ASEPTIC TECHNIQUE

Aseptic technique comprises specific, careful practices to minimize contamination by pathogens.

protect the patient from infection, and to prevent the spread of pathogens.

Aseptic technique is a set of practices that healthcare professionals use to protect patients and
themselves from infection. It includes the use of sterile gloves and gowns during surgery.
Aseptic technique is a standard healthcare practice that helps prevent the transfer of germs to or
from an open wound and other susceptible areas on a patient’s body.

Aseptic techniques range from simple practices, such as using alcohol to sterilize the skin, to full
surgical asepsis, which involves the use of sterile gowns, gloves, and masks.

Healthcare professionals use aseptic technique practices in hospitals, surgery rooms, outpatient
care clinics, and other healthcare settings.

Using aseptic technique prevents the spread of infection by harmful germs. Healthcare
professionals use aseptic technique when they are:

 performing surgical procedures

 performing biopsies

 dressing surgical wounds or burns

 suturing wounds

 inserting a urinary catheter, wound drain, intravenous line, or chest tube

 administering injections

 using instruments to conduct a vaginal examination

Aseptic technique vs. clean technique

Aseptic technique and clean technique are two closely related healthcare practices that both aim
to keep people safe from infection. The aim of using aseptic technique is to eliminate germs,
which are disease-causing microorganisms. Clean technique focuses on reducing the
number of microorganisms in general. Healthcare professionals learn both aseptic and clean
techniques and use them in different situations. They will use aseptic technique during
surgical operations or when inserting a foreign object, such as a catheter, into a person’s
body. Clean technique is often sufficient for long-term care, in-home care, and some outpatient
clinical settings. Healthcare professionals use clean technique for people who are not at high risk
of infection. For example, they may use clean technique when changing the dressing on a wound
that is healing. Some examples of clean technique practices include thorough handwashing,
wearing gloves, and maintaining a clean environment or work area. Clean technique uses
non-touch practices. Non-touch practices prohibit healthcare professionals from touching key
parts of objects, such as syringe tips and the inside of sterile dressings, even when they are
wearing gloves. The medical community defines clean technique as a modified form of aseptic
technique, as maintaining proper hygiene and a clean environment will help achieve asepsis.

Types of aseptic technique

 barriers

 patient and equipment preparation

 environmental controls

 contact guidelines

Barriers
Barriers prevent the transfer of germs between healthcare professionals, patients, and the
environment. Aseptic barriers include:

 sterile gloves

 sterile gowns

 sterile masks

 sterile drapes

 protective wrappers on sterilized instruments

Patient and equipment preparation

Healthcare professionals must thoroughly prepare both the patient and the equipment before a
medical procedure takes place.

Aseptic preparation may involve:

 disinfecting a patient’s skin using antiseptic wipes

 sterilizing equipment and instruments before a procedure

 keeping sterilized instruments inside plastic wrappers to prevent contamination before

Environmental controls

Healthcare professionals also have to consider the patient’s immediate surroundings. It is

Maintaining an aseptic field involves:

 keeping doors closed

 limiting entry to necessary personnel only

 permitting only one patient per aseptic field

Contact guidelines

Once a healthcare professional has washed their hands and donned their sterile barriers, they
must follow sterile-to-sterile contact guidelines. These guidelines prohibit any contact between
sterile and nonsterile items. At this point, healthcare professionals can only touch sterile objects
and surfaces, and they must avoid touching nonsterile items and surfaces at all costs. The same
guidelines apply to sterile devices. If a sterile instrument falls on the ground and the wrapper
sustains damage, a healthcare professional must remove the instrument and re-sterilize it before
use.

Using aseptic technique at home

The proper execution of aseptic technique requires training. If a person needs to use aseptic
technique at home, a trained healthcare professional can demonstrate the proper practices to
them. Anyone performing aseptic techniques at home will need to have sterile gloves and special
dressing kits at hand. While aseptic technique requires proper training and the use of specialist
equipment, clean technique is much easier to achieve at home. Clean technique involves
thoroughly washing the hands, wearing gloves, and maintaining a clean environment.

FIVE ESSENTIAL PRINCIPLES OF ASEPTIC TECHNIQUE

There are essential principles that should be applied when performing a procedure that requires
aseptic techniques. These principles are:

1.Sequencing:

Sequencing involves a series of actions that ensure each procedure is performed in a safe and
appropriate order. Sequencing includes assessing for risks to patient safety and the HCW and
identifying strategies to mitigate these risks prior to starting the procedure. When considering the
steps for sequencing, the HCW should consider the following points:

Perform a risk assessment:

▪ Are there environmental or patient factors that increase the risk for this procedure?

