vascular access infection prevention
Back to the Basics With ANTT Best Practices
today ’ s world of healthcare there is so
In much distracting information , about products and new policies , downsizing to manage costs , and necessary activities to manage crises like COVID-19 , that we have little time to focus on basic safety practices . Basic practices like attention to good cleaning of skin and access points prior to procedures are often overlooked or given brief action . While education in healthcare curriculum intends to cover asepsis and sterile procedures , many of the foundational concepts of clean hands and establishing a clean working area are forgotten as we give attention to the equipment and the need to hurry through the procedure and be ready to move to the next patient . Concerns over infection associated with peripheral intravenous insertions and management , as noted in the recent ECRI Safety Report , require us to reassess our monitoring practices and educational efforts that ensure the best outcomes for our patients .
We can learn much from our colleagues in the United Kingdom ( UK ) who emphasize an educational process known as Aseptic Non Touch Technique ( ANTT ), as required training for all clinicians interacting with patients and procedures , in keeping with the information available at the Association for Safe Aseptic Practices ( ASAP ) at
www . antt . org / ANTT _ Site / home . html ).
The ANTT model and principles were originally developed by Stephen Rowley and Simon Clare , received fast adoption by the National Health System ( NHS ) of the UK , are incorporated into all NHS hospital policies , and generally accepted across Europe within healthcare practices . Some standard language within the ANTT policies are as follows : “ The hospital has adopted a specific type of aseptic technique known as ‘ Aseptic Non Touch Technique ’ ( ANTT ) as the chosen method for any aseptic procedure that breeches the body ’ s natural defenses ( The ASAP , 2015 ). All staff involved in aseptic procedures must complete ANTT training and be assessed as competent or provide written evidence of ANTT competence from another NHS organization . All staff have a role in ensuring their own and others ’ compliance with
Used courtesy of the Association for Safe Aseptic Practice ASAP and Stephen Rowley
ANTT .” These principles of ANTT include the concepts that asepsis is the aim for all invasive clinical procedures and should be standardized with training incorporated within all healthcare worker training .
ANTT education is achieved with attention to patient procedures and supplies used within those procedures for key-site and key-part protection from microorganisms . Basic precepts of always washing hands prior to the procedure , never contaminate covered key parts , touch other supply items as needed within the clean field and take appropriate infection prevention precautions , are emphasized in ANTT training . Within this ANTT model procedures are identified as Standard ANTT and Surgical ANTT which serve to establish the type of procedure for general asepsis or surgical critical sterile practices .
The Standard ANTT approach is applied to procedures such as peripheral intravenous ( IV ) catheter insertions , venipuncture , and wound care , that are considered general critical procedures , short in duration (> 20 minutes ), not significantly invasive or technically complicated , and involve minimal key parts . The focus of Standard ANTT is that key sites and key parts are protected during the procedure , but maximum sterile barriers are not required . Key sites to avoid touching without sterile gloves include insertion and puncture areas of skin , subcutaneous port ( port ) access sites , and any open wounds . Key parts that should not have touch contamination include all items that must
www . healthcarehygienemagazine . com • april 2021
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