Aseptic Technique

The aseptic technique is an essential nursing and medical skill in reducing healthcare-associated. It aim is to prevent the transfer of microorganisms from the healthcare worker, procedure equipment or the immediate environment to the patient.

In 2001, a framework for an aseptic practice called the Aseptic Non-Touch Technique (ANTT)^® was described by Rowley S. Aseptic Non-Touch Technique. Aseptic Non-Touch Technique resources are freely available with each Health and Social Care Trust in N. Ireland.

An aseptic technique is used during a medical procedure that enters the body site, usually by puncturing the skin (inserting indwelling devices, e.g. IV cannulas, CVC catheters), inserting instruments into a body cavity (e.g. endoscopy), or cutting the skin in a surgical procedure. In addition, the aseptic technique is also used to maintain indwelling devices and manage wound dressing.

Aseptic Non-Touch Technique is achieved by identifying before an invasive procedure is performed.

• Key parts: Sterile needles, syringe tips, intravenous line connections, exposed lumens of catheters, etc.
• Key sites: Open wounds and insertion and ongoing care of invasive/ indwelling devices, urinary and umbilical catheters, tracheostomy tubes, chest drains, gastrostomy, jejunostomy, nasogastric tubes, etc.

It is essential to follow these steps to achieve an aseptic technique:

• The person performing the aseptic technique should be well-trained and competent.
• Before inserting invasive devices, disinfect hands using an antiseptic (4% chlorhexidine or 5% povidone-iodine solution). 
• All items used during the procedure must be sterile.
• Never re-use single-use medical devices: syringes, needles, IV Cannula, central venous catheters, etc.
• It is also essential that during aseptic procedures, the key parts remain sterile throughout the clinical procedures. For example, during the administration of intravenous therapy, the key parts are usually those that come into direct contact with the liquid infusion—for example, needles, syringe tips, exposed lumens and the tip of IV catheters.
• Apply single-use antiseptic solutions. Inappropriate use of multi-use antiseptic solutions, sterile saline, water, and lubricants can result in contamination, and documented outbreaks have been reported.
• If it is necessary to touch a key part or key site directly, sterile gloves are recommended. Otherwise, non-sterile gloves can be used depending on the task.
• Throughout the procedure, maintain the aseptic non-touch technique, open items partially and keep them in the original sterile packing. Do not throw sterile items on a non-sterile area or an area which is not disinfected.

During clinical procedures, this is achieved by a range of methods, including:

• Performing hand hygiene before the procedure
• Use of appropriate types of gloves (sterile or clean non-sterile gloves, depending on the task)
• Creating a clean/aseptic field before the procedure
• Maintaining a clean/sterile field during the procedure and ensuring that only clean/sterile equipment is in contact with it.
• Not touching the ‘key parts’ either directly or indirectly.