1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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

11. 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

12. 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

13. 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

14. 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

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

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

17. 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)

18. 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

19. 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

20. 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

21. 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

22. 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

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

24. Cycle of Infection (cont.)
Back

25. Apply Your Knowledge
What are fomites?

26. 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.

27. 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

28. 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

29. 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

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

31. 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.

32. 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.

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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?

40. 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.

41. 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

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

43. 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

44. 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

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

46. 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.

47. 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.

48. End of Chapter
End of Chapter