ANTT v2: An updated practice framework for aseptic technique

Rowley, Stephen; Clare, Simon; Macqueen, Susy; Molyneux, Rebecca

doi:10.12968/bjon.2010.19.sup1.47079

Cited by 61 publications

(43 citation statements)

References 14 publications

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“…Certain organisms can produce exopolysaccharide to form a microbial biofilm layer that acts as a solid enclave where organisms can embed avoiding host defence mechanisms and making them less susceptible to antibiotics. 9,27 In such circumstances, antimicrobials alone are not sufficient to eradicate infection and the CVC should be replaced. Nevertheless, line change ought to be reserved as the last resort if the infection is not clearing despite aggressive antimicrobials, or the child becomes unwell as frequent change of CVCs can damage the veins and limit future access sites.…”

Section: Discussionmentioning

confidence: 99%

Aseptic non‐touch technique and catheter‐related bloodstream infection in children receiving parenteral nutrition at home

et al. 2015

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Objectives: Parenteral nutrition (PN) at home is an acceptable form of delivering long-term PN for children with intestinal failure. Catheter-related bloodstream infection (CRBSI) is one of the serious complications of long-term PN and can lead to increasing morbidity and mortality. Using aseptic non-touch technique (ANTT) was proven to decrease the incidence of CRBSI in hospital patients. In this study we aimed to review the incidence of CRBSI in children receiving PN at home in our institution using the ANTT and a simplified training programme for parents and carers. Methods: We retrospectively collected clinical and microbiological data on all children with intestinal failure (IF) who were on treatment with PN at home under our specialist IF rehabilitation service between November 2012 and November 2013. Results: Thirty-five children were included, 16 of whom did not have any infection recorded during the study period. The overall CRBSI rate was 1.3 infections per 1000 line-days, with Staphylococcus being the commonest organism. Twenty-one children did not require catheter change and the overall catheter changes were 1.8 per 1000 line-days. Conclusion: In this article, we report a low incidence of CRBSI in a single institution by using the principle of ANTT for accessing central venous catheters combined with a simplified, nurse-led, two-week standardised training programme for parents of children going home on PN.

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Section: Discussionmentioning

confidence: 99%

Aseptic non‐touch technique and catheter‐related bloