NCM 103:

FUNDAMENTALS OF
NURSING PRACTICE
(Skills)
COURSE CONTENT

 I. ASEPSIS
A. Infection process Cycle
a. Factors Affecting Host Susceptibility
B. Types of Asepsis
C. Procedures in
a. Handhygiene
b. sterile gloving
c. Removing the Gloves
D. Specimen Collection
E. Opening Sterile Packs
ASEPSIS

DEFINITION:

ASEPSIS is the freedom from infection or

infectious material

Microorganisms-small organisms that

can not be seen with the naked eye
A. INFECTION PROCESS CYCLE

INFECTION

the invasion of the body by a pathogenic

microorganism that produce and multiply thereby
causing a disease.
INFECTION PROCESS CYCLE
 6 LINKS IN THE INFECTION PROCESS CYCLE

Etiologic Agent – the microorganism.

Reservoir – where infectious agents live or multiply.
Portal of Exit – the route by which microorganism leave
the reservoir.
Mode of Transmission – the method by which a
microorganism is transferred from the
reservoir to a susceptible host.
Portal of Entry – the route by which microorganism
enter a susceptible host.
Susceptible Host – any person who is at risk for
infection.
FACTORS INFLUENCING HOST SUSCEPTIBILITY

• virulence of the microorganism

• number of invading
microorganisms
• decreased ability to resist
infection
• defense mechanism of the body
• normal human flora
 B. TYPES OF ASEPSIS:

1.MEDICAL ASEPSIS (Clean Technique)

includes all practices intended to confine a specific
microorganism to a specific area, limiting number,
growth and spread of microorganism.

2. SURGICAL ASEPSIS (Sterile Technique)

involves practices used to render and keep objects
and areas free from microorganisms.
 BASIC PRINCIPLES OF MEDICAL ASEPSIS
IN PATIENT CARE

1. Practice good hand hygiene technique.

2. Carry soiled items, including linens, equipment, and other
used articles, away from the body.
3. Do not place soiled bed linen or any other items on the
floor, which is grossly contaminated.
4. Avoid having patients cough, sneeze or breathe directly
on others.
5. Move equipment away from you when brushing, dusting or
scrubbing articles.
6. Avoid raising dust. Use a specially
treated or a dampened cloth.
DO not shake linens.
BASIC PRINCIPLES OF MEDICAL ASEPSIS
IN PATIENT CARE
7. Clean the least soiled areas first and then move to the more
soiled ones.
8. Dispose of soiled or used items directly into appropriate
containers.
9. Pour liquid, that are to be discarded, such as bath water,
mouth rinse and the like, directly into the drain to avoid
splattering in the sink and onto you.
10.Sterilize items that are suspected of containing pathogens.
11. Use personal grooming habits that help prevent spreading
microorganisms.
12.Follow guidelines conscientiously for
infection control or barrier
techniques as prescribed by
the agency.
 BASIC PRINCIPLES OF
SURGICAL ASEPSIS
1. Only a sterile object can
touch a sterile object.
2. Open sterile packages so
that the first edge of the
wrapper is directed away
from the worker.
3. Avoid spilling any solution
on a cloth or paper used as
a field for sterile setup.
4. Hold sterile objects above
waist level.
5. Avoid talking, coughing,
sneezing or reaching over a
sterile field or object.
 BASIC PRINCIPLES OF SURGICAL ASEPSIS

6. Never walk away from or turn your back on a

sterile field.
7. All items brought into contact with broken
skin, used to penetrate the skin to inject
substances into the body, or used to enter
normally sterile body cavities should be
sterile.
8. Use dry, sterile forceps when necessary.
9. Consider the outer 1” edge of a sterile field to
be contaminated.
10.Consider an object contaminated
if you have any doubt as to its
sterility.
 C. PROCEDURES IN HANDWASHING, GLOVING AND REMOVING THE GLOVES

1. HANDWASHING
 the rubbing together of all surfaces and
crevices of the hands using soap or a
chemical and water.

3 ESSENTIAL ELEMENTS OF HANDWASHING

1. soap or chemical
2. water
3. friction
 CIRCUMSTANCES THAT REQUIRE HANDWASHING

1.after arriving at work

2.before leaving work
3.between client contacts
4.after removing gloves
5.when hands are visibly soiled
6.before eating
7.after excretion of body waste
8.after contact with body fluids
9.before and after performing
invasive procedures
10.after handling contaminated
equipment
EQUIPMENT NEEDED:

1. Antimicrobial soap
2. Antiseptic hand rub
3. paper or cloth towels
4. sink
5. running water
Hand Hygiene
• Assessment

• 1. Inspect surface of hands for breaks or cuts in skin or

cuticles, cover lesions with dressing before providing
care, determine if lesions are too large to cover.

• 2. inspect hands for visible soiling

• 3. inspect condition of nails, ensure nails are short and

smooth
Hand hygiene
• Implementation:

• 1. Push wrist watch and long uniform sleeves abve

wrists, removed any rings

• 2. Use antiseptic hand rub

a. dispense appropriate amount of product into palm of one

hand

b. rub hands together, cover all surfaces.

c. rub hands together until alcohol dries, allow hands to dry

completely before applying gloves.
Hand hygiene
• Use regular or antimicrobial soap

a. stand in front of sink, keep hands and uniform away from

sink surface.

b. turn on water. Use faucets or pedal to regulate flow and

temperature

c. avoid splashing water against uniform

d. regulate flow of water so temperature is warm

e. wet hands and wrists, keep hands and forearms lower than
elbows
Hand hygiene

f. Apply appropriate amount of antiseptic soap, rub hands together

g. Wash hands, properly for at least 15 to 20 seconds, keep finger

tips down

h. Clean under fingernails with nails of other hand or disposable

nail cleaner

i. Rinse hands and wrists, keep hands down and elbows up.

j. Dry hands and wrists thoroughly

Hand hygiene
j. Dry hands and wrists thoroughly

k. discard paper towel in proper receptacle if used

l. use clean, dry paper towel to turn off hand faucet or

turn off with foot or knee pedals.

m. apply appropriate lotion to hands.

 B. GLOVING

 designed to keep the organisms out of a defined

area, to render the area free of microorganisms
both pathogens and non-pathogens.

CIRCUMSTANCES REQUIRING GLOVING:

 when the nurse is likely to handle any body substances
 nurses who have open sores or cuts on the hands
 when the hands will come in contact with an open wound or
when the hands might introduce microorganisms into body
orifice.

EQUIPMENT: sterile gloves of the appropriate size

Sterile gloving
• Assessment
• 1. Consider type of procedure to be performed,
consulted agency policy on use of sterile gloves.

• 2. consider patient’s risk for infection

• 3. select correct size and type of gloves, examine glove

package to determine if it was dry and intact with no
water stains.
Sterile gloving
• 4. inspect condition of hands, determine if presence of
lesions will prevent participation in a procedure.

• 5. assess patient for risk factors applying latex gloves:

a. Previous reaction to other items containing latex

b. Personal history of asthma, contact dermatitis, eczema,
urticaria or rhinitis
c. History of food allergies
d. Previous history of adverse reactions during surgery or dental
procedure
e. Previous reactions to latex products
Sterile gloving
1. Apply gloves
a. perform thorough hand hygiene, place glove package
near work area.

b. remove outer glove wrapper by peeling sides

apart.

c. grasp inner package on appropriate workspace, open

package, keep gloves on inside surface of wrapper.
Sterile gloving
d. Identify right and left glove. Glove dominant hand first.

e. Grasp glove for dominant hand by touching only glove’s s inside

surface.

f. Pull glove over dominant hand, ensure cuff did not roll up wrist

g. Slip fingers under cuff of second glove with dominant hand

h. Pull second glove over non dominant hand

i. Interlock hands once both gloves were on, held hands away from
the body until beginning procedure.
Sterile gloving
2. Perform procedure

3. Remove gloves
a. grasp outside of one cuff with other gloved hand,
avoiding touching wrist

b. pull glove off by turning it inside out, place glove in

gloved hand
Sterile gloving
• c. place fingers of bare hand inside remaining glove
cuff , peel glove off inside out and over previously
removed glove. Discard both gloves in receptacle.

• d. perform thorough hand hygiene.

• Equipment: sterile gloves of the appropriate size

• Immunocompromised- low immune
system
• Immunocompetent- high immune system

• Probiotic- good bacteria

• Antibiotic- bad bacteria
sterile- above waist, below the head
unsterile- below waist, above the head

Note: sterile to sterile

unsterile to unsterile
skin to skin
mouth- dirtiest part of our body
warm water open the spores of the skin