Aseptic dressing technique

Question 1

What do the letters ANTT stand for?

Answer 1

Aseptic non-touch technique.

Question 2

Why should a wound be exposed for as short a time as possible

Answer 2

Prevent wound cooling and minimise exposure to airborne organisms.

Question 3

What does the term asepsis mean?

Answer 3

The absence of pathogenic organisms. For example bacteria, fungi, viruses or other micro-organisms that cause disease.

Question 4

When is an aseptic dressing used?

Answer 4

When patients require:

• A wound dressing
• A change of dressing
• Removal of a wound drain
• Removal of stitches or staples

Question 5

What are the three modes of transmission that contribute to the wound

Answer 5

• Direct contact
• Airborne
• Self-contamination

Question 6

How can you reduce the risk of a wound becoming infected as a result of direct contact?

Answer 6

• Using appropriate hand hygiene
• Sterile gloves
• Sterile equipment
• non-touch aseptic technique

Question 7

How can you reduce the risk of a wound becoming infected as a result of airborne?

Answer 7

• Minimising the length of time the wound is exposed
• Closing windows before putting a dressing on
• Ensure linen is clean
• Do not talk, cough or sneeze over the wound

Question 8

Define self-contamination in relation to wounds

Answer 8

Self-contamination is when bacteria normally is carried harmlessly on the skin or in the gastrointestinal tract which can contaminate wounds

Question 9

Define asepsis

Answer 9

The state of being free from living pathogenic organisms

Question 10

Define aseptic technique

Answer 10

When there is a risk of introducing micro-organisms into the patients body

Question 11

Aseptic non-touch technique

Answer 11

Avoiding touching either directly or indirectly the key parts of the equipment required, for example the new dressing, as well as the patient during the aseptic technique. ANTT is crucial in achieving asepsis and the prevention of infections.

Question 12

Define key site in relation to wounds

Answer 12

Usually the patients wound or an access site for a medical device

Question 13

Define the micro critical aseptic field

Answer 13

A smaller version of the aseptic field and is used to protect a single key part from contamination for example the sterile packaging

Question 14

Define the aseptic field

Answer 14

A designated aseptic working space that contains and protects sterile equipment used to carry out the procedure

Question 15

Define general aseptic field

Answer 15

is used to promote asepsis rather than ensure it, this may be through the use of a clean tray or trolley

Question 16

What are the 3 principles of aseptic technique

Answer 16

• Maintain asepsis to avoid contaminated wounds leading to infection.
• Expose the wound for a minimum amount of time this is because when the dressing is removed the temperature of the wound decreases affecting the oxygenation and passage of blood of the cells decreasing the healing process. Also wounds are at risk of re-injury when they are exposed.
• Ensure a safe and efficient aseptic technique to avoid contamination of the wound. Do not leave a patient unattended and ensure their dignity and privacy is maintained.

Question 17

What is the aseptic technique step by step?

Answer 17

1. Introduce yourself and explain to the patient the procedure you are going to undertake and gain consent.
2. Perform hand hygiene and put an apron on
3. Clean the trolley from the back to the front in a sweeping gesture including the trolley legs.
4. Gather the equipment and place on the bottom of the trolley. As you do this, check the packaging is intact, and that all the equipment and solutions are within the expiry date.
5. Take the trolley to the bedside. If necessary adjust the height of the bed to a safe working height.
6. Remove the outer packaging of the dressing pack. With your fingertips touching only the outside of pull back the corners opening the pack fully and lay it flat on the top shelf of the trolley to create an aseptic field.
7. Pick up the orange waste bag and put your hand inside so it acts as a glove. Use the orange waste bag to arrange the equipment on the aseptic field.
8. Turn the orange waste bag inside out removing the adhesive (sticky) strip and attach this to the side of the trolley between the patient and the aseptic field to drop used equipment into.
9. Carefully open the syringe packaging and new dressing packaging drop both pieces of equipment onto the aseptic field. Then open the cleansing solution and pour it into the tray/gallipot.
10. Put on the non-sterile gloves
11. Remove the existing dressing. Before dropping this into the orange waste bag inspect the dressing and wound to determine the type and amount of exudate. Then remove the non-sterile gloves.
12. Perform hand-hygiene using the alcohol based hand rub ensure hands are completely dry before continuing.
13. Carefully open the sterile gloves without touching the aseptic field. Taking care not to touch the outside of the gloves, put them on as follows. Pick up the first glove by the wrist part that is folded back and put the glove on. Pick up the second glove by putting your gloved fingers under the cuff and put the glove on. Adjust the gloves over your fingers to ensure a good fit. Then pick the packaging up from the middle and put on the bottom shelf of the trolley.
14. Place the dressing towel under the patients wounded area e.g. the arm to avoid excess fluids spilling onto the bed sheets or patients clothing.
15. Fill the syringe with the cleansing solution holding the syringe in your dominant hand and the folded gauze in the other just below the wound. Slowly allow the cleansing solution to flow over the wound bed. The gauze swab will absorb and solution as it is held below the wound.
16. Discard the syringe into the orange waste bag.
17. Use a gauze swab to dry the skin around the wound, not the wound bed itself. Use each swab once and move it in one direction.
18. Drop soiled swabs into the orange waste bag
19. Apply the new dressing press gently on the edges to ensure (it is fastened) adhesion. Do not touch the island part of the dressing.
20. Remove the dressing towel and place on the aseptic field. Wrap all the disposable items in the aseptic field and discard them in the orange waste bag with any other wrappers from the bottom shelf.
21. Remove gloves and discard into the orange waste bag.
22. Remove the orange waste bag from the trolley, fold the over the top to seal this with the adhesive strip. Place on the top of the trolley.
23. Replace the bedclothes and check the patient is comfortable. If necessary, adjust the height of the bed.
24. Discard the orange waste bag into clinical waste and take the trolley back to the clean utility room.
25. Remove your apron and discard in clinical waste bin.
26. Perform hand hygiene
27. Document aseptic dressing technique, including details of the appearance of the wound bed. Report any abnormalities.

Question 18

List the equipment required to complete an aseptic dressing technique

Answer 18

• Dressing trolley or other suitable surface
• Dressing pack containing; sterile gloves, swabs, tray/gallipot, dressing towel and orange waste bag
• 5–10 ml syringe
• Cleansing solution
• New dressing according to the care plan and local policy
• Alcohol-based hand rub or hand-washing facilities
• Pair of non-sterile gloves