providers realize and respond to the vital impor-
tance of the environment in the total medical
management plan of each patient.
PATHOGENIC ORGANISM CONTROL
All health care, regardless of who provides it
or where it is provided, must be directed towards
maintaining, promoting, and restoring health.
Because of this, all persons seeking assistance in
a health care facility must be protected from ad-
ditional injury, disease, or infection. Adherence
to the principles and practices of safety aspects
protects a patient from personal injury. Addi-
tionally, attention to personal and environmental
hygiene not only protects against further injury
but also constitutes the first step in controlling
the presence, growth, and spread of pathogenic
organisms. Some of the basic concepts of personal
hygiene and communicable disease control are ad-
dressed in the Preventive Medicine chapter of
this manual. Additional information concerning
patient-related personal hygiene will be found in-
tegrated throughout various sections of this
chapter. The discussion that follows addresses in-
fection control particularly in the context of
medical and surgical aseptic practices.
Medical asepsis is the term used to describe
those practices used to prevent the transfer of
pathogenic organisms from person to person,
place to place, or person to place. Medical asep-
tic practices are routinely used in direct patient
care areas as well as in other service areas in the
health care environment to interrupt a chain of
events necessary for the continuation of an infec-
tious process. The components of this chain of
events consists of the following:
INFECTIOUS AGENT. An organism capable
of producing an infection or infectious disease.
RESERVOIR OF INFECTIOUS AGENTS.
A carrier on which an infectious agent depends
primarily for survival. The agent lives, multiplies,
and reproduces so that it can be transferred to
a susceptible host. Reservoirs of infectious agents
are man, animal, plants, soil, or organic matter.
Man himself is the most frequent reservoir of in-
fectious agents pathogenic to man.
PORTAL OF EXIT. The avenue by which the
infectious agent leaves its reservoir. These avenues
include various body systems, such as respiratory,
intestinal, and genitourinary tract, and open le-
sions when the reservoir is a human.
MODE OF TRANSMISSION. The mechan-
ism by which the infectious agent is transmitted
from its reservoir to a susceptible being (host).
Air, water, food, dust, dirt, insects, inanimate ob-
jects, and other persons are examples of modes
PORTAL OF ENTRY. The avenue by which
the infectious agent enters the susceptible host.
In the human being, these correspond to the exit
route avenues, including the respiratory and
gastrointestinal tracts, and through a break in the
skin or direct infection of the mucous membrane.
SUSCEPTIBLE HOST. A human being or
other living organism which affords an infectious
agent nourishment or protection to survive and
Removal or control of any one component in
the above chain of events will control the infec-
Two basic medical asepsis practices are hand-
washing and linen handling procedures. Frequent
handwashing and proper linen handling are ab-
solutely essential practices for preventing and con-
trolling the spread of infection and transmittable
diseases. The following are some common in-
stances when provider handwashing is necessary:
. Before and after each patient contact
. Before handling food and medications
. After coughing, sneezing, or blowing your
. After using the toilet
Improper handling of linen results in the
transfer of pathogenic organisms through direct
contact with the health care providers clothing
and subsequent contact with the patient, patient
care items, or other materials in the care environ-
ment. Proper linen handling is such an elemen-
tary procedure that, in theory, it seems almost un-
necessary to mention; however, it is a procedure
so frequently and carelessly ignored that emphasis