Nursing Education Department

Aseptic Technique
Study Module for Nurses

1|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015

Nursing Education Department

Index Page 1 page 2 Page 3 page 3 Page 4 Cover Page Index Definition Principles of Aseptic Technique Procedure

Page 4 Clean Technique (Medical Asepsis) Page 5 Page 6 Page 6 Page 7 Page 8 Sterile Technique (Surgical Asepsis) Maintaining Asepsis Other Recommendations to Maintain Asepsis Recommendations for Health Care Workers regarding Hand and skin Preparation Reference

2|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015

Nursing Education Department
Definition 1. Aseptic technique refers to practices designed to render and maintain objects and areas maximally free of microorganisms. This may consist of aid in the prevention of surgical site, urinary tract, bloodstream, and pneumonia infections that may be device or procedure related. Clean technique (medical asepsis) refers to practices that reduce the number of microorganisms or prevent/reduce transmission from one person (or place) to another. Sterile technique (surgical asepsis) refers to practices that provide the maximum reduction of skin microorganisms without damaging tissues. It involves the use of barrier techniques to decrease the transmission of microorganisms from personnel to patients. Both sterile and clean techniques are elements of this infection method, although both have distinct similarities and differences.

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Principles of Aseptic Technique A. Staff undertaking aseptic procedures adhere to the Hand Hygiene Policy and the Dress Code policy. (Please read the Hand Hygiene study module for detailed information) B. The setting should be prepared including the decontamination of the working surface or tray to be used with detergent and water or detergent wipes and then dried C. The type of hand hygiene will depend on the procedures

D. The extent of the use of drapes and protective clothing will depend on the type of procedure and it’s complexity E. F. All packaged sterile items for the procedure should be assembled prior to starting the procedure Staff should check the packaging is intact and expiry date has not been exceeded

G. All packaged sterile items such as needles and syringes should be opened carefully by peeling back the packaging and not pushing it through the back of paper H. If possible 30 minutes should be left after bed making or domestic cleaning before exposing or dressing wounds or performing any other aseptic procedure I. J. K. Soiled dressings should be removed carefully Wounds should be exposed for the minimum time to avoid contamination Gloves should be changed and hands decontaminated at any stage when contamination has occurred. Staff should NEVER apply hand hygiene products to gloved hands The procedure should be performed avoiding accidental contamination of sterile equipment and site

L.

3|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015

Nursing Education Department
PROCEDURE A. Clean technique (medical asepsis) 1. Use clean techniques for routine patient care procedures. 2. Prepare and organize equipment and supplies. 3. Reduce the number of skin microorganisms by adhering to proper hand hygiene practices. 4. Use clean or sterile single-use patient devices and equipment if available, or use reusable devices and equipment that have been properly cleaned and reprocessed. 5. Select an appropriate site on patient (isolate the area) a. Prepare the patient’s skin before the procedure by applying the hospital-approved antiseptic agent to the patient’s clean skin Use correct skin prep for the patient’s body site Clean from the area that is clean to the area that is dirty Remove hair only when necessary; do so immediately before the procedure using clippers or razors

b. c. d.

6. Use barrier techniques to reduce microbial transmission from patient to personnel. a. Use a “no-touch” dressing technique to avoid the contamination of sterile supplies. Use sterile gloves or forceps for the application of dressings. Wear a clean gown/apron to minimize the contamination of clothing. Wear clean gloves to avoid direct contact with infectious materials.

b. c.

7. Provide environmental controls to reduce microbial transmission. a. Use negative-pressure rooms for patients with infectious agents that can be spread by airborne route. Change the covers/sheets used on examination table, stretchers or wheelchairs between patients.

