frequent hand washing and proper linen-handlingprocedures.HAND WASHING.—The following are somecommon instances when provider hand washing isimperative:Before and after each patient contactBefore handling food and medicationsAfter coughing, sneezing, or blowing your noseAfter using the toiletLINEN HANDLING.—Improper handling oflinen results in the transfer of pathogenic organismsthrough direct contact with the healthcare provider’sclothing and subsequent contact with the patient,patient-care items, or other materials in the careenvironment. Proper linen handling is such anelementary procedure that, in theory, it seems almostunnecessary to mention. However, it is a procedure sofrequently ignored that emphasis is justified.All linen, whether clean or used, must never beheld against one’s clothing or placed on the floor. Thefloors of a healthcare facility are considered to begrossly contaminated, and, thus, any article coming incontact with the floor will also be contaminated. Placeall dirty linen in appropriate laundry bags. Linen frompatients having infectious or communicable diseasesmust be handled in a special manner.Isolation TechniqueIsolation technique, a medical aseptic practice,inhibits the spread and transfer of pathogenicorganisms by limiting the contacts of the patient andcreating some kind of physical barrier between thepatient and others. Isolation precautions in hospitalsmust meet the following objectives. They mustbe epidemiologically sound;recognize the importance that body fluids,secretions, and excretions may have in thetransmission of nosocomial (hospitaloriginating) pathogens;contain adequate precautions for infectionstransmitted by airborne droplets and other routesof transmission; andbe as simple and as patient friendly as possible.In isolation techniques, disinfection proceduresare employed to control contaminated items and areas.For purposes of this discussion, disinfection isdescribed as the killing of certain infectious(pathogenic) agents outside the body by a physical orchemical means. Isolation techniques employ twokinds of disinfection practices, concurrent andterminal.CONCURRENT DISINFECTION.— Con-current disinfection consists of the daily measurestaken to control the spread of pathogenic organismswhile the patient is still considered infectious.TERMINAL DISINFECTION.—Terminaldisinfection consists of those measures taken todestroy pathogenic organisms remaining after thepatient is discharged from isolation. There are avariety of chemical and physical means used todisinfect supplies, equipment, and environmentalareas, and each facility will determine its ownprotocols based on the recommendation of an InfectionControl Committee.SURGICAL ASEPTIC TECHNIQUELEARNING OBJECTIVE: Recall theprinciples and guidelines for surgical aseptictechnique, and determine the correctsterilization process for different types ofmaterials.As used in this discussion, surgical aseptictechnique is the term used to describe the sterilization,storage, and handling of articles to keep them free ofpathogenic organisms. The following discussion willaddress the preparation and sterilization of surgicalequipment and supplies, and the preparation of theoperating room for performing a surgical procedure. Itshould be noted that specific methods of preparationwill vary from place to place, but the basic principles ofsurgical aseptic technique will remain the same. Thisdiscussion will present general guidelines, andindividual providers are advised to refer to localinstructions regarding the particular routines of aspecific facility.Before an operation, it is necessary to sterilizeand keep sterile all instruments, materials, andsupplies that come in contact with the surgical site.Every item handled by the surgeon and the surgeon’sassistants must be sterile. The patient’s skin and thehands of the members of the surgical team must bethoroughly scrubbed, prepared, and kept as aseptic aspossible.2-30
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