Introduction to Aseptic Technique
To minimise the risk of infection through the presence of pathogenic microorganisms to patients during clinical procedures, it is critical for healthcare professionals in operating suites to practice aseptic technique (Australasian College for Infection Prevention and Control 2017). As part of the National Safety and Quality Health Service (NSQHS) standard developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC), the aseptic technique aims to prevent and control healthcare associated infections (Department of Health Victoria 2014).
Preventing Infections with Aseptic Technique
Aseptic technique is a requirement for all invasive procedures, with the central goal for clinicians to maintain asepsis in the healthcare setting through hand hygiene, non-touch technique, glove usage and the sterility of equipment. A key factor of aseptic non-touch technique is hand hygiene, which must be performed correctly to achieve a higher level of protection against pathogens. Based on the most recent WHO guidelines, alcohol gel, such as PrimeOn Hand Sanitiser, provides the best antimicrobial efficacy compared to other hand hygiene solutions and is recommended for preoperative surgical hand preparation (National Health and Medical Research Council 2010).
According to Rowley and Clare (2011), performing aseptic technique involves identifying and protecting key parts (medical equipment) and key sites (devices connected to the patient). The choice of which glove to wear draws a parallel to the risk of contamination between the healthcare worker and the patient. Sterile gloves are required for complicated procedures that may require touching of key parts and sites, whereas non-sterile gloves are the preferred choice for basic procedures where there is no contact with key parts and sites. With the right level of training and experience in how to prevent infections with aseptic technique, clinicians are better able to protect their patients during invasive procedures, as well as reduce postoperative complications.
Types of Aseptic Technique
Aseptic technique isclassified into two different categories: standard aseptic technique and surgical aseptic technique. As shown in Table 1, there are many risk factors and infection control components for clinicians to consider for invasive clinical procedures. Determining the most suitable aseptic technique and performing it correctly requires a thorough understanding of the process to undertake both types of aseptic technique.
The Australasian College for Infection Prevention and Control (2015) highlights this process:
- Environmental Control Measures
- Infection Control Measures
- Aseptic Field Selection and Management
- Non-Touch Technique
- Waste Management
- Cleaning of Equipment
Table 1: Aseptic technique overview for invasive clinical procedures (ACIPC 2015)
| STANDARD ASEPTIC TECHNIQUE | SURGICAL ASEPTIC TECHNIQUE |
|
|
| Environmental Risks | Environmental Risks |
|
|
| Infection Control Measures | Infection Control Measures |
| Routine Hand Hygiene | Surgical Hand Scrub |
|
|
| Non-Sterile Glove Use | Sterile Glove Use |
|
|
| Aseptic Field Selection and Management | Aseptic Field Selection and Management |
| General Aseptic Field Management | Critical Aseptic Field Management |
|
|
| Non-Touch Technique | Non-Touch Technique |
|
|
| Waste Management | Waste Management |
|
|
| Cleaning of Equipment | Cleaning of Equipment |
|
|
What Procedures Require Aseptic Technique?
Knowing which clinical procedures require aseptic technique is just as important as understanding which type of aseptic technique to perform. The below shows some common clinical examples requiring the application of either the standard or surgical aseptic technique (ACSQHC 2018; Department of Health Victoria 2014; The Royal Children’s Hospital Melbourne 2013).
Standard Aseptic Technique
1. Preparation and Administration of Medical Treatment
Preparation and administration of medication for patients, such as chemotherapy
2. Simple Wound Management
Application of simple wound dressings; for example, patients with wrist lacerations and skin abrasions
3. IV Therapy and Transfusion Therapy
Insertion of an intravenous (IV) cannula to administer IV fluids, as well as blood transfusions
4. Catheter and Drainage Bag Management
Emptying drainage bags in a sterile field, such as a urinary drainage bag
Surgical Aseptic Technique
1. Surgery
Performing surgical procedures, such as cardiac operations
2. Complex Wound Management
Application of large complex wound dressings; for example, patients with burn wounds
3. Vascular Access Device Management
Insertion of vascular access devices, such as peripherally inserted central catheter (PICC) for intravenous therapy of antibiotics
References
- Australasian College of Infection Prevention and Control (ACIPC) 2015, Aseptic Technique during invasive clinical procedures, viewed 2 May 2019, <https://www.acipc.org.au/aseptic-technique-resources/>
- Australasian College of Infection Prevention and Control (ACIPC) 2017, AT Presentation (Applying Aseptic Technique), viewed 2 May 2019, <https://www.acipc.org.au/aseptic-technique-resources/>
- Australian Commission on Safety and Quality in Health Care (ACSQHC) 2018, 3. Preventing and Controlling Healthcare-Associated Infection – Aseptic Technique: Action 3.9, viewed 8 May 2019, <https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-prevention-and-control-infection-healthcare-2010>
- Department of Health Victoria 2014, Standard 3: Aseptic Technique Learning Module (Preventing and Controlling Healthcare Associated Infections)
- National Health and Medical Research Council (NHMRC) 2010, Australian Guidelines for the Prevention and Control of Infection in Healthcare, viewed 8 May 2019, <https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-prevention-and-control-infection-healthcare-2010>
- Rowley, S & Clare, S 2011, ‘ANTT: a standard approach to aseptic technique’, Nursing Times, vol.107, no.36, pp.12-14, viewed 6 May 2019, <https://www.nursingtimes.net/clinical-archive/infection-control/antt-a-standard-approach-to-aseptic-technique/5034771.article>
- The Royal Children’s Hospital Melbourne 2013, An Introduction to Aseptic Technique – National Safety and Quality Health Service Standard 3: Preventing and Controlling Healthcare Associated Infections, viewed 3 May 2019,<https://www.rch.org.au/WorkArea/DownloadAsset.aspx?id=38303>
