2. Scope The guideline is for all staff who undertakes activities which require asepsis as part of their role/job description.

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1 1. Introduction 1.1 Aseptic technique is an essential procedure aimed at protecting patients from infection during invasive procedures. This is achieved by minimising the presence of pathogenic micro-organisms as much as is practically possible. Aseptic Non Touch Technique (ANTT) is a specific type of aseptic technique with a unique theory and practice framework (Rowley et al 2010). 1.2 The EPIC 3 guidelines (2013) and NICE clinical guidelines (2012) endorse the use of ANTT as a framework for standardisation of safe aseptic practice. 2. Scope The guideline is for all staff who undertakes activities which require asepsis as part of their role/job description. 3. Standards and Procedural Statements 3.1 ANTT should be practiced during all invasive procedures, these can include: cannulation, intravenous line assembly, phlebotomy, wound care and urinary catheterisation, these are examples not an exhaustive list. There are posters demonstrating how asepsis can be achieved at the end of the guideline (See pictorial guides at the end of the guideline). If hard copies are required these should be obtained from the print room at the Leicester Royal Infirmary, the contact details are, extension, 6415 or LRI.print@interservefm.com 3.2 The Key Principles of ANTT are: a) Always clean hands effectively b) Non Touch Technique Always Consider appropriate Personal Protective equipment c) Take appropriate equipment precautions clean equipment d) Take Appropriate Steps to Protect Key parts at all times 3.3 A - Always clean hands effectively - Hand Hygiene Hands should be cleaned at a range of times in order to prevent Healthcare Associated Infections (HAI) (UHL Hand Hygiene Policy ID: UHLSP ). i) Before patient contact ii) Before a clean/aseptic procedure iii) After body fluid exposure/risk iv) After patient contact v) After contact with the patients environment Aseptic Non Touch Technique (ANTT) Guidelines Page 1 of 10

2 3.4 N Non touch technique always - Personal Protective Equipment Prior to the task a risk assessment must be undertaken to determine appropriate Personal Protective Equipment for the procedure. (Personal Protective Clothing for Infection Prevention Guideline ID: ) Sterile gloves must be worn when there is a potential or actual risk of a key part being touched during the procedure, for example, wound care or catheterisation Non-Sterile gloves are worn where there is no risk of a key part being contaminated, for example, drug preparation, drug delivery, cannulation or phlebotomy. 3.5 T Take appropriate equipment precautions - Aseptic Field A clean working environment is essential to ANTT. Before an ANTT procedure begins the aseptic field must be prepared. This may be a plastic tray or a dressing trolley depending upon the task to be undertaken Before the procedure can commence the aseptic field must be thoroughly cleaned and disinfected, by either Chlor-Clean or distel wipes. It is essential that the aseptic field is allowed time to dry before starting the procedure to ensure that the disinfection process has been completed After the procedure the same cleaning and disinfection should take place as described in and the trays/trolleys must be stored in a clean and dry area of the unit or ward. 3.6 T Take appropriate steps to protect key parts at all times - Key Parts and Key Sites Key parts are those parts of equipment that if contaminated pose an increased risk of the patient acquiring an infection. Key parts come into contact with the patient directly or via an infusion or connection. Examples: a) In intravenous therapy key parts, would be the fluid to be infused and the equipment that comes into contact with the fluid such as needles tips, syringe tips and needle free connectors. b) In wound care, the dressing pack, dressings and sterile gloves can be considered key parts If a key part becomes contaminated during a procedure then the contaminated item should be disposed of and a new one obtained Key Sites are any active parts that are connected to the patient. Examples: a) Wounds, when they are exposed without a dressing. b) Insertion sites of venous access devices. Aseptic Non Touch Technique (ANTT) Guidelines Page 2 of 10

3 4. Education and Training 4.1 ANTT is currently taught by the clinical skills department as an integral element of the task to be undertaken examples are, phlebotomy, catheterisation and intravenous drug administration. 4.2 All relevant staff must complete ANTT theory training which is available to staff on the e-uhl website as an e-learning package. ( 5. Monitoring and Audit Criteria Key Performance Indicator Training records of relevant staff completing the ANTT e-learning training on e-uhl ANTT Posters are displayed in clinical areas Method of Assessment Frequency Lead Report Run from e-uhl Visual inspection Every six months Every six months Line Managers Every six months IP Team 6. Legal Liability Guideline Statement Guidelines or Procedures issued and approved by the Trust are considered to represent best practice. Staff may only exceptionally depart from any relevant Trust guidelines or Procedures and always only providing that such departure is confined to the specific needs of individual circumstances. In healthcare delivery such departure shall only be undertaken where, in the judgement of the responsible healthcare professional it is fully appropriate and justifiable - such decision to be fully recorded in the patient s notes 7. Supporting Documents and Key References Epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England- A.Bak, A.Browne, R.J. Pratt,C.M. Pellowe,J.Prieto,H.P. Loveday, M.Golsorkhi, A.Tingle, J.A. Wilson, Journal of Hospital Infection (2013) 65S, S1 S64 available from - Based_Guidelines_for_Preventing_HCAI_in_NHSE.pdf National Institute for Health and Clinical Excellence (NICE) (2012) Infection prevention and Control of healthcare-associated infections in primary and community care. NICE clinical guideline 139 Rowley S and Clare S (2011) ANTT: a standard approach to aseptic technique. Nursing Times Vol 107 No 36 Rowley et al 2010 ANTT v2: An updated framework for aseptic technique. British Journal of Nursing (Intravenous Supplement ) Vol 19 No 5 UHL Hand Hygiene Policy UHL Personal Protective Equipment Guideline Aseptic Non Touch Technique (ANTT) Guidelines Page 3 of 10

4 8. Key Words ANTT, Aseptic Non-Touch Technique, Sterile Procedures This line signifies the end of the document This table is used to track the development and approval and dissemination of the document and any changes made on revised / reviewed versions Author / Lead Officer: Reviewed by: DEVELOPMENT AND APPROVAL RECORD FOR THIS DOCUMENT Elizabeth Hoyle Job Title: Infection Prevention Nurse Specialist Elizabeth Hoyle Approved by: Policy and Guideline Committee Date Approved: 18/10/13 REVIEW RECORD Date Issue Reviewed By Description Of Changes (If Any) Number August Elizabeth Hoyle Changed to the new format. DISTRIBUTION RECORD: Date Name Dept Received June 2015 All CMG s via heads of nursing All CMG s Aseptic Non Touch Technique (ANTT) Guidelines Page 4 of 10 V2 Approved by Policy and Guideline Committee on 31 July 2015 Trust Ref: B20/2013 Next Review: July 2018

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