Sterile Procedures
LESSON 2: Medical asepsis
2-5
2-5. PROCEDURE FOR APPLYING MEDICAL ASEPSIS
Hospital-acquired (nosocomial) infections and cross infections (infections that are transmitted between individuals with different pathogens) show the need of applying basic principles of medical asepsis. The following steps outline the basic procedures used in applying medical asepsis.
a. Perform Patient Care Handwash. Follow previous instruction on patient care handwash. The patient care handwash is the most important step in preventing and controlling infection. There may be times when you do not have the materials or the time to do a thorough handwash; however, always wash your hands and clean your fingernails if time permits.
b. Disinfect Materials as Required. Disinfecting means cleaning objects to remove most organisms. Follow directions explicitly where chemical agents are used.
c. Maintain Clean Patient Care Environment.
(1) Concurrent cleaning. Disinfect and dispose of infectious matter immediately during the course of a disease. This is a constant task.
(2) Terminal cleaning. Disinfect contaminated materials after a patient dies, transfers, or is discharged.
(a) Use freshly prepared germicidal detergent solution to wash furniture, mattress covers, grossly soiled areas of walls, and equipment not handled by central supply.
(b) Wet-vacuum or mop floors.
(c) If an isolation room, read isolation technique sign for special instruction.
d. Use Clean and Dirty Utility Rooms. Clean and dirty articles are not stored in the same place in order to prevent contamination. Clean rooms are used to store clean, unused equipment. Dirty rooms are rooms used to store contaminated items such as used linen, trash, contaminated equipment, dirty dietary trays, and basic laboratory tests.
e. Store and Handle Linen Properly.
(1) Clean linen. Store clean linen in a clean room marked for clean linen only. Prevent the contamination of clean linen by:
(a) Limiting access to authorized personnel only.
(b) Washing hands before handling clean linen.
(c) Keeping linen from touching floor or any other known dirty surface.
(d) Keeping linen from touching uniform.
(2) Dirty or soiled linen. Dirty linen is linen that has been used and maybe contaminated with blood, urine, feces, and so forth. Store dirty linen in the "dirty" utility room. Prevent the spread of contamination by following these rules.
(a) Do not shake or toss dirty linens.
(b) Do not allow uniforms to come into contact with dirty linens.
(c) Remove dirty linen from the area using procedures established by local standing operating procedures (SOP).
f. Store and Handle Equipment and Supplies Properly.
(1) Store clean and dirty equipment and supplies in separate areas.
(2) Cleanse dirty equipment thoroughly before placing with clean equipment for reuse by another patient.
(3) Use disposable equipment whenever possible.
(4) Use separate disposable items for each patient.
g. Dispose of Waste Materials.
(1) Uncontaminated trash. Uncontaminated trash results from normal living routine of patients. Uncontaminated trash requires no special handling. Remove all unconsumed food items from patient care areas as soon as possible after patients have finished eating.
(2) Contaminated trash. Contaminated trash results from contamination with bodily secretions and/or excretions of the patient. Contaminated trash requires special handling.
(a) Seal each bag according to local SOP before removing from patient's bedside.
(b) Place each bag in specific area or container designated and labeled "contaminated trash."
(c) Remove each bag from the ward or clinic frequently according to the local SOP.
(3) Excretions.
(a) Clean bedpans and urinals after each use.
(b) Flush away all contents promptly unless specimens are required.
(c) Cover the bedpan or urinal with paper cover when it is necessary to carry it from the patient's room to another area.
h. Follow Specific Isolation Techniques for Patients with Communicable Diseases. See Lesson 5 of this subcourse for instruction on isolation techniques. For a brief description of some selected communicable diseases along with pertinent points in health care, see FM 8-33, Control of Communicable Diseases in Man, an official report of the American Public Health Association.
i. Other Considerations.
(1) Standing liquids (including medications). Time, date, and label all standing liquids at time of change. Standing liquids should be changed every 24 hours unless otherwise directed.
(2) Refrigerators. Clean and check temperature of refrigerators according to the local SOP. Contents should be labeled and dated.
