Aseptic Technique Ref: IPC-0001-019.v1855174515996c2342ce9-b91db9ea1760519cc6f6ec439f67c6f2.ssl.cf3.rackcdn.com ›

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Aseptic Technique Ref: IPC-0001-019.v1 Status: Ratified Document Type: Procedure

Contents 1. 2. 3. 3.1. 3.2. 3.3. 3.4. 3.5. 4. 5. 6. 7.

Purpose .............................................................................................................3 Related documents ...........................................................................................3 Process .............................................................................................................4 Hand Decontamination .......................................................................................4 Barriers – Using Protective Equipment ............................................................... 4 Preparing and Maintaining a Sterile Field............................................................ 4 Safe Technique...................................................................................................5 Procedure for Undertaking Aseptic Technique .................................................... 5 Audit ..................................................................................................................7 Definitions .........................................................................................................7 References ........................................................................................................8 Document control .............................................................................................9

IPC-0001-019.v1 Aseptic Technique Procedure

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1. Purpose Following this procedure will help the Trust to:• •

Provide assurance of safe aseptic technique practices in clinical and community areas. Ensure staff who undertake aseptic technique provide safe and competent effective practice, and have an effective framework to minimise the spread of infection while undertaking this procedure.

2. Related documents The Infection Prevention and Control Policy and Standard (Universal) Precautions for Infection Prevention and Control define the universal standards for IPC which must be read before carrying out the procedures described in this document. This procedure also refers to: Medical Devices Policy  Wound Care Guidelines  Policy for Consent to Examination or Treatment

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3. Process Aseptic technique is a sterile method used to prevent contamination of open wounds and other susceptible sites by potentially pathogenic (harmful) microbes. 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. Aseptic technique should be used in preparation and during any invasive procedure which breaches the body’s natural defences e.g. the skin, mucous membranes. It is also used to prevent introducing harmful microbes into a susceptible site or wound from hands, surfaces or equipment e.g. when handling equipment, such as performing urinary catheterisation, which will enter a normally sterile area. Aseptic technique also prevents the transfer of harmful microbes from the susceptible site or wound to staff and other patients.

3.1. Hand Decontamination Hand washing is the single most important procedure for preventing healthcare acquired infection as hands have been shown to be the most common route of transmission of infection. Hands should be washed and thoroughly dried or alcohol hand gel applied before and throughout the aseptic technique procedure. This will remove and destroy transient micro-organisms. Hand Hygiene

3.2. Barriers – Using Protective Equipment Protective clothing must be worn to prevent transfer of potentially pathogenic bacteria from patient to staff or staff to patient:  Sterile gloves must be worn;  Wearing gloves prevents direct contact from the hands and the susceptible site or wound;  Disposable aprons are water repellent and impermeable to bacteria. Wearing an apron will prevent contamination of user’s clothing from becoming soiled, wet or stained during patient care activities;  Aprons and gloves must be changed or removed and disposed of after each episode of care and hands washed and dried.

3.3. Preparing and Maintaining a Sterile Field  

The appropriate surface or dressing trolley used to undertake the procedure must be cleaned with detergent and water and thoroughly dried before and after each procedure. Collect all equipment required for the procedure together. Place all of the equipment required

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 

     

for the procedure (on the bottom shelf of the trolley if available), making sure that the dressing pack and any equipment is undamaged, dry and intact. Open the dressing pack and, using only the corners, place the sterile field onto the trolley or appropriate clean surface. Sterile items do not come into contact with non-sterile objects: this includes not only products used during the procedure but also the final dressing. This will prevent the susceptible site or wound from being contaminated during the procedure. Only sterile items should come into contact with the susceptible site or wound. The purpose of maintaining a safe environment is to reduce possible contamination of the susceptible site and the environment. All procedures which require an aseptic technique should be performed in a clinical room if available, or in a patient’s individual room. Limit the number of people in the room during the procedure. The environment including the dressing trolley or appropriate surface must be cleaned and disinfected in preparation before and after use. Dispose of clinical waste correctly in line with Trust Policy.

3.4. Safe Technique Only perform the procedure if you are correctly trained and competent in doing so or adequately supervised. Service specific training will be delivered by the Nursing Directorate to units as and when required.

3.5. Procedure for Undertaking Aseptic Technique Action

Rationale

Check the patient’s documentation/ Nursing/Medical instructions regarding wound care. Check all details verbally with patient if appropriate/necessary. Qualified professional to complete appropriate documentation following the assessment, including care plan

To confirm correct patient and ensure the practitioner has the correct details for the care to be provided

Fully explain the procedure to the patient including who is delivering their care. Allow time to provide support, reassurance and discussion. Seek verbal consent for procedure and document same in patient notes.

To obtain patient consent and co-operation To ensure the patient is informed about the procedure about to be undertaken and ensure quality of care delivery To provide documentary evidence to support informed consent

Ask the patient about previous medical history and any experiences/problems post medical/surgical/ procedure or episode of care

Involves patient in their holistic care and identifies if patient is experiencing any current problems which need addressing

Check if patient has any known allergies

To ensure appropriate, safe dressing choice is

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made Assess the environment to reduce the risk of potential cross infection e.g. minimise the amount of movement within the room, prior to commencing the procedure Ensure that the patient is comfortable, safe and is positioned appropriately to perform the relevant procedure

To ensure that safe practice is performed whilst maintaining the patients dignity, privacy and comfort

Clean the dressing trolley/appropriate surface with detergent and water/detergent wipes. Collect all equipment required for the procedure checking expiry dates before use

To minimise the risk of cross infection To ensure the procedure is performed without interruption or problems and to minimise patient discomfort and promote comfort

Check all packaging is intact and sterile and appropriate to be used for identified patients’ care

To ensure that only sterile equipment is used To ensure that all equipment used is fit for purpose

Cover cuts and abrasions on hands with waterproof dressing Remove any jewellery/wrist watch and ensure ‘bare below the elbows’ is adopted prior to the procedure Put on plastic apron Wash and dry hands with liquid soap and disposable hand towels.

