Applicability: All staff CONTENTS. 1. Introduction. 2. Principles of Asepsis. 3. Education. 4. Audit

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1 Title: ASEPTIC TECHNIQUE Ref: 0994 Version 3 Classification: Protocol Directorate: Infection Control Due for Review: 29/08/16 Document Control Responsible Sue Bradbury, Specialist Nurse Practitioner in Infection for review: Control Ratified by: Dr S Hoque, Director of Infection Prevention & Control (Acute Trust) J Viner, Director of Infection Prevention and Control (Community Trust). Jacquie Phare, Director of Nursing & Professional Practice (TSDHCT) Applicability: All staff CONTENTS 1. Introduction 2. Principles of Asepsis 3. Education 4. Audit Appendix A- Recommended Technique for commonly Performed Procedures Key References Technique Page 1 of 3

2 Summary This policy aims to provide guidance on the where, when and how as well as a definition for the practice of aseptic technique. It helps to identify principles for aseptic practice to help prevent infection. Key points include: hand hygiene, the use of personal protective equipment and thoughtful preparation in order to facilitate the procedure and maintain patient comfort as much as possible. Remember not to contaminate the sterile field and equipment during the procedure and that good preparation is key to a satisfactory procedure. 1. Introduction Definition technique is the method used to prevent contamination of surgical wounds and other susceptible sites from potentially pathogenic organisms. This can be achieved by ensuring that clinical staff understand the principles, follow recommended protocols and use only sterile equipment and fluids during invasive procedures. The principles of asepsis remain the same whether you are dealing with a CVC line, postoperative wound, intravenous cannula or leg ulcer etc. However the level of precautions will vary depending on procedure, e.g. (see appendix A). Rationale To minimise the risk of introducing potentially pathogenic micro organisms into a susceptible site. technique should be used in preparation and during any invasive procedure which breaches the body s natural defences e.g. the skin, mucous membranes, or when handling equipment, such as urinary catheters, which will enter a normally sterile area. 2. Principles of Asepsis Hand hygiene Hand washing is the single most important procedure for preventing healthcare acquired infection as hands have been shown to be the common route of transmission of infection. Transient bacteria can be removed by effective hand hygiene techniques. See SDHCT Hand Decontamination policy. Ref 0239 Community Healthcare staff should refer to Infection Control and hand hygiene policy available on ICARE. Protective clothing Protective clothing must be worn to: prevent transfer of potentially pathogenic bacteria from patient to staff or staff to patient prevent user s clothing from becoming soiled, wet or stained during patient care activities. Appropriate protective equipment must be worn, depending on procedure e.g. aprons, gloves for a wound dressing sterile gown, gloves, eye protection for a CVC line Recommended Technique Applicable for Commonly Performed Procedure Page 1 of 1

3 (see SDHCT Standard Precautions Standard Infection Control Precautions Policy. Ref 0514) Non-Touch Technique A Non-Touch Technique is used to maintain asepsis. Key principles include; effective hand washing avoiding contamination of key components or sterile equipment appropriate use of Personal Protective Equipment It is essential to ensure that hands, even though they have been washed, do not contaminate the patient or sterile equipment. This can be achieved by wearing sterile gloves and using forceps as appropriate. Catheterisation in community patients must be undertaken using an non-touch technique. Inanimate objects All instruments, fluids and materials which come into contact with a wound MUST be sterile to avoid the risk of contamination. This includes not only products used during the procedure but also the final dressing. Damage to packaging and the use by date must be checked. Dressing trolley The trolley must be cleaned with detergent and water daily or if it becomes visibly contaminated. Detergent wipes must be used between cases. These trolleys should not be used for other purposes. Sticky tape residues must be removed from the trolley rails. 3 Education 4 Audit All new clinical members of staff will receive training on the principles of asepsis during clinical induction. technique will be part of the competency assessment for other invasive interventions such as, cannulation, insertion of chest drains and suturing. Compliance with this policy will be monitored by the Department of Health, Saving Lives: reducing infection, delivering clean and safe care, High Impact Interventions, No1Insertion of Peripheral Cannula and No2 Central Venous Catheters. Annual audit will also be undertaken. ACKNOWLEDGEMENTS Leeds Mental Health Trust for allowing us to modify their policy Appendix A- Recommended Technique for commonly Performed Procedures Technique Page 3 of 3

