Medical Asepsis

Asepsis means absence of disease producing organisms. The microorganisms of different types are present everywhere in our environment and in the human body. The purpose of medical asepsis is to prevent by all means of cross-infections from one patient to another, including communicable disease infections.

The purpose of surgical asepsis is to prevent by all means of infections of the wounds of surgical patients, infection of the uterus during and after delivery, and infection that could be introduced by invasive procedures such as catheterisation, injections and infusions.

Medical Asepsis:

This includes:

1.     General cleanliness

2.     Isolation of infected persons.

3.     Disinfection of all articles that may be contaminated, or used for more than one patient.

4.     Correct and frequent hand-washing by all those caring for patients.

Hand-washing technique:

1.     Wet the hands under running water.

2.     Apply soap thoroughly, and use a brush for the nails if possible.

3.     Rinse well.

4.     Dry with a clean towel. It is important to keep the nails short.

Use of Gowns, Gloves and Masks, in Medical Asepsis:

a.     Any patient who is a source of infection needs to be isolated. The type of isolation depends on the method by which the organisms may spread from person to person.

b.    Gown: Gown protection is needed for persons in close contact with a patient who may spread infection by urine, faeces, vomit, or wound drainage. (e.g) typhoid fever, dysentery, cholera, gas gangrene.

c.      Gloves: This is needed to protect persons coming in close contact with a patient having a communicable disease, which is air-borne. (e.g) diphtheria, sore throat, meningitis, chickenpox, whooping cough etc. In most of these cases a gown is also needed.

d.    Gown technique: At the entrance to the patients unit a stand should be provided on which to hang the isolation gown. If the stand is inside the unit, the gown is hung with the contaminated side out.

If outside the unit, it is hung clean side out.

To put on the gown, insert your hands into the sleeves of the gown without touching the contaminated side.

Then fasten the neck-band, which is considered clean. Fasten the belt and then carry out the work in the unit.

After finishing, untie the belt, wash your hands and untie the neckband.

Remove the first sleeve, remove the second sleeve by grasping it with the gown-covered hand.

Place the gown carefully on the hook, then wash your hands again thoroughly.

Use of gloves: Clean gloves are usually adequate in medical asepsis, but when handling a wound after surgery or the vagina during delivery or in the puerperium, sterile gloves are needed.

After using the gloves, they are removed and placed into a disinfectant solution. The gloved hands may be washed under the running water before taking them off and then placed in the disinfectant solution.

Use of Masks: Clean masks should be kept in a clean area near the hand-washing facilities at the entrance of the isolation unit. Take a mask and tie it on before you enter. When leaving, wash hands, remove the mask holding the strings only, and drop it into a second container for used masks. Masks must be disinfected before being used again. Now disposable masks are available for use and throw.

 Principles of isolation technique:

The degree of isolation will depend on the type of disease.

The patient should be isolated as long as he/she is a source of infection. The time depends on the particular disease.

Persons attending the patient should be limited to one or two and no visitors allowed.

The room should have only essential furniture and be easily cleaned (Damp dusting and floor cleaning).

Gown, apron and mask should be provided for any one entering the room. Used masks are to be dropped into disinfectant solution.

Hands should be washed with soap and water after touching the patient. All the articles used by him should be disinfected

Everything taken out of the room must be disinfected. Dust, excreta and discharges, waste food soiled linen and utensils, must  be disposed off with care.

For terminal disinfection, the patient is given a bath and clean clothes, and taken away from the isolation room. Then the room and everything in it is thoroughly disinfected.

Barrier nursing:

In this type of isolation, the corner of a general medical ward is suitable for patient with infections other than air-borne. (e.g) Typhoid fever, dysentery and diarrhoea. It is best if the room is screened against flies. A gown or apron and hand washing facilities are kept at the bedside. Excreta must be carefully disposed of bedpans and bed linen is disinfected. All other precautions are taken to prevent the spread of the infections.