Notes

Asepsis
Asepsis is a condition that is free of pathogens. Maintaining asepsis in a health care facility is the primary way to prevent the spread of disease from person to person. It works by breaking the chain of infection.

Medical and Surgical Asepsis
The two basic types of asepsis are medical asepsis and surgical asepsis. Medical asepsis is maintaining a clean environment in order to reduce the number of pathogens. It is also called clean technique. Common medical aseptic practices include handwashing, routine cleaning, and using personal protective equipment, such as gloves and masks.
Surgical asepsis is maintaining a sterile field. A sterile field is an environment that is free from all microorganisms and spores. Surgical asepsis is also known as sterile technique. It is required for most invasive procedures and operations. In order for an environment to stay sterile, only sterile items can come into contact with other sterile items. Surgical asepsis takes skill and foresight.

Sterilizing
The three levels of asepsis are sterilizing, disinfecting, and cleaning.
-Sterilization is the highest level of asepsis. It is a type of surgical asepsis that kills all microorganisms, including viruses and spores. Sterilization is used on instruments and equipment, not on people. It is used for critical devices that come in contact with sterile body tissues, such as equipment used during surgery.
Sterilization methods include pressurized steam, dry heat, and chemical solutions. However, the CDC recommends heat and steam sterilization be used over chemical solutions due to limitations and increased room for error during chemical processing. Before sterilizing, thorough cleaning is essential because inorganic and organic materials that remain on the surfaces of instruments interfere with the effectiveness of this process.
-Steam: Steam is the preferred method of sterilizing medical and surgical instruments. The most common piece of equipment used for sterilization in a medical office is an autoclave, which uses pressurized steam to kill microorganisms. Autoclaves sterilize equipment at temperatures of 250°F (121°C) for 30 minutes.
-Dry Heat: Dry heat is the method of sterilization used for materials that are damaged by moisture and so cannot be sterilized using steam. Dry heat uses temperatures of 340°F (170°C) for at least 60 minutes for sterilization.
-Chemical Solutions: Today, chemical soaking is primarily intended for high-level disinfection, as its effectiveness in sterilization can vary. Chemical sterilization is achieved by soaking instruments and equipment in a carefully prepared solution for 3 to 12 hours. This method is typically used with equipment that is too large for autoclaving or equipment that cannot withstand high temperatures, such as rubber, plastic, and fiber optics.

Disinfecting
Disinfection is the middle level of asepsis and can be classified as high-level or low-level.
-Prior to disinfecting, thorough cleaning is essential because inorganic and organic materials that remain on the surfaces of the instruments interfere with the effectiveness of this process.
High-level disinfection destroys most pathogens but is not always effective on spores. It is used for semi-critical devices, such as endoscopes, ultrasound probes, and ventilators, that come in contact with mucous membranes or non-intact skin.
-Low-level disinfection kills most bacteria, some fungi, and some viruses. It is used for non-critical patient care surfaces that come in contact with intact skin, such as bedrails, call lights, and vital sign machines. Additionally, using disinfecting wipes to clean high-touch surfaces in healthcare facilities is a method of low-level disinfection. This practice helps to prevent the spread of healthcare-acquired infections.
-Wheelchairs and beds are typically wiped down with wipes that contain strong disinfectant solutions. Make sure to read the manufacturer's label for proper protective measures before using the cleaning product.
Because disinfectants are usually chemical solutions, the disinfection process is generally used on objects and equipment, rather than on people. Common disinfectant solutions include chlorine and bleach. The time an object must soak in the disinfectant varies based on the solution. Be sure to verify the disinfection time on the manufacturer's label.

Cleaning
Cleaning is the lowest level of asepsis. It is also called sanitization. Cleaning is the removal of visible organic and inorganic material from objects and surfaces. The cleaning process does not destroy viruses or spores.
Cleaning is normally done manually or mechanically using water with detergents or enzymatic products. The process does not require harsh chemicals to destroy pathogens, so cleaning can be used on people as well as on objects and equipment. Examples include using soap to wash hands or using alcohol to prepare a patient's skin for a procedure.
In addition to soap and alcohol, antiseptic solutions such as iodine and betadine are often used in the cleaning process. Always read and understand the manufacturer's label carefully before use.