Aseptic technique
Aseptic technique is a crucial method employed in healthcare settings to prevent the introduction of pathogens, which include harmful microorganisms like viruses and bacteria, into clinical environments. The primary goal of this technique is to maintain asepsis, ensuring the absence of these pathogens to protect both patients and healthcare workers from infection. Key practices involve thorough hand hygiene, the use of sterile instruments and personal protective equipment (PPE), and the establishment of sterile fields during medical procedures.
In operating rooms, strict protocols are in place, such as proper patient skin preparation and minimizing traffic to reduce contamination risks. However, aseptic techniques are not limited to surgical environments; they are also applicable in various clinical situations, like dressing changes and catheter insertions. Adherence to these procedures helps mitigate the risk of surgical site infections, which are a significant concern given the high volume of surgical procedures performed annually. Maintaining a clean environment through effective practices is essential, particularly for patients with weakened immune systems. Overall, aseptic technique plays a vital role in enhancing patient safety and reducing healthcare-associated infections.
Aseptic technique
Definition
The aseptic technique involves applying preventive measures to minimize the chance of introducing into clinical settings the microorganisms, such as viruses and harmful bacteria (known as pathogens), that cause disease. In other words, its purpose is to maintain asepsis, or the absence of pathogens, in clinical settings. The aseptic technique is intended to protect the patient and the healthcare worker from pathogens and to prevent their spread.
Pathogens may introduce infection to a patient through contact with the environment, with personnel, or with medical equipment. The environment contains potential hazards that may disseminate pathogens through movement, touch, or proximity.
Aseptic technique involves a set of procedures designed to remove or kill microorganisms on hands and objects, reducing a patient’s risk of exposure. It includes the use of sterile instruments and of barriers such as personal protective equipment, adequate handwashing, patient preparation, and maintenance of sterile fields and a safe environment in surgical and other areas for medical procedures.
Minimizing Contamination During Surgery
Interventions such as minimizing surgical room traffic, isolating a patient to reduce airborne contamination, and using low-particle-generating surgical attire contribute to reducing environmental hazards. Equipment or supplies can be sterilized through chemical treatment, radiation, gas, or heat.
The most prominent example of aseptic technique occurs in the operating room, in which clinicians work to prevent postoperative infection. Aseptic technique protocols during surgical procedures include patient skin preparation, handwashing and surgical scrub, barrier protection for the patient (draping) and the surgical team (surgical attire), and maintenance of the sterile field.
Hand hygiene among medical personnel is the most important aspect of reducing contamination. Adequate handwashing involves removing jewelry, avoiding contact with the sink, and performing vigorous hand scrubbing. Thorough drying is critical because moist surfaces encourage pathogen growth. Bare hands are potential sources of infection, and glove use is important.
Sterile surgical clothing and protective devices, called personal protective equipment (PPE), such as gloves, face masks, goggles, and transparent eye and face shields serve as barriers against microorganisms. Surgical attire must be worn with deliberate care to prevent contact with sterile surfaces with nonsterile objects, including skin. Procedures for putting on surgical attire include covering facial hair, tucking hair out of sight, and removing jewelry or other dangling objects that may contain microorganisms. Personnel assist the surgeon in putting on gloves and the surgical gown and in arranging equipment to minimize the risk of contamination. Creating surgical fields with drapes, which are sterilized linens placed on the patient or around the field to define sterile areas, helps maintain asepsis in the operating room during surgery or other invasive procedures.
Other principles applied to maintain asepsis include ensuring that all items in a sterile field are actually sterile. Also, sterile packages should be opened as close as possible to the time of use.
Moist areas are not considered sterile. Contaminated items must be removed immediately, and nonsterile items should not cross a sterile field. Edges of sterile fields are not considered sterile, and a margin of safety is maintained between sterile and nonsterile objects. Drapes or wrapped kits of equipment are opened in a manner to prevent contents from touching nonsterile surfaces. Others who work close to the sterile field, such as anesthesia personnel, also must follow aseptic technique. During a procedure, staff members are positioned so that those who have undergone surgical scrub and are wearing sterile attire are closest to the patient, while unscrubbed staff members remain on the perimeter to obtain supplies, acquire assistance, and communicate with outside personnel.
Nonsurgical Clinical Settings
The aseptic technique is also used in a variety of settings outside the operating room. A primary difference between the operating room and other clinical environments is that areas outside the operating room generally do not allow for the same rigorous level of asepsis. Avoiding potential infection is still the goal, however. For example, changing a surgical dressing at the patient’s bedside should still include thorough handwashing, use of gloves and other protective garb, creation of a sterile field, and avoidance of contact with nonsterile items.
Typical situations that require aseptic measures include insertion of intravenous lines, urinary or other catheters, and drains; changing of wound dressings; vaginal exams during labor; and respiratory suction. General habits such as prompt disposal of contaminated needles or blood-soaked bandages and dressings and the prevention of accumulation of drained bodily fluids through regular emptying of receptacles help preserve and maintain a clean medical environment and keep it as free of microorganisms as possible.
Impact
Practices that clean (remove dirt and other impurities), sanitize (reduce the number of microorganisms), or disinfect (remove most microorganisms) are not always adequate to prevent infection. The National Institutes of Health estimates that over 50 million surgical procedures are performed in the United States annually. Surgical site infections are among the most common nosocomial, or hospital-acquired, types of infection and result in longer hospital stays and greater patient costs. The aseptic technique is vital in reducing the morbidity and mortality associated with surgical infections. Aseptic technique is especially important in cases involving patients who have compromised (weak) immune systems.
The U.S. Food and Drug Administration (FDA) distributes guidance for manufacturers to ensure the products purchased by hospitals and used in clinical settings are manufactured in a safe, sanitary way. These manufacturing practices are updated when required. The FDA also issues recalls of medical products when an issue arises. The Centers for Disease Control also offers similar guidance.
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