Medical Assisting Chapter 19 PowerPoint® to accompany Medical Assisting Chapter 19 Second Edition Ramutkowski  Booth  Pugh  Thompson  Whicker Chapter 19 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Principles of Asepsis Objectives 19-1 Explain the historical background of infectious disease prevention. 19-2 Identify the types of microorganisms that cause disease. 19-3 Explain the disease process. 19-4 Explain how the body’s defenses protect against infection. 19-5 Describe the cycle of infection.

Principles of Asepsis Objectives (cont.) 19-6 Identify and describe the various methods of disease transmission. 19-7 Explain how you can break the cycle of infection. 19-8 Compare and contrast medical and surgical asepsis. 19-9 Describe how to perform aseptic hand washing.

Principles of Asepsis Objectives (cont.) 19-10 Define Bloodborne Pathogens Standards and Universal Precautions as described by the rules and regulations of the Occupational Safety and Health Administration (OSHA) 19-11 Explain the role of Universal Precautions in the duties of the medical assistant.

Principles of Asepsis Objectives (cont.) 19-12 List the procedures and legal requirements for disposing of hazardous waste. 19-13 Explain how to educate patients in preventing disease transmission.

Introduction Our bodies are amazing structures that defend us against infections under normal circumstances. You will learn: About disease causing microorganisms. How the body fights against disease. Ways infections occur You can be instrumental in helping to break the cycle of infection by practicing asepsis in the office and educating patients in the prevention of disease transmission.

History of Infectious Disease Prevention Hippocrates – first attempt to prevent infection. He believed: Environment and natural forces play an important part in role of disease and health Simple treatments, using strong drugs and surgery only as a last resort.

Joseph Lister Discovered how to use chemical antiseptics to control surgery related infections Used antiseptics to disinfect surgical equipment and supplies Microorganisms are simple forms of life commonly made up of a single cell only seen with a microscope.

Holmes and Semmelweis Semmelweis Demonstrated that puerperal fever was carried from patient to patient by doctors. Semmelweis Also concluded puerperal fever was a communicable disease.

Microorganisms Microorganisms live all around us. Viruses – smallest infectious agent Bacteria – single celled reproduced quickly Protozoans – single celled found in soil (most do not cause disease) Fungi – complex cell structure (most do not cause disease) Parasites – cause disease

Disease Process Begins with microorganisms finding host Grows with specific requirements Proper temperature, pH, and moisture level Damage is caused by: Depleting nutrients Reproducing themselves Making body cells the target of body’s own defenses Produce toxins

Body’s Defenses Lines of Defense Immunity – resistant to pathogens and the disease they cause If defenses are not functioning properly, person will become susceptible to invasion and infection. Lines of Defense Skin Normal flora Staying healthy

Defenses Against Disease Infection is the presence of a pathogen in or on the body Nonspecific defenses - mechanisms to protect us against pathogens in general Nonspecific Defenses Species resistance Mechanical barriers Chemical barriers Fever Inflammation Phagocytosis

Specific Defenses Against Disease Lymphocytes and macrophages are the major cells Antibodies and complement are the major proteins involved in specific defenses Immunity Protects the body against very specific pathogens

Apply Your Knowledge What are three lines of defense against microorganisms?

Apply Your Knowledge -Answer What are three lines of defense against microorganisms? Lines of Defense Skin Normal flora Staying healthy

Types of Immunity Naturally acquired active – naturally exposed to an antigen (usually long lasting) Artificially acquired – being injected with a pathogen (immunizations or vaccines) Naturally acquired passive – immunity through his mother (short-lived) Artificially acquired passive – immunity when person is injected with antibodies (short-lived)

T Cells Helper T cells Memory T cells increase antibody formation, memory cell formation, B cell formation, and phagocytosis Memory T cells memory cells “remember” the pathogen that activated the original T cell person is later exposed to the same pathogen, memory cells trigger an immune response that is more effective than the first immune response

Cell-Mediated Immunity Two major types of lymphocytes B Cells and T Cells Recognize antigens in the body B cells: Respond to antigens by becoming plasma cell -make antibodies against the specific antigen T Cells: Cell-mediated bind to antigens on cells and attack them directly

Click for Cycle of Infection A reservoir host –animal, insect or human body where pathogen is growing (carrier, unaware of presence of pathogen) Means of exit – pathogen must exit the host Nose, mouth, eyes or ears Feces or urine Semen, vaginal fluid or other reproductive discharge Blood or blood products Click for Cycle of Infection

Cycle of Infection (cont.) Means of transportation – must spread to another host by some means of transmission Vectors – living organisms, insects or person Fomites – inanimate objects such as clothing, water, food Airborne transmission Blood-borne transmission Ingested transmission Touching During pregnancy or birth Click for Cycle of Infection

Cycle of Infection (cont.) Means of Entrance Enter through any cavity lined with mucous membrane Mouth, nose, vagina, rectum Through ears, eyes, intestinal tract, urinary tract, reproductive tract, breaks in the skin Click for Cycle of Infection

Cycle of Infection (cont.) Susceptible Host determined by: Age Genetic predisposition Nutritional status Disease process Stress levels Hygiene habits Click for Cycle of Infection

Cycle of Infection (cont.) Back

Apply Your Knowledge What are fomites?

