Aseptic Techniques

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Asepsis can be defined as the complete absence of bacteria, fungi, viruses or other microorganisms that could cause disease. Aseptic techniques refer to a set of skills that are used to ensure any environment being examined or dressed remains free from micro-organisms by not directly touching the wound or any other surface that might come into contact with the wound (McFerran and Martin 2008). Sterilization techniques and effective hand washing technique also play a major role in maintaining aseptic conditions. Aseptic techniques may be adopted in a number of environments including surgery, community and ward based nursing. There are many procedures which require asepsis such as inserting a catheter, suturing a wound (Aziz 2009) or inserting a vascular access device (NICE 2013). I will be looking at the use of aseptic techniques when dressing a wound in particular. Wounds can be divided into two categories, surgical and traumatic. Surgical wounds are produced and closed under controlled conditions intended to prevent the access of microbes, healing by primary intention. Traumatic wounds may be heavily contaminated with microorganisms and are left open to cleanse and heal by secondary intention (Ayliffe et al 1999). Wound dressings are carried out frequently on wards and in the community and can involve leg ulcers, pressure sores and less superficial wounds healing by primary intention. Wounds healing by secondary intention are left open to allow the free drainage of exudate and the formation of granulation tissue to fill the cavity (3M 2013). I will explain the importance of the techniques used, when it is required for them to be used and why it is relevant to contemporary nursing practice. I will discuss the risks associated with the techniques, how they should be performed with a range of opinions from evidence based practice including the rationale behind the technique. The aseptic ‘non-touch’ technique (ANTT) is based upon theoretical framework and best available evidence (ANTT 2011). It is adopted when attending to wounds which require aseptic conditions. The procedure is comprised of four points which focus around timing, equipment, the patient and the technique (Aziz 2009). Rowley (2010) describes aseptic non-touch technique as a method of changing a dressing without directly touching the wound. Ayliffe et al (2000) concludes; by ensuring that only sterile fluids or uncontaminated objects make contact with the wound, an aseptic field can be maintained by preventing the contamination of susceptible sites. Firstly the nurse must make the decision about which technique to adopt, this may be dependent on a number of factors. The location the procedure is being performed in may influence the nurse to choose one technique over the other. District and community nurses may choose the clean technique as it is believed that it is not always possible to achieve a completely aseptic field in a patients home. The longevity of the wound will also contribute to the decision to use the clean or aseptic technique. Chronic wounds may be treated as infected and therefore a clean procedure will be used however an acute short-term wound may be treated aseptically (Flores 2008). According to Aziz (2009) the technique is comprised of effective hand washing, maintaining an aseptic field and glove choice. A clean, flat surface is required to place sterile equipment on, this should be a dressing trolley on a ward. In a patients home it may be a chair, table or even the floor. A ‘wound dressing’ kit is made up by the nurse and should have a sterile dressing pack, the appropriate dressing, bandages, scissors, hypo-allergenic tape and syringes for irrigation. It should also contain personal protective equipment (PPE), including gloves, an apron and also alcohol hand rub. A solution for cleaning or irrigation which may consist of sodium chloride (normal saline), sterile water or an antiseptic solution should be included depending on...
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