Asepsis, or the
aseptic technique, is another term related to sterilization. It involves the
exclusion of microorganisms from a medical environment or procedure. Surgeons
might wear sterile gloves, isolation gowns or suits and masks in the operating
room as part of surgical asepsis or sterile technique. The aseptic technique
may involve sterilizing the skin with alcohol and often includes other steps to
preserve a sterile environment.
The aseptic technique
is critical because of the prevalence of healthcare-acquired infections (HAIs).
HAIs are infections patients contract through exposures that occur in the
healthcare environment. While one in 31 hospital patients has an HAI at any
given time, most are preventable. Some of the most common HAIs include:
·
Catheter-associated urinary tract
infections.
·
Central line-associated bloodstream
infections.
·
Surgical site infections.
·
Ventilator-associated pneumonia.
·
Clostridium difficile infections.
The procedures most
likely to result in these infections demand an aseptic technique. Healthcare
professionals employ it when they are:
·
Dressing surgical wounds and burns.
·
Performing biopsies.
·
Suturing wounds.
·
Inserting a urinary catheter, chest
tube, intravenous line or wound drain.
·
Administering injections.
·
Performing surgical procedures.
·
Conducting vaginal examinations with
instruments.
·
Delivering babies.
Healthcare
professionals must perform four types of aseptic techniques, including:
1.
Barriers
Barrier medical
devices stop germs from transferring between healthcare workers, patients and
surfaces. Aseptic barriers include:
·
Sterile masks
·
Sterile gowns
·
Sterile drapes
·
Sterile gloves
·
Protective packaging on sterilized
instruments
Before donning
sterile barriers, healthcare workers first perform hand hygiene, usually
through washing or sanitizing their hands.
2.
Equipment and Patient Preparation
Any procedure
involving an aseptic technique requires a healthcare professional to prepare
both the patient and equipment first. This type of preparation might involve:
·
Using antiseptic wipes to disinfect a
patient’s skin.
·
Sterilizing equipment and instruments.
·
Keeping sterilized equipment inside
plastic wrappers to prevent contamination before use.
3.
Environmental Controls
It’s also critical to
consider the patient’s surroundings, or the designated aseptic field. The room
where the procedure takes place usually marks the boundary of the aseptic
field. Maintaining the aseptic field involves:
·
Keeping doors closed.
·
Minimizing entries and exits from the
defined aseptic area.
·
Allowing only one patient per aseptic
field.
·
Permitting only necessary personnel.
4.
Contact Guidelines
Once a healthcare
professional has initiated aseptic technique by washing their hands and donning
sterile barriers, they must follow certain rules for contact. They may only
touch sterile surfaces and instruments in keeping with sterile-to-sterile
contact guidelines. They cannot touch any non-sterile surfaces. The sterile
devices must follow the same rules. Any sterilized device that falls to the
floor, becomes compromised or sustains damage to its wrapper must be removed
and resterilized before use.
The
Differences Between Aseptic, Sterile and Clean Techniques
It’s easy to
misunderstand the relationship between the aseptic and sterile techniques
because the two terms go hand in hand. Essentially, sterile describes an object
that has been completely rid of microbes. Asepsis describes the conditions
required to keep that object sterile. The sterile technique involves methods
such as dry heat, ethylene oxide or gamma rays to produce a sterilized device.
The aseptic technique involves creating barriers, preparing patients and
equipment, controlling the environment and following contact guidelines.
Aseptic technique and
clean technique are similar in that they are used during medical examinations
and procedures to limit harmful pathogens. When achieving medical asepsis, the
goal is to prevent the exposure of any microbes through the use of sterile
barriers and materials. When employing a clean technique, the goal is to lower
the number of pathogens, or harmful microbes, exposed to the patient.
The
clean technique involves three of the same methods as the aseptic one:
·
Barriers
·
Patient and equipment preparation
·
Environmental controls
Besides the absence
of sterile-to-sterile contact guidelines, the three methods are applied more
loosely in the clean technique. For example, with barriers, the healthcare
professional need only use appropriate hand hygiene and non-sterile gloves.
Rather than sterilizing tools, the worker ensures they don’t become directly
contaminated. The patient also doesn’t need to remain in an aseptic field.
Instead, the environment undergoes routine cleaning.
Healthcare
workers use clean techniques while:
·
Giving an injection.
·
Emptying a urinary catheter drainage
bag.
·
Inserting or removing a peripheral
intravenous line.
·
Removing a urinary catheter.
·
Giving a bed bath.
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