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4|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015

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B. Sterile technique (surgical asepsis) 1. Use sterile techniques for all invasive procedures. 2. Reduce the number of skin microorganisms by adhering to proper hand hygiene practices. 3. Decontaminate your hands using an antiseptic hand rub (chlorhexidine/alcohol-based product) or antiseptic soap before putting on sterile gloves. 4. Prepare and organize equipment and supplies. 5. Use sterile, single-use patient devices and equipment. 6. Select the appropriate site on the patient (isolate the area) a. Prepare the patient’s skin before the procedure by applying the hospital-approved antiseptic agent to the patient’s clean skin Use the correct skin prep for the patient’s body site Clean from the area that is cleanest to the area that is dirty Remove hair only when necessary; do so immediately before the procedure using clippers and NOT razors

b. c. d.

7. Use barriers to decrease the transmission of microorganisms from personnel to the patient. a. Mask, sterile gown and gloves, head cover, and large sterile surgical drape on the patient should be used. Put on appropriate sterile apparel as required by risk of procedure to be performed. Maintain an area of sterility with the use of sterile supplies (e.g., gloves, drapes, and other equipment).

b. c.

8. Provide environmental controls to maximize the reduction of microorganisms during procedure. a. b. Use special treatment rooms when indicated (e.g., in the OR or radiology). Maintain positive pressure in the room.

NB: Use negative-pressure rooms for patients with infectious agents spread by the airborne route. Provide a higher rate of air exchanges through the ventilation system. c. d. Exclude visitors and unnecessary personnel. Keep doors closed during procedures or use other physical barriers such as screens to divert traffic.

5|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015

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e. Avoid cleaning/maintenance activities in the area during the procedure. C. Maintaining Asepsis 1. It is important to be fully prepared before starting any procedure. 2. Anticipate what is needed for the procedure. 3. Supplies required may include but are not limited to the following: a. b. c. d. e. Clean trolley (tray) Supplies (PPE, gauze, site prepping solutions) Equipment (proper pack, size, type, amount) Accessible disposal unit Help (if required)

4. Avoid leaving the room/bedside to get supplies. 5. Follow the approved policy for the procedure being performed. 6. Change gloves (after removing old dressing and before applying clean dressing). D. Other recommendations to maintain asepsis 1. Clean and disinfect environmental surfaces routinely after each procedure. a. b. Use clean equipment and supplies (mops, water, cleaning cloths). Use detergent to remove soil.

2. Clean up body fluid spillage using hospital-approved disinfectant. 3. Dispose of all contaminated materials and supplies appropriately to avoid contaminating HCWs, patients and environmental surfaces. 4. Reprocessing of reusable equipment and surgical instruments must be done by the designated department. 5. Use special equipment for ventilation (e.g., high-efficiency particulate air filters or laminar air flow) when feasible.

6|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015

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E. Recommendations for Health Care Workers regarding Hand and skin preparation

7|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015

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F. REFERENCE 1. Association for Professionals in Infection Control (APIC) and Epidemiology, Inc. (2009). Chapter 19: Hand Hygiene. In APIC Text of infection control and epidemiology (3rd ed.) Association for Professionals in Infection Control (APIC) and Epidemiology, Inc. (2009). Chapter 20: Aseptic Technique. In APIC Text of infection control and epidemiology (3rd ed.) WHO Guidelines on Hand Hygiene in Healthcare 2009 (World Alliance for Patient Safety) Dougherty L and Lister S (Eds) (2004) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 6th Edition. Blackwell Publishing. Oxford NICE (2008) Surgical site infection Prevention and treatment of surgical site infection NICE clinical guideline 74 http://guidance.nice.org.uk/CG74/Guidance/pdf/English Pratt et al (2001) The epic Project: Devleoping National Evidence based Guidelines for Preventing healthcare associated infections. Pase 1:Guidelines for Preventing Hospital Acquired Infections. Journal of Hospital Infection 47(Suppl):S1-S82.

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Aseptic Technique examination is based on the contents of this study module 80% PASSING Score. You are only allowed to commit 2 mistakes for a 10 items Exam.

8|8 Aseptic Technique Study Module Prepared By: AEA 1 January 2015