Apply Your Knowledge -Answer What are fomites? Fomites are inanimate objects such as clothing, water, food that serve as a means of transportation for microorganisms.

Break the Cycle Asepsis – condition in which pathogens are absent or controlled Maintain strict housekeeping standards Adhering to government guidelines to protect against disease Educating patients in hygiene, health promotion and disease prevention

Medical Asepsis Clean technique - based on maintaining cleanliness to prevent spread of microorganisms Keep office clean: Reception room clean, well lit, and ventilated Keep furniture in good repair Strict “no food or drink” policy

Medical Asepsis (cont.) Handwashing Beginning of day After breaks Before and after each patient Before and after handling equipment or specimens After blowing your nose or coughing

Medical Asepsis (cont.) Sanitization – reduction of the number of microorganisms Disinfection – destruction of infectious agents on an object Sterilization – removal of all microorganisms

Surgical Asepsis Keep the surgical environment completely free of all microorganisms. Sterile technique used for even minor operation or injections. Object is either sterile or not sterile; if unsure then it is not sterile.

OSHA Bloodborne Pathogens Standards Written OSHA Exposure Control Plan must be created and updated annually Training must be provided to all employees as mandated by the standard that includes use of PPE. Employees must take hepatitis B vaccine or decline in writing.

Hazardous Waste Operation & Emergency Response Final Rule Hazardous waste products include: Blood and blood products Body fluids and tissue Cultures Vaccines Sharps Gloves Specula Inoculating loops Paper product contaminated with body fluids

Universal Precautions Use universal blood and body fluid precautions for: Blood and blood products Human tissue Semen and vaginal secretions Saliva from dental procedures Cerebrospinal, synovial, pleural and other body fluids

Standard Precautions Combination of Universal Precautions and rules to reduce the risk of disease transmission. Applies to: Blood All body fluids, secretions, and excretions except sweat Nonintact skin Mucous membrane

OSHA Routine Safeguards Category I Tasks: Those that expose a worker to blood, body fluids, or tissue or those that have a chance of spills or splashes. (Always were specific protective measures) Category II Tasks: Do not usually involve risk of exposure Category III Tasks: Do not require special protection

Personal Protective Equipment Employers must provide personal protective equipment (PPE) at no charge to the employee. Disposable, sterile, exam & utility gloves Masks and protective eyewear or face shields Protective clothing

Postprocedure Cleanup OSHA required steps: Decontaminate all exposed surfaces Replace protective coverings on surfaces or equipment Decontaminate receptacles Pick up any broken glass with tongs Discard all potentially infectious waste materials

Apply Your Knowledge The physician is going to remove a small growth from your patient’s back. In order to prepare for this procedure what steps would you take to prevent the spread of infection?

Apply Your Knowledge -Answer The physician is going to remove a small growth from your patient’s back. In order to prepare for this procedure what steps would you take to prevent the spread of infection? Use medical asepsis while preparing the patient and then use surgical asepsis during the procedure. Follow all CDC and OSHA rules for the prevention of infection and disease.

Exposure Incidents A worker has reason to believe that he has come in contact with a substance that may transmit infection Notify physician or employer Employer must offer free medical evaluation Testing for HBV if not immunized Postexposure evaluation with written report

Educating Patients Stress basic principles of hygiene and disease prevention Handwashing Daily hygiene Use tissues when coughing or sneezing Routinely disinfect rooms at home

Educating Patients (cont.) You will teach patient about: Nutrition and diet Exercise and weight control Prevention of sexually transmitted disease Smoking cessation Proper use of medications Stress reduction techniques

Your Role in Patient Education Remember the following factors when providing education: Psychological and lifestyle factors Patient’s age and family circumstances Disease and disorders Patient’s psychological condition Remind patient to eat healthfully

Apply Your Knowledge What is the first step to take after you have been stuck with a blood-tinged needle?

Apply Your Knowledge -Answer What is the first step to take after you have been stuck with a blood-tinged needle? Notify the physician or employer.

Medical Assistant Summary You must follow federal regulations related to infection control and asepsis. You need to know the how pathogens cause disease, how disease is transmitted and how to prevent the spread of infection.

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