surgical procedures.
c)
Provide environmental controls to reduce contamination maximally.
1)
Provide higher rate of air exchanges by ventilation system.
2)
Maintain positive pressure in room.
d)
Clean and disinfect environment surfaces routinely with germicidal
detergent.
e)
Use efficacious germicidal agent for cleanup of blood or body
fluids.
|