4 Appendix A Recommended Technique Applicable for Commonly Performed Procedures Procedure Technique Comments Central venous catheter Surgical hand hygiene Chest drain insertion Surgical hand hygiene Cervical Smear Clean Use a sterilised speculum Epidural Surgical hand hygiene Gastrostomy or jejunotomy tube insertion (endoscopic/surgical or radiological guidance) Surgical hand hygiene Lumbar puncture Surgical hand hygiene Indwelling urinary catheter insertion Intermittent urethral catheterisation Clean in patients home in hospital Sterile gloves and single use disposable apron Sterile gloves and single use disposable apron in hospital IUD insertion Surgical hand hygiene required IV medication preparation for immediate use and administration Suprapubic catheter insertion Suction-Laryngeal Endotracheal Tracheostomy Wound care for wounds healing by primary intention e.g. surgical wound Wound care for wounds healing by secondary intention e.g. venous ulcers non-touch technique Clean Clean Clean non sterile gloves Surgical hand hygiene Manage as surgical wound until healed Dispose of catheter after each insertion Sterile gloves and single use disposable apron Clean gloves and single use disposable apron Recommended Technique Applicable for Commonly Performed Procedure Page 1 of 1

5 Protocols & Guidelines Document Control This is a controlled document. It should not be altered in any way without the express permission of the author or their representative. On receipt of a new version, please destroy all previous versions. Ref: 0994 Title: Technique Date of Issue: 29 August 2014 Next Review Date: 29 August 2016 Version: 3 Author: E Childs, Director of Nursing and Governance Index: Infection Control Classification: Protocol Applicability: All staff The guidance contained in this document is intended to be inclusive for Equality Impact: all patients within the clinical group specified, regardless of age, disability, gender, gender identity, sexual orientation, race and ethnicity & religion or belief. Evidence based: Yes 1. Infection Control Nurses Association. (ICNA) Asepsis: Preventing Healthcare Associated Infection epic2: National Evidence Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England. Journal of Hospital Infection Supplement 1 Volume 65 February Department of Health (2007) Saving Lives: reducing infection, References: delivering clean and safe care. London: DH. 4. Department of Health (2009). The Health and Social Care Act Code of Practice for the NHS on the prevention and control of Healthcare associated infections and related guidance. DOH. 5. ANTT Theoretical Framework for Clinical Practice: Rationale supporting evidence. Version 2.5, The Association of Safe Practice (ASAP) Produced following audit: No Audited: Yes Approval Route: See ratification Date Approved: 31 July 2012 Approved By: Dr S Hoque Director of Infection Prevention & Control (Acute Trust). J Viner Director of Infection Prevention and Control (Community Trust) Ms E Childs, Director of Nursing and Governance Links or overlaps with other policies 0239 Hand Decontamination Policy; 0514 Standard Infection control Precautions; 0611 Peripheral Venous Cannula Standards of Care All SDHCF Trust strategies, policies and procedure documents. PUBLICATION HISTORY: Issue Date Status Authorised 1 12 July 2007 New Dr A Maggs, Director of Infection Prevention & Control 2 28 January 2010 Revised Dr A Maggs, Director of Infection Prevention & Control 3 9 August 2012 Revised Dr S Hoque, Director of Infection Prevention and Control (Acute Trust) J Viner, Director of Infection Prevention and Control (Community Trust) 3 29 August 2014 Date change Sue Bradbury, Specialist Nurse Practitioner, Infection Prevention and Control Technique Page 5 of 5

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