providers realize and respond to the vital importance of the environment in the total medical management plan of each patient.
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 additional injury, disease, or infection. Adherence to the principles and practices of safety aspects 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. Some of the basic concepts of personal hygiene and communicable disease control are addressed in the Preventive Medicine chapter of this manual. Additional information concerning patient-related personal hygiene will be found integrated throughout various sections of this chapter. 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 health care environment to interrupt a chain of events necessary for the continuation of an infectious 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 infectious 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 lesions when the reservoir is a human.
MODE OF TRANSMISSION. 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 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 multiply.
Removal or control of any one component in the above chain of events will control the infectious process.
Two basic medical asepsis practices are handwashing and linen handling procedures. Frequent handwashing and proper linen handling are absolutely essential practices for preventing and controlling the spread of infection and transmittable diseases. The following are some common instances when provider handwashing is necessary: