for the patients comfort. Artificial light should be
strong enough to prevent eyestrain and diffuse enough
to prevent glare. Whenever possible, provide a bed
lamp for the patient. As discussed earlier under
Safety Aspect, a dim light is valuable as a comfort
and safety measure at night. This light should be
situated so it will not shine in the patients eyes and yet
provide sufficient light along the floor so that all
obstructions can be seen. A night light may help orient
elderly patients if they are confused as to their
surroundings upon awakening.
In conclusion, it is important that you understand
the effects of the environment on patients. People are
more sensitive to excessive stimuli in the environment
when they are ill, and they often become irritable and
unable to cooperate in their care because of these
excesses. This is particularly apparent in critical care
areas (e.g., in CCUs and ICUs) and isolation, terminal,
and geriatric units. You must realize and respond to the
vital importance of the environment in the total
medical management plan of your patients.
PATHOGENIC ORGANISM CONTROL
LEARNING OBJECTIVE: Recall medical
asepsis principles and recognize medical
All health care, regardless of who provides it or
where it is provided, must be directed toward
maintaining, promoting, and restoring health. Because
of this goal, all persons seeking assistance in a
healthcare facility must be protected from additional
injury, disease, or infection. Adherence to good safety
principles and practices protects a patient from
personal injury. Additionally, 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. The discussion that follows
addresses infection 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 aseptic practices are
routinely used in direct patient care areas, as well as in
other service areas in the healthcare environment, to
interrupt a chain of events necessary for the
continuation of an infectious process.
components of this chain of events consist of the
elements defined below.
An infectious agent is an organism that is capable
of producing an infection or infectious disease.
Reservoir of Infectious Agents
A reservoir of infectious agents is the carrier on
which the infectious agent primarily depends for
survival. The agent lives, multiplies, and reproduces
so that it can be transferred to a susceptible host.
Reservoirs of infectious agents could be man, animal,
plants, or soil. Man himself is the most frequent
reservoir of infectious agents pathogenic to man.
PORTAL OF EXIT.The portal of exit is the
avenue by which the infectious agent leaves its
reservoir. When the reservoir is man, these avenues
include various body systems (such as respiratory,
intestinal, and genitourinary tracts) and open lesions.
MODE OF TRANSMISSION.The mode of
transmission is the mechanism by which the infectious
agent is transmitted from its reservoir to a susceptible
being (host). Air, water, food, dust, dirt, insects,
inanimate objects, and other persons are examples of
modes of transmission.
PORTAL OF ENTRY.The portal of entry is the
avenue by which the infectious agent enters the
susceptible host. In man, these portals correspond to
the exit route avenues, including the respiratory and
gastrointestinal tracts, through a break in the skin, or
by direct infection of the mucous membrane.
SUSCEPTIBLE HOST.The susceptible host
is man or another living organism that affords an
infectious agent nourishment or protection to survive
Removal or control of any one component in the
above chain of events will control the infectious
Two Basic Medical Asepsis Practices
The two basic medical asepsis practices that are
absolutely essential in preventing and controlling the
spread of infection and transmittable diseases are