Republic of the Philippines

President Ramon Magsaysay State University

(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

NCM 112
Putting Personal Protective Equipment

Alma D. Bautista, RN, LPT

 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Introduction
Microorganisms are always present in the
environment. Some live on the skin, others are
common inhabitants of the intestinal tract and
others are found among other places, in the air, in
the soil, in articles and equipment in the hospital
and on our clothes. Therefore, knowledge of
asepsis and an awareness of how microorganisms
are transmitted that are essential for safe nursing
care environment.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
01 02 03
Medical
Infection Asepsis
Asepsis
An invasion of the body The absence of disease- Practices designed to
tissue by microorganisms producing microorganisms reduce the number and
and their proliferation Being free from infection transfer of pathogens.
there. Clean technique
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
04 05 06
Surgical
Sepsis Septicemia
Asepsis
Practices that render and The presence of infection. Transport of an infection
keep objects and are free or the products of
from microorganisms. infection throughout the
Sterile technique body or by blood.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
07 08 09

Carrier Contact Reservoir

A person or an animal who A person or animal known The natural habitat for the
is without signs of illness or believe to have been growth and multiplication
but who harbors pathogens exposed to a disease. of microorganisms.
within his body that can be
transferred to another.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
10 11 12
Transient
Resident flora
flora or Sterilization
or bacteria
bacteriapicked
The microorganism The microorganism that The process by which all
by the skin as a result of normally live on person’s microorganisms including
normal activities that can skin. their spores are destroyed.
be removed readily.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
13 14 15

Disinfectant Antiseptic Bactericidal

A substance, usually A substance, usually A chemical that kills
intended for use on intended for use on microorganisms
inanimate objects that persons that inhibit the
destroys pathogens but growth of pathogens but
generally not the spores. not necessarily destroy
Ex. surgical instruments them.
thermometers Ex. the substance used for
surgical wounds.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
16 17 18
Contaminatio
Bacteriostatic Disinfection
n
An agent that prevents The process by which The process by which
bacterial multiplication something is rendered pathogens but not their
but does not kill all forms uncleaned or unsterile. spores are destroyed from
of organisms. inanimate objects.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
19 20 21
Communicabl Infectious
Pathogen
e Disease Disease
Results if the infectious Results from the invasion A disease-producing
agent can be transmitted to and multiplication of microorganism
an individual by direct or microorganisms in a host.
indirect contact through a
vector or vehicle, or as an
airborne infection.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
22 23 24
Communicabl Infectious
Pathogen
e Disease Disease
Results if the infectious Results from the invasion A disease-producing
agent can be transmitted to and multiplication of microorganism
an individual by direct or microorganisms in a host.
indirect contact through a
vector or vehicle, or as an
airborne infection.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
25 26 27

Pathogenicity Virulence Specificity

The ability to produce a The vigor with which the The organism’s attraction
disease. organism can grow and to a specific host, which
multiply. may include humans.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
28 29 30
Opportunistic Nosocomial
Isolation
Pathogens Infection
Causes disease only in Hospital-acquired The separation of persons with
susceptible individual. infection. communicable diseases from
other persons so that either
direct/indirect transmission to
susceptible persons is
prevented.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Terminologies
31 32 33
Isolation
Isolation Etiology
Techniques
The separation of persons with Practices designed to The study of causes.
communicable diseases from prevent the transfer of
other persons so that either
specific microorganisms.
direct/indirect transmission to
susceptible persons is
prevented.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Stages of Infectious Process

0 0 Illness Period.
Incubation
1 Period.
Extends from the entry of 3 Specific signs and symptoms
microorganisms into the body develop and become evident.
to the onset of signs and
symptoms.

0
02 Prodromal Convalescent Period.
Period.
Extends from the onset of 4 Signs and symptoms start to
non-specific signs and abate until the client returns
symptoms to the appearance to normal state of health.
of specific signs and
symptoms.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

(1) Etiology/Infectious Agent:

(microorganisms): Bacteria, fungi, virus,
parasites

(6) Susceptible Host (2) Reservoir (source): Human beings,

Immunosuppressed children/elderly, inanimate objects, plants, general
chronically ill, those with trauma or environment such as air, water and soil.
surgery
The Chain
(5) Portal of Entry
of (3) Portal of Exit

Infection
Mucous membrane, non-intact skin, GI Sputum, emesis, stool, blood
tract, GU tract, respiratory tract

(4) Modes of Transmission

Contact, vehicle, airborne, vetorborne
1. Etiologic Agent
 
These may be bacteria, virus, fungi or parasites. The ability of the
infectious agent to cause a disease depends on its pathogenicity,
virulence, invasiveness and specificity.
 
2. Reservoir (source)
 
Humans (clients, visitors, health care personnel)
Animals (insects, rats)
Plants
General Environment (Water, air, food and soil)
 
3. Portal of Exit from Reservoir
 
Respiratory Tract: droplets, sputum
Gastrointestinal Tract: vomitus, feces, saliva, drainage tubes
Urinary Tract: urine, urethral catheters
Reproductive Tract: semen, vaginal discharge
Blood: open wound, needle puncture site
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

4. Mode of Transmission
 
a. Contact Transmission. This may be direct or indirect contact:

 Direct contact involves immediate and direct transfer from person to person (body surface – to – body surface). Examples:
healthcare personnel to clients during bathing, dressing changes, insertion of tubes and catheters; direct transfer between two
clients, with one acting as the source and the other as the host.
 Indirect contact occurs when a susceptible host is exposed to a contaminated object such as dressing, needle and surgical
instrument.

