General Principles of Medical Asepsis
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Home > Policies & Forms > Policies > SPHS > Patient Focused Policies > Surveillance, Prevention & Control of Infection (IC) > General Principles of Medical Asepsis

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General Principles of Medical Asepsis

All Facilities

Policy
The hospital environment can be considered a potential reservoir of infection, for it houses both patients with a variety of pathogenic microorganisms and a large number of susceptible individuals.


Procedure

  1. Employees must be familiar with Administrative Policies related to Infection Control.

  2. Employees must be familiar with the Standard Precautions and Transmission-based Precautions Policy.

  3. Employees must be familiar with the general principles of medical asepsis, which are as follows:

    1. Handwashing – Handwashing is the single most important means of preventing the spread of infection in the hospital. Hands should be washed before beginning work, after using the bathroom, before and after patient contact, before eating and before leaving work. Using mechanical friction, all areas of the arms, lower than the elbows, should be well lathered and scrubbed. Special attention should be given to the nails and nail beds. Rings and jewelry should be removed from hands and wrists because these articles may shelter large numbers of microorganisms. Thoroughly rinse hands under running water.

    2. Dressing Changes – Wash hands and don gloves as necessary. Remove dressings using no-touch technique and place them in a disposable bag. The physician will remove the sutures. Place the removed sutures in the disposable bag. If needed, apply a sterile dressing. Never touch the skin around a wound without sterile gloves being worn. Place tightly closed disposable bag in the infectious waste receptacle in soiled utility room. Wash hands. The use of gloves does not negate the importance of handwashing before and after patient care.

    3. Pre-operative Shave Procedure – The purpose of the pre-operative shave is to cleanse, to remove hair from and degerm the operative site. It is important to be informed of the exact area to be prepared for any out of the ordinary aspects, i.e., rashes, lesions, warts or other skin eruptions. Nicking the skin during prepping heightens the possibility of infection. Report any of these observations to your supervisor and the physician before continuing with the prep. If the skin is nicked, an Incident Report shall be completed. The physician shall be notified immediately. The pre-operative prep should be done as close to the time of surgery as practically feasible. At times, clipping of hair or a depilatory agent will be used instead of shaving. This is also an acceptable practice.

    4. Urinary Catheter – Scrupulous aseptic technique in catheter insertion and daily cleaning at the point of insertion of the catheter with soap and water is utilized to reduce the incidence of infection.

    5. Emptying Urinary Catheter Bags – When a care provider is emptying a urinary catheter bag, this should be viewed as a single interaction for a single patient and the tasks for one patient should be completed before going to the next patient. Wearing gloves for emptying catheter bags is wise because it is difficult not to get urine on the hands. It is unacceptable to consider it a single task to empty the catheter bags for several patients in sequence without changing gloves and washing hands between patients. This is because of the real risk of transmitting organisms from the catheter bag drainage spout of one patient to the next patient’s drainage spout on the hands of personnel.

    6. Intravenous – Aseptic technique is mandatory in the preparation and administration of intravenous solutions. The longer the catheter remains in place, the greater the potential of infectious complications.

    7. Intravenous Hyperalimentation – Hyperalimentation is long-term parenteral nutrition administered through an indwelling catheter placed into a subclavian or jugular vein and directed into the superior vena cava. Hyperalimentation has been found to be extremely valuable, even life saving. However, there are risks – the most common of which is sepsis. Strict adherence to stringent aseptic technique is, therefore, critical to the control of infection.

    8. Care of the Body after Death from Infectious Disease – Infection control is of prime importance in the care of the body after death when the deceased patient has had an infectious disease. When taking care of a deceased patient who has had an airborne infectious disease, prescribed isolation technique should be followed and the patient’s body labeled with ”Airborne Precautions” before being transported to the morgue. All other patients are cared for under Standard Precautions Policy and Procedures .

    9. Personal Hygiene – All hospital personnel must be hygienic. If any employee is hygienically offensive, it is your responsibility to report the situation to the proper supervisor.

