Asepsis & Sterile Dressing Technique

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ASEPSIS
Asepsis is essential to keep the patient as free from hospital micro organisms as possible

It is a method used to prevent contamination of wounds and other sites by organisms that could cause infection


HOW?
Ensuring that only sterile equipments & fluids are used during invasive Medical & Nursing Procedures



?What are microorganisms
Organismis which can only be seen by a microscope *
To live they need warm temp, moisture, darkness*
Anaerobic and Aerobic microorganisms*
Nonpathogenic and Pathogenic microorganisms {Bacteria, viruses, fung}i*

?How microorganisms spread
Direct / Indirect contact*
Airborne*
Oral route*
Insects*

CATEGORIES OF ASEPSIS
1. Medical or Clean Asepsis
- aims to reduce the number of organisms & prevent their spread.

2. Surgical or Sterile Asepsis
- aims to eliminate micro organism from a given areas.

The following factors could influence infection process
:Age
* Neonates & eldery are more at risk due to their immature and / or inefficient immune systems
(Nutritional status (malnutrition*
Debilitating diseases eg. Diabetes*
Immunosuppressive drug therapy*
Patients undergoing surgery or invasive procedures*

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PRINCIPLES TO PREVENT INFECTION


Hands have been shown to be an important route for transmission of infection, therefore proper hand washing cansignificantlyreduce

Number of micro-organisms on the hands-
Risk of transmission of organisms to patients-
Risk of cross-contamination among patients-
Risk of infection among other health care workers-
Risk of transmission of infectious organisms toyourself-


b. Sterile Dressing Technique
It is essential to ensure washed hands do not contaminate the sterile field or equipment
sterile gloves-
using forceps-


[b]c. Inanimate Objects
All instruments, fluids & materials that come into contact with the wound must be sterile
Therefore be aware of
what is sterile-
what is not sterile-
keeping the two seperate-
replacing contaminated items immediately-


[b]d. Dressing Trolley

Dressing trolleys are cleaned after every use with soap & water, and dried carefully with paper towels
Apply antiseptic sprays or solutions prior to re-using trolley
Trolleys used for aseptic procedures
must not be used for any other purposes
[/b][/b]

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e. Protective Clothing
Protective clothing devices / barriers are recommended to....
Prevent the users clothing becoming contaminated with pathogens which in turn could contribute to spread nosocomial infection
Prevent the users clothing from becoming soiled
Prevent the user acquiring infection from patient

f. Patient Hygiene
The patients own skin flora is always a potential
source of infection, therefore encouragement of good potential hygiene
will help reduce this hazard
g. Airbourne Contamination
-Routine ward procedures such as bed making, cleaning, ward rounds etc. disperse organisms into the the air
Ideally such activities should stop at least 30 minutes prior to any planned treatment / procedures
Wounds should be exposed for the minimum time possible while clean wounds should be dressed before contaminated wounds
Dirty dressings should be placed carefully into clinical waste bags, sealed before disposal into yellow clinical waste bags



Donning Sterile Gloves
1Wash hands.
2Open the outer wrap and remove the inner wrap.

3Place the inner wrap on a clean, dry flat surface.

Open the inner wrapper by
lifting the folded edges and unfoldoutward away from gloves. Touch only
the folded edge, and keep gloves inside the wrapper




5. With your non-dominant
hand, grasp the folded edge of the opposite glove with your thumb and
two fingers, touching only the inside surface of the glove


6.Lift the glove up from wrapper to waist level
7. While still holding the cuff, slip the dominant hand into the glove. Pull the glove over the hand

8. With the gloved sterile hand, slip your fingers under the cuff of the opposite glove and pick the glove up


9. Maintain gloved fingers under cuff while glove is pulled on. Keep sterile thumb out and away from arm
10. Adjust both gloves touching only sterile surfaces with sterile surfaces



11. Keep sterile gloved hands in front above waist level folded together if not starting procedure

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Dressing The Wound

Why have a dressing ?
Absorption of wound exudates
Protection of the wound
Asepsis
Compression of the wound
Immobilization and support
Comfort
Aesthetic purposes

Why change the dressing ?
Any disturbance of the dressing will
expose the wound to the air and this along with handling, is likely to
increase the risk of infection
Touching/ cleaning the wound and pulling off the dressing, also disturbs the growing epithelium, and healing is hampered
Dressing may be removed in 48 hours post-op or
removal of clips, stitches-
dressing is soaked with discharge-
swelling/ inflammation around the wound-
pain/ tenderness to the touch-
or unexplained increase in the patient’s temp-

Asepsis
The most important element of surgical dressing
The intention is to avoid as much as possible any contamination of the clean wound
-Where infection is already present,
asepsis reduces the possibility of it spreading to other sites, or to
other patients, the nurse and equipment

The main routes of wound infection in the hospital are:
Airborne- infection (staphylococcus/ streptococcus
Auto- infection
Cross- infection
Contaminated- equipments
(pseudomonas aeruginosa, Escherichia coli)

Sterile Dressing
Non – Touch Technique
Touch Technique

1Check the orders-
2-Prepare dressing trolley
3-Assemble sterile, non-sterile materials; solution needed
4- Identify the patient and explain procedure to patient
5- Wash hands
6-Provide privacy
7-Position the patient for comfort/safety, right height of the bed8-Apply clean gloves
9-Loosen tape, slowly pulling tape toward wound
10-Remove soiled dressing, note drainage, then discard
11- Assess incision area
12- Remove and discard clean gloves
13. Wash hands
14. Prepare sterile field

15. Open Dressing Supplies
16. Pour Sterile Solution

17. Apply sterile gloves
18. Cleanse wound as needed
19. Apply sterile dressing
20. Secure according to extent and nature of wound

21. Discard gloves

22. Reposition patient for comfort and safety.
23. Dispose of equipment.
24. Wash hands.
25. Report and document: appearance of wound, drainage, dressing change, materials used, and client's response to procedure.

10 Golden Rules Of Asepsis
1. Sterile touching sterile remains sterile
2. Sterile touching unsterile contaminates all
3. Sterile items should be kept dry - moisture aids transmission of micro – organisms
4. If there is any doubt about the sterility of an item it must be considered non – sterile
5. Reaching across the sterile field with bare hands / arms which are non - sterile must be avoided

ASEPSIS
Through good aseptic techniques you will help in the recovery and eventual return to good health of the patient.