Contact transmission of infectious

organisms on the hands of caregivers
is the most frequent mode of
transmission in health care facilities.

b. Droplet Transmission. This may be considered a type of contact transmission.

 It occurs when mucous membrane of the nose, mouth, or conjuctiva are exposed to secretions of an infected person who is
coughing, sneezing, laughing or talking, usually within a distance of 3 feet.
c. Vehicle Transmission. This involves the transfer of microorganisms by way of vehicles or contaminated items that
transmit pathogens.
Examples: food, water, milk, blood, eating utensils, pillows, mattress.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

d. Airborne Transmission. This occurs when fine particles are suspended in the air for a long
time or when dust particles contain pathogens. Air current disperses microorganisms, which can
be inhaled or deposited on the skin of a susceptible host.
e. Vectorbone Transmission. Vectors can be biologic or mechanical.
 Biological vectors are animals, like rats, snails, mosquitos.
 Mechanical vectors are inanimate objects that are infected with infected body fluids like
contaminated needles and syringes.
 
5. Portal of Entry

 This permits the organism to gain entrance into the host,

 Pathogens can enter susceptible hosts through body orifices such as the mouth, nose, ears, eyes,
vagina, rectum or urethra. Breaks in the skin or mucous membranes from words or abrasions
increase chance for organisms to enter hosts.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

 
6. Susceptible Host
 
 A host is a person who is at risk for infection; whose own body defense
mechanisms, when exposed, are unable to withstand the invasion of pathogens.
Example: malnourished children, the elderly, the client with leukemia are
immune-compromised, and therefore, have propensity to develop numerous types
of infection.
 
For organisms to spread disease, they must grow, reproduce, and move from
one source to another.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Factors Influencing the Host’s Susceptibility

 Intact skin and mucous membrane are the body’s first line of
defense.
 The normal ph levels of secretions and ofgenito-urinary tract
help ward off microbial invasion.
 The body’s WBC influence resistance to certain pathogens.
 The age, sex, and race have been shown to influence
susceptibility.
 Immunization. (natural/acquired), acts to resist infection.
 Fatigue, climate, general health status, presence of pre-existing
illness, previous/current treatments and some kind of
medications may play a part in the susceptibility of a potential
host.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Principles Underlying Medical and Surgical Asepsis

 
 The patient is a source of pathogenic microorganisms.
 The patient’s microorganisms leave through specific routes.
 There are always microorganisms in the environment which in some individuals and under certain circumstances
can cause illness.
 Microorganisms harmful to man can be transmitted by direct by direct and indirect contact.
 Spread of infection from source to others can be prevented by various methods to stop the spread as close to the
source as possible.
 The effectiveness of medical/surgical asepsis is dependent on the conscientiousness of those carrying them out.
 In observing medical asepsis, areas are considered contaminated if they bear or are suspected of having pathogens.
 In observing surgical asepsis, areas are considered contaminated if touched by any object that is not sterile.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Breaking the Chain of Infection: Aseptic Practices

 
 Handwashing
 Cleaning, Disinfection, Sterilization
 Use of Barriers
 Isolation Systems
 Surgical Asepsis
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Handwashing
 Handwashing is the single most important infection control practice. All
caregivers, clients and family members should learn handwashing
techniques.
 Microorganisms are transient flora until the hands are washed.
 Soap and water and alcohol – based hand rubs are effective preparations for
removing transient microorganisms.
 Wash hands before and after every client care contact.
 Effectiveness of handwashing is greatly influenced by adequate friction and
thoroughness of surfaces cleansed.
 Handwashing for medical asepsis is done by holding hands lower than the
elbows. Hands are more contaminated than lower arms.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Handwashing
 Wash hands using running water, soap and friction for 15 to 30 seconds on
each hand. This is to mechanically loosen and remove dirt and
microorganisms on all hand surfaces.
 Clean under fingernails.
 Ideally, turn off faucet with clean paper towel.
 Keep fingernails short and avoid nail polish to prevent harboring
microorganisms.
 Always wear gloves during client care when the skin is abraded.
 
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

  Use of Bacteria
 Techniques that prevent the transfer of pathogens from one person to
another are referred to as “barriers.”
 The most commonly used barriers are as follows:
 
Masks
Caps and shoe coverings
Gloves
Private rooms
Waterproof disposable bags for linen and trash
Labeling and bagging of contaminated equipment and specimens
Control of airflow into the sterile areas and out of contaminated
areas
Goggles or face shields
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Masks
● Masks should fit tightly to the face, covering the nose and the mouth.
● Masks lose their effectiveness if they are wet, worn for long periods, and when they are not
changed after caring for each client.
● Disposable articulate respirators look like masks but fit the face more tightly and are able to
filter out particles or organisms as small as 1 micro millimeter. These are indicated
whenever a caregiver is working with a client who has, or is suspected of having
contagious, airborne diseases such as tuberculosis.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Gowns
● Gowns should be worn when caregiver’s clothing is likely to be soiled by infected material.
● Use gowns only once and discard them.
● Change gown when it becomes wet.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

 Caps and Shoe Coverings

● Caps are used to cover the hair, and special covers are available for shoes.
● These shield body parts from accidental exposure to contaminated body secretions.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683

Gloves
● Gloves protect the hands for acquiring infective organisms.
● These reduce likelihood of transmission of microbial flora from personnel to clients or from
client to other clients.
● Gloves should be changed and discarded between clients or when they become torn or
grossly soiled.
● Hands are washed and dried before and after removing the gloves.
● Gloves should not be washed and reused.
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683
 Republic of the Philippines
President Ramon Magsaysay State University
(Formerly Ramon Magsaysay Technological University)
Iba, Zambales,Philippines
Tel/Fax No.: (047) 811-1683