To reduce the risk of cross infection and wound infection

Empty the dressing pack onto a clean field and using only the corners of the outer wrapping of the pack, open the sterile field

To ensure that areas of potential contamination are kept to a minimum To minimise the risk of cross infection

Open packs of remaining equipment and gently tip contents onto the sterile field Sterile saline solution can be used for wound cleansing If Irripod system is used, a sterile gauze swab may be used to hold the unit to assist maintaining sterility of gloves

To prepare the equipment prior to commencing the procedure so that wound exposure, once the dressing is removed, is kept to a minimum To reduce the risk of cross infection and maintain wound bed temperature (reduction in temperature can affect/ delay wound healing)

Wash and dry hands or use alcohol hand gel

Hands may be contaminated whilst handling outer dressing packaging

Place hand in disposable plastic bag, arrange contents of dressing pack on sterile field

To maintain sterility of dressings

Remove used dressings with hand covered with disposable plastic bag, invert bag and place in area which is easily accessed for disposing of remaining dressing products

To minimise the risk of contamination by placing soiled dressing directly into disposable bag

If dressings are complex non sterile gloves will need to be worn to remove the dressings. Wash and dry hands or use alcohol hand gel.

Hands may be contaminated whilst handling outer dressings To maintain sterility of the equipment/

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procedure Put on first sterile glove touching only the inside of the wrist end of the glove, then put on second sterile glove by only touching the outer aspect of the glove ie the fingers ensuring the gloves do not touch any unsterile object

To reduce the risk of cross infection Gloves provide greater sensitivity than forceps and are less likely to cause trauma

Dispose of any sharps/ instruments immediately after use, into sharps box

To prevent sharps injury

Dispose of all clinical waste in disposable plastic bag Wash and dry hands Clean trolley/clean field following use with detergent and water/detergent wipes

To prevent cross-contamination from soiled dressings To reduce risk of cross contamination

Complete all relevant patient documentation on PARIS Offer advice and support and allow time for discussion to answer any queries or concerns and explain ongoing care management

To ensure that the patient is involved in and informed about their care To provide documentary evidence to support episode of care To facilitate continuity of care and maintain communication links with colleagues

4. Audit An annual audit plan is produced and endorsed by the Infection Prevention and Control Committee. Adherence to these policy documents will be audited using an evidence based audit tool. Results of audits should be fed back, via Clinical Governance structures, to the Infection Prevention and Control Committee to contribute to future reviews. Audit of practice will be required under the supervision of the ward/unit manager using a competence assessment framework

5. Definitions Term

Definition

Aseptic technique

The sterile method used to prevent contamination of open wounds and other susceptible sites by potentially pathogenic (harmful) microbes. 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.

Single patient use

A device can be used more than once on one patient only. A device to be used once and discarded.

Single use equipment IPC-0001-019.v1 Aseptic Technique Procedure

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Personal Protective Equipment [PPE]

Personal protective clothing utilized in the clinical area includes gloves (sterile and non-sterile), aprons, eye protection and facemasks. The aim is to create a barrier to reduce the risk of transmission of infection.

Cleaning

A process that will physically remove contaminating microorganisms and organic material. Essential prior to disinfection and sterilization.

Sterilisation

A process that removes or destroys all living micro-organisms including bacterial spores.

Decontamination

A combination of processes which removes or destroys contamination so that infectious agents or other contaminants cannot reach a susceptible site, in sufficient quantities to initiate infection or other harmful response.

6. References Infection Prevention and Control Nurses Association (ICNA) 2003. Asepsis: Preventing Healthcare Associated Infection. www.icna.co.uk Epic2: National Evidence Based Guidelines for Preventing Healthcare-Associated Infections in NHS hospitals in England. Journal of Hospital Infection Supplement 1 Volume 65 February 2007 DoH (2006) Essential steps to safe, clean care. Reducing healthcare-associated infections in Primary Care Trusts; Mental health trusts; Learning disability organisations; Independent healthcare; Care Homes; Hospices: GP practices and Ambulance Services. Department of Health (2006) The Health Act 2006 Code of Practice for the Prevention and Control of Health Care Associated Infection London DH 2006.

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7. Document control Date of approval:

05 September 2013

Next review date:

05 September 2016

This document replaces:

Aseptic Technique Policy IC/0020/v2(2)

Lead:

Name

Title

Angela Ridley

IPC and Physical Healthcare Senior Nurse

Name

Title

Alexia Hardy

Senior Nurse

This document has been agreed and accepted by: (Director)

Name

Title

Chris Stanbury

Director of Nursing and Governance

This document was approved by:

Name of committee/group

Date

Quality and Assurance Committee

05 September 2013

An equality analysis was completed on this document on:

27 May 2011

Members of working party:

Amendment details:

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