Indications for use
Aseptic technique should be used during any invasive procedure, for example:
- when dressing wounds that are healing by primary intention
- when removing or manipulating invasive devices such as drains, sutures or clips
- when inserting devices, i.e. catheters (urinary, intravenous, central venous, etc.)
- when taking a catheter specimen of urine (CSU).
Or when a clean technique is insuffi cient to protect the patient from cross-infection.
What you need for the Asceptic Technique
Dressing trolley ✵ sterile dressing pack, containing a disposable plastic tray, gauze, sterile gloves, sterile field, disposable clinical waste bag ✵ sterile saline solution for wound cleansing ✵ jug ✵ warm water ✵ detergent, warm water, 70% alcohol or chlorhexidine solution for cleaning trolley surface ✵ sterile 20ml syringe and 20ml sterile saline for irrigation ✵ prescribed or appropriate dressings ✵ appropriate local documentation.
Discuss and explain the procedure with the patient and gain permission. Wash the trolley with detergent and water then allow to dry. Assemble all equipment on the bottom shelf of this clean, dry trolley and prepare the clinical treatment room for the patient. Place the sterile saline solution packet for wound cleansing in a jug and add warm water, enough to barely cover the packaging. If you do not have access to a clinical treatment room and will be performing the procedure by or on the patient’s bed, either at home or in a hospital ward, ensure the bed linen and surrounding areas are clean and free from clutter and dust, close the bed curtains or bedroom door to maintain privacy and dignity, and take your trolley to the patient.
How you do it
- Wash your hands and put on your apron.
- Loosen the dressing, but do not expose to environment and possible contamination risk.
- Wash your hands or use alcohol gel.
- Decontaminate the top and sides of the dressing trolley using the 70% alcohol or chlorhexidine solution and allow it to dry.
- Check the expiry dates and ensure that all packaging is intact to ensure that only sterile products are used.
- Open the sterile pack and allow it to drop on to the top shelf of the dressing trolley, do not allow the outer pack to touch the trolley to prevent contamination.
- Open the inner pack using only the outer corners of the pack, thus any potential contamination is kept to the outer corners only.
Open any further sterile equipment and allow it to drop on to the sterile field.
- Remove the warmed saline solution from the water jug, open without touching the inner packaging and pour into a galley pot.
- To arrange the contents of the sterile pack, carefully pick up the clinical waste bag from the top opening, put your hand inside, without touching the outside of the bag to keep it sterile. Use this covering to arrange your contents.
- Keeping your hand inside the clinical waste bag now remove the dressing; fold the bag inside out, the contents should now be secured inside and the bag can be used for further clinical waste.
- Assess the wound and take appropriate actions.
- Decontaminate hands again, using alcohol gel and allow to dry, in case of re-contamination.
- Apply sterile gloves.
- Clean around the wound, if deemed necessary by wound assessment, using gauze and the warmed saline solution. Do not allow your gloved hand to touch the patient. Pick up the gauze in your dominant hand (the use of forceps should be minimized to prevent trauma to the area), place the gauze in the warmed saline solution and allow it to absorb some of the warmed solution, the warming of the solution aids re-vascularization and minimizes discomfort. Squeeze out the excess over the galley pot.
- Irrigation cleans tissues and flushes cell debris and drainage from an open wound. Irrigation helps the wound heal properly from the inside tissue layers outward to the skin surface; it also helps prevent trauma and premature surface healing over an abscess pocket or infected tract. Do not use too much pressure when irrigating as this can remove granulating tissue as well as necrotic tissue.
- Apply a new sterile dressing as appropriate.
- Discard contaminated equipment appropriately in clinical or household waste (use local policy).
Return the trolley to storage after cleaning with detergent and water.
- Ensure patient comfort.
- Document the procedure.
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