    10. Employee Rashes or Skin Lesions – Lesions on Body lesion such as boils, abscesses, impetigo, etc., must be reported to the employee’s supervisor. The employee shall be referred to Occupational Health

    11. Patients with Rashes or Skin Lesions – The most important intervention for rashes or skin lesions is to call it to the attention of the patient’s physician and determine its cause promptly. In many cases, prompt recognition of the rash, identification of the cause, and prompt appropriate intervention can prevent transmission to the care provider and others. If a transmissible skin condition is identified, a “CONTACT PRECAUTIONS” sign shall be placed on the door of the patient’s room so that ALL personnel can be advised of the protective barriers to be utilized.

    12. Skin Punctures/Blood and Body Fluid Exposure – If you break skin from a sharp object or sustain a blood or body fluid splash to the eyes, nose, or mouth or to open areas of your skin, you are required to report the incident to your supervisor for referral to Occupational Health Services. An Incident Report is to be completed.

    13. Equipment Handling – Equipment used for patient care is contaminated after use whether visible soiled or not. Reusable equipment must be cleaned and disinfected before being used for another patient. Hands must be washed immediately after use of equipment for patient care.

    14. Sterilized Articles – Articles which have been sterilized must be carefully protected from contamination. Initial and put an expiration date on all packs and containers of sterile articles. If articles are not used within the specified period of time or if the packs become wet or damaged, the articles must be sterilized again. Consider all opened, wet or damaged packs as contaminated.

    15. Work Area Sanitation – Work areas must be free from refuse, especially around refuse disposal units. Refuse in high risk areas – Surgical Suites, Laboratory, Dietary, Emergency Room, Isolation Rooms and Central Sterile Processing should be removed at least twice during the day shift.

    16. Disposable Equipment and Supplies – Disposable equipment and supplies should be used whenever possible. Some of the used supplies become infectious waste if contaminated with large amounts of blood or body fluids or after use in high-risk areas. (See Infectious Waste Management, Standard Precautions and Transmission-Based Precautions Policies).

    17. Handling of All Specimens – All specimens of blood or body fluids such as sputum, feces, urine or drainage from any body site should be handled as if it were a source of infection. Disposable specimen containers are to be used and their disposal must be proper. Caution should be taken by persons who collect, transport and test specimens in order to prevent transmission of infection. All specimens should be transported to the laboratory in specimen transport bags.

    18. Storage of Clean Equipment – All IV poles, weight scales, walkers, etc. should be stored in a clean storage area. These items should be wiped down with a disinfectant after patient use before storage.

    19. Needle Syringe Disposal – Used needles and syringes are potential health hazards and should be treated with respect. Contaminated needles and syringes must be discarded uncapped and unbroken into a needle and other sharps disposal boxes. Needle disposal boxes, when full, will be removed by Building Services.

    20. Food – Food products are a major source of infectious microorganisms. The consumption of food by employees is forbidden in patient and/or work areas. Employees have designated areas for food consumption.

    21. Various warm-blooded animals are recognized as reservoirs of infectious disease agents of man. Because of this zoonosis, warm-blooded animals are forbidden in the hospital. A seeing-eye dog may be accompanied by a legally blind individual to certain areas of the hospital. See Administrative policy. If rodents are observed, it is the responsibility of the employee to report the incident to a supervisor.

    22. Insects – Insects such as flies, cockroaches, etc. are a main source for transmitting disease. All employees are to be instructed to report to their supervisor or any member of the Infection Control Committee when insects are observed.

    23. Warning Signs – All warning signs such as Biohazard,Isolation Precautions, Do Not Enter, Radioactivity, etc. are to be recognized and observed by all employees.

    24. Refrigerators – Food is not to be stored in refrigerators containing medications, blood products, biohazard specimens or chemicals.

    25. Smoking – Cigarettes are not sold in the hospital. Smoking is not allowed inside the hospital.

    26. Preparation of Medication Sites – All patient skin sites utilized for intradermal, subcutaneous or intramuscular injections are to be cleaned prior to injection with a disinfectant such as alcohol suitable for topical use. All intravenous injection ports are likewise to be cleaned prior to and after manipulation with alco-wipes.
Revised: May 22, 1989; August 1997; January 2000
Reviewed: June 2003
Reviewed by the Infection Control Committee: December 20, 2005
Reviewed by the Infection Control Committee: December 2006

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Chairman, Infection Control Committee

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President, Medical Executive Staff

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President, S.P.H.S.


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