While the principles of aseptic technique remain constant for all procedures, the level of practice will change depending upon a standard risk assessment.
|Key-Sites||Open wounds, including insertion and puncture sites.|
|Key Parts||Parts of the procedure equipment that come into direct or indirect contact with the key-sites, other key-parts, or liquid infusions. Examples of key-parts are: needles or introducers; surgical instruments such as scalpel blades, forceps, and retractors; invasive devices such as PICC lines or urinary catheters.|
|Key-part and key-site identification and
|The best way to protect a key-site or key-part is not to touch it. Key-sites and key-parts are identified and protected by use of a non touch technique. Only aseptic key parts contact other aseptic key parts and/or key sites. If a key-site or key-part must be handled directly, sterile gloves are required. Contamination of key-sites or key-parts poses a high risk of infection to the patient.|
|Hand hygiene||Hand hygiene is performed as per the Queensland Health Hand Hygiene Guideline and the World Health Organisation 5 Moments for Hand Hygiene. In surgical aseptic technique, a surgical hand scrub is required.|
|Glove use||If it is necessary to touch key parts or key sites directly, sterile gloves are required. This is normally required for surgical aseptic technique. Otherwise non-sterile gloves are used in line with standard precautions.|
|Aseptic Fields||These provide a controlled aseptic working space. Aseptic fields are increased in size and sterile drapes added on the basis of procedure complexity.|
|Critical aseptic fields; ensuring asepsis||Used when key parts/sites cannot be protected with covers and caps, or handled at all times by a non-touch technique, or when open and invasiveprocedures require large working areas for long durations. The critical aseptic field itself is managed as a key part - only sterilized equipment may come in contact with it. Sterile gloves and often, full barrier precautions are required.|
|Critical micro aseptic fields||This is the protection of key parts and sites by syringe caps, sheathed needles, covers/packaging and non touch technique. Critical micro aseptic fields are used as part of both surgical and standard aseptic non touch technique, and may be used as a component of a larger critical aseptic field, or as the critical component of a general aseptic field.|
|General aspetic fields; promoting asepsis||Used when key parts can easily and optimally be protected by critical micro aseptic fields and a non touch technique. The main general aseptic field is not managed as a key part and is used to promote asepsis. Aseptic technique is simplified and usually involves non-sterile gloves.|
|Environmental control||Avoid nearby environmental risk factors that could compromise aseptic technique, such as bed making or cleaning activities.|
|Sequencing||Procedures should be performed in a sequence that ensures efficient, logical and safe practice, allowing the protection of key-sites and key-parts at all times.|
The healthcare worker is required to perform a risk assessment for procedures to decide:
This resource has been developed as an adjunct to the Quick Start Guide developed by the Australian Council on Safety and Quality in Healthcare (ACSQHC) to support infection control staff in implementing and providing evidence for the aseptic technique section of Standard 3 of the National Safety and Quality Health Service Standards. This table of examples of evidence may be used as guidance on how best to meet the requirements of Measure 3.10 of the Standard within existing programs and resources.
|3.10 Developing and implementing protocols for aseptic technique||
A local policy document shall be in place for aseptic technique - this does not mean the procedures should be about aseptic technique but they should outline the components of procedures that are essential to perform the procedure using safe aseptic technique. For example, elements of a procedure for a device insertion that should be mentioned specifically, to address aseptic technique, are requirements for;
To satisfactorily meet (SM) this measure your facility/HHS should have procedures in place for the following (for example) including the relevant elements of aseptic technique;
|3.10.1 The clinical workforce is trained in aseptic technique||
Training for aseptic technique may already by incorporated into existing education strategies. Documentation to evidence this may be:
|3.10.2 Compliance with aseptic technique is regularly audited||
|3.10.3 Action is taken to increase compliance with the aseptic technique protocols||
Documented record of a gap analysis to assess compliance of facility with this standard:
Actions taken as a result of auditing of compliance:
Documentation of general infection control interventions that impact on performance of aseptic technique, for example, hand hygiene program, infection control education/awareness programs on specific procedures/elements of procedures, e.g. change of skin prep products.
Self assessment survey of practice or of understanding of aseptic technique principles, and action taken as a result of this survey. For example, use of results of survey to guide education to be delivered to specific areas.
NHMRC Australian Guidelines for the Prevention and Control of Infection in Healthcare. 2010. Available from: http://www.nhmrc.gov.au/guidelines/publications/cd33
Rowley S, Clare S. Improving standards of aseptic practice through an ANTT trust-wide implementation process: a matter of prioritisation and care. Journal of Infection Prevention 2009; 10(s1) s18-s23
Aseptic Technique Workbook - developed by SA Health Infection Control Service