Aseptic Technique

Aseptic Technique

The term aseptic means free from pathogenic microorganisms

Aseptic technique: aims to prevent pathogenic organisms in

sufficient quantity to cause infection from being introduced to
susceptible sites by hands, Surfaces and equipment
Surgical Asepsis-involves procedures which attempt to
eliminate all microorganisms including pathogen and spores,
from an object or area by creating a critical aseptic field.
 Aseptic Technique

Utilised by OT personnel to minimise the

patients risk of exposure to endogenous
& exogenous microorganisms when the
patients natural body defences are
breached during surgery or other
procedures
 ACORN Standard 2: Aseptic Technique

Refers to knowledge & application of skills required

when developing & maintaining a sterile field using
aseptic technique
Also includes the wearing of perioperative attire,
handwashing techniques, gowning & gloving
techniques, selection & use of surgical drapes &
sterilisation of surgical instruments
 The Sterile Field

Aseptic technique relates to the activities of preparing, creating &

maintaining a sterile field
Includes the
- area immediately surrounding the draped patient
- Sterile surgical personnel
- Sterile draped instrument tables & equipment
 Unscrubbed personnel

Face the sterile field on approach

Refrain from leaning over the sterile field
Maintain an appropriate distance from sterile field at
all times approx 30cm
Refrain from moving between 2 sterile fields
Handwashing
Technique
 Scrubbing, Gowning & Gloving

Surgical Scrub
- process of eliminating debris & transient flora from the hands & forearms of staff
before undertaking invasive procedures
- Significantly reduces resident flora & leaves an antimicrobial residue on skin
- Aims to inhibit growth of microorganisms for several hours
 Surgical Handwash

Washing Technique Duration Drying When Needed

Remove jewellery First wash for Dry with Before any

Keep fingernails short the day = 5 sterile invasive surgical
Inspect skin for mins towels procedure
intactness Subsequent
Wash hands, nails & washes = 3
forearms thoroughly & mins
apply a TGA approved
hand disinfectant &/or
antiseptic
Rinse carefully,
keeping hands above
elbows
No touch techniques
apply
S7 ACORN (2012)
 Gowning & Gloving

Minimises risk of surgical site infection

Protects team from exposure to contamination from blood & other body
fluids
Impervious to fluids
Double gloving is recommended practice
- Although no evidence to suggest double gloving reduces SSIs it does protect the
team against perforation & potential exposure to blood & bodily fluids
 Face Masks

Normally manufactured with 3 ply material made up from a melt blown

placed between non-woven fabric, the melt-blown material acts as the filter
that stops microbes from entering or exiting the mask.
Most surgical masks feature pleats/folds commonly 3 pleated are used
allowing the user to expand the mask so it covers from the nose and under
the chin.
Some suggestion that surgical facemasks dont actually result in any harm
or benefit in preventing SSIs (Lipp & Edwards, 2005)
 Standard v. Additional Precautions

ACORN (2014-2015) endorses

- 2 tiered approach to infection prevention

Standard precautions
- Designed for the care of all patients regardless of their presumed infectious
status; constitute best practice
- Personal Protective Equipment [PPE]
Additional precautions
- Required when standards precautions are insufficient in preventing the
transmission of infectious diseases
 Reprocessing of Reusable Items

Inadequate decontamination, disinfection & sterilisation has been

implicated in outbreaks of infections
Application of recognised standards related to methods of
cleaning, packaging, sterilisation & storage contribute to
prevention of SSIs
Physical properties of the item impact the cleaning method, mode
of transmission, packaging & storage

ACORN (2014)
 Modern Sterilising Techniques

All items should be thoroughly cleaned after use & their functionality
assessed prior to sterilisation or disinfection
All items should be arranged so that all surfaces will receive contact with
the sterilising agent (all jointed instruments should be open & unlocked
trays usually specially designed to maintain these instruments)
Appropriate chemical indicators & control labels should be used
Biological monitoring may be utilised
 Cleaning & Sterilising of Equipment

Cleaning low grade decontamination; washing anything that has

come in contact with a patient with neutral detergent
Disinfection higher grade decontamination; kills microorganisms
using toxic or corrosive substances (used on equipment that does
not enter the sterile surfaces of the body)
Sterilisation highest grade decontamination; kills microorganisms
& their spores using heat, pressure, radiation & chemicals
(reserved for equipment or instruments entering the sterile areas of
the body)
 Standard Theatre Attire

All undergarments should be covered by perioperative attire [2

piece scrub suit; boiler suit; dresses with pantyhose]
Change daily or when wet
Fasten jackets [must be cuffed]
Not wear outside HCF
Lanyards shall not be worn
Cover gowns & shoe covers not necessary [no evidence to
suggest inhibiting microbial load or prevent infection]
 Standard Theatre Attire

Change head covers daily

All hair & facial should be covered completely
Shoes shall provide full protection [fully enclosed over the forefoot]
Fingernails kept clean & free from artificial nails/ nail polish
Jewellery kept to minimum [no loose neck chains or earrings]
 It is everyones
responsibility to maintain
the principles of infection
control & asepsis
 Infection Prevention References

Australian College of Operating Room Nurses [ACORN]. (2012). Standard

Statement 2: Aseptic Technique. South Australia: ACORN.
ACORN. (2012). Standard Statement 6: Environmental Management. South
Australia: ACORN.
ACORN. (2012). Standard Statement 7: Infection Prevention. South Australia:
ACORN.
ACORN. (2012). Standard Statement 21: Surgical Scrubbing, Gowning &
Gloving. South Australia: ACORN.
Australian Day Surgery Nurses Association [ADSNA]. (2006). Best practice
guidelines for ambulatory surgery & procedures. Sydney: ADSNA.
AIHW (2007). Sentinel events in public hospitals 2004-2005
Hand Hygiene Australia. [HHA]. (2010).
http://www.hha.org.au/ForHealthcareWorkers.aspx
Lipp, A., & Edwards, P. (2005). Disposable surgical face masks: a systematic
review. Canadian Operating Room Nursing Journal, 23(3), 24-38.
 References

Australian College of Operating Room Nurses [ACORN]. (2012). Standard

Statement 2: Aseptic Technique. South Australia: ACORN.
ACORN. (2012). Standard Statement 6: Environmental Management. South
Australia: ACORN.
ACORN. (2012). Standard Statement 7: Infection Prevention. South Australia:
ACORN.
ACORN. (2012). Standard Statement 21: Surgical Scrubbing, Gowning &
Gloving. South Australia: ACORN.
Australian Day Surgery Nurses Association [ADSNA]. (2006). Best practice
guidelines for ambulatory surgery & procedures. Sydney: ADSNA.
AIHW (2007). Sentinel events in public hospitals 2004-2005
Hand Hygiene Australia website
http://www.hha.org.au/ForHealthcareWorkers.aspx
Lipp, A., & Edwards, P. (2005). Disposable surgical face masks: a systematic
review. Canadian Operating Room Nursing Journal, 23(3), 24-38.