▪ Is the procedure technically difficult or an emergency situation?

▪ Will this procedure require a standard or surgical aseptic technique?

▪ Is there a risk of infection transmission or contamination risk with this procedure?

▪ Do you know how to perform this procedure?

▪ What PPE do you need for this procedure?

▪ What action is required to mitigate these risks?

Pre-procedure preparation:

▪ Prepare the environment

▪ Select the correct equipment; check the condition, integrity and expiry date of each item
required for the procedure

▪ Plan each step of the procedure to avoid a breach in asepsis

▪ Inform the patient and prepare them for the procedure.

Performing the procedure:

▪ Set up the equipment immediately prior to performing the procedure

▪ Perform the procedure in a safe, logical order.

Post procedure practices:

▪ Remove gloves and perform hand hygiene

▪ Settle the patient

▪ Pack away equipment and dispose of waste

▪ Document the outcome from the procedure including any breaches in asepsis, any corrective
actions taken at the time of the procedure to minimise any infection risks or if multiply attempts
were required to complete the procedure (such as the number of attempts to insert a peripheral
cannula).

2. Environmental control

There are many factors in the clinical environment which can increase the risk of infection and
patient harm during a procedure. These factors include:

▪ Other activities that are occurring in the nearby environment that may increase the risk of
contamination during the procedure (e.g. for example bed making, dusting, or cleaning)

▪ Whether the environment is a controlled setting, such as a laboratory, pharmacy, or operating

▪ The condition of the work area, surface and equipment used for this procedure (e.g. how clean
is the equipment? Is the equipment required for the procedure damaged or rusty?)

▪ Fans and open windows can cause air turbulence and contamination of the aseptic field. Where
practical, these factors should be removed (e.g. wait until cleaning has finished, replace damaged
equipment) or otherwise controlled to reduce the risk of contamination and infection
transmission.

3. Hand hygiene: There are critical moments before, during and after an invasive procedure
or a procedure requiring aseptic technique when hand hygiene should be performed. These
moments are:

▪ Before and after collecting the equipment

▪ After setting up an aseptic field

▪ Immediately before donning gloves (if gloves are required),

▪ Immediately after completing the procedure and removing gloves

▪ Immediately after cleaning up and disposing of equipment and waste.

Hand and wrist jewellery must be removed prior to the procedure and performing hand hygiene.
If gloves become grossly contaminated or torn during a procedure, the gloves need to be
removed, hand hygiene must be performed, and new gloves applied.

1. Maintenance of aseptic fields

The HCW should ensure that the aseptic field, the key parts, and key sites are always
protected. The HCW should always:

▪ Prepare the key site with the correct solution e.g. cleanse with normal saline,
chlorhexidine, or other suitable solutions

▪ Clean and or disinfect all the equipment and key parts to be used

▪ Establish an aseptic field, for example, by using a sterile tray, or using a laminar flow hood
▪ Use techniques that protect the key site and all key parts used for the procedure
▪ Use the most suitable technique for the type of procedure, e.g. a non-touch technique if
suitable or use sterile gloves if you need to handle sterile equipment and the procedure site.

5. Personal protective equipment (PPE)

PPE is important for protecting both the patient and HCW during aseptic procedures. The
HCW should consider the following points:

▪ What PPE is required to protect the patient, the aseptic field and yourself during the
procedure?

▪ Do you require protective eyewear, a face shield and/or a surgical mask?

▪ Can you perform this procedure with non-sterile gloves or are sterile gloves required?

▪ Do you require a sterile gown or plastic apron to protect the patient, aseptic field, and
yourself?

▪ What is the correct sequence for putting on and removing PPE

STANDARD PRECAUTION

Standard precautions are infection control practices that are used to prevent the transmission
of infections. Standard precautions should be applied at all times during patient care
regardless of infection status.

Standard precautions include:

• Hand hygiene

• Aseptic technique

• Use of personal protective equipment (PPE)

• Safe use of sharps

• Environmental cleaning

• Reprocessing of medical equipment

• Appropriate handling of linen and waste management.

Standard precautions should always be applied when in contact with blood, body fluid,
secretions, excretions, non-intact skin and mucous membranes. For optimal aseptic technique
to occur, all the elements of standard precautions must be used by the healthcare worker
(HCW).