1. Infection Control & Aseptic Non-Touch Technique
Sally Aucken & Catherine Jones

2. Learning Objectives
Understand why critically ill pateints are vulnerable to infection
Identify key principles infection control within a critical environment.
Identify the key principles of Aseptic Non-Touch Technique (ANTT)
Demonstrate knowledge of differences between standard and surgical ANTT

3. Infection Control
WHY ARE CRITICALLY ILL PATIENTS MORE VULNERABLE TO INFECTION?

4. Infection Control:
Vigilant bedspace decontamination between patients. (Soapy Wipes)
Deep Clean Team for infected patients.
Daily dampdusting.
Personal Protective Equipment:
Visors available at each bedspace.
Gloves & Apron to be worn for any patient contact.
Relatives to gel hands on entering unit & wear aprons at bedspace
Full plastic gown for ‘dirtier’ procedures e.g. reaching over patient for roll.

5. Infection Control:

6. Infection Control:
DAILY DAMPDUSTING IS MANDATORY

7. Catheter Care: Daily catheter care with soap & water
Observe & document entry site daily
Always hang the catheter bag below the level of the bladder
Do not allow the catheter to come into contact with the floor
Interruption of closed catheter circuit should only be undertaken with good clinical reason – Sterile gloves should be worn.
Label catheter bag & change every 7 days

8. Failures in asepsis during aseptic technique
observed in NHS Trusts ( ).
Contamination of key-parts
Poor cannulation site care
Poor hand cleaning
Each of these poor practices places the patient at high risk of infection.
Which do you always get right?
Poor aseptic field management
Poor key-part cleaning 8

9. This presentation shows ANTT applied to IV therapy
However, …
ANTT can be applied to any aseptic technique
You are now going to look at two ways in which safe
ANTT can be taught and practiced.
By understanding the principles underpinning ANTT.
By learning the sequence of the IV ANTT guideline.

10. The main infection risk to the patient is the health care professional
Principle 1
The main infection risk to the patient is the health care professional
principle1
The ANTT Theory &
Practice Framework

11. principle 2 Sterile Asepsis Clean The ANTT Theory & Practice Framework
Health care workers must understand what asepsis is and how to establish and maintain it
principle 2
The ANTT Theory &
Practice Framework
Sterile Asepsis Clean
Free from micro-organisms Free from pathogenic An important action in
Not achievable in typical organisms. Achievable in removing dirt to help achieve
health care settings. typical health care settings. asepsis. But not a satisfactory
standard in itself for invasive
procedures.

12. Identifying and protecting key-parts and key-sites is paramount
Principle 3
Identifying and protecting key-parts and key-sites is paramount
Key-sites are open wounds, including insertion and puncture sites. Key-parts are the parts of the procedure
equipment that come into direct or indirect contact with any liquid infusion or key-sites and with any active key-parts
connected to the patient. If contaminated they present a very high risk of infection to the patient.
principle 3
The ANTT Theory &
Practice Framework

13. principle 4 The ANTT Theory & Practice Framework Principle 4
Clinical procedures must be risk-assessed to determine the level of aseptic technique required
principle 4
The ANTT Theory &
Practice Framework
Risk assessment 1
To determine type of technique:
‘With Standard- ANTT, can I ensure aseptic
key-parts only come into contact with other aseptic key-parts or key-sites’?
Risk assessment 2
To determine sterile or non sterile gloves:
‘Can I perform this procedure without touching key-parts or key-sites directly?’

14. Asepsis is maintained with either Standard or Surgical ANTT
Principle 5
Asepsis is maintained with either Standard or Surgical ANTT
principle 5
The ANTT Theory &
Practice Framework

15. principle 6 The ANTT Theory & Practice Framework Principle 6
Aseptic fields are important. Standard and Surgical-ANTT require different aseptic field management.
principle 6
The ANTT Theory &
Practice Framework
Standard ANTT Surgical ANTT
General aseptic field Critical aseptic field
(Doesn’t require to be managed critically*) (Must be managed critically*)
Micro critical aseptic fields essential Micro critical aseptic fields desirable
* Only sterilised and aseptic equipment can come into contact with the aseptic field.

16. Standard-ANTT - aseptic field management 17

17. Standard-ANTT - The general aseptic field does not require managing critically
Micro critical
aseptic fields
(Essential) 18

18. This is a typical confused aseptic field
This is a typical confused aseptic field. A ‘sterile’ drape has been added on the basis the patient is immunosuppressed . Subsequently, the health care worker believes it ok to leave the key-parts unprotected. But rather than add an extra layer of safety, has this not introduced extra risk?
Exposed key-parts

19. principle 7 NTT in Standard-ANTT NTT in Surgical-ANTT
The ANTT Theory &
Practice Framework
Principle 7
Non-touch technique is the most important component of Surgical and Standard-ANTT
NTT in Standard-ANTT NTT in Surgical-ANTT

20. Appropriate infective precautions help promote and ensure asepsis
Principle 8
Appropriate infective precautions help promote and ensure asepsis
principle 8
The ANTT Theory &
Practice Framework

21. Aseptic practice should be standardised
Principle 9
Aseptic practice should be standardised
principle 9
The ANTT Theory &
Practice Framework

22. principle 10 The ANTT Theory & Practice Framework Principle 10
Safe aseptic technique is reliant upon effective staff training in infection control, safe environments
and fit for purpose equipment.
principle 10
The ANTT Theory &
Practice Framework
(Board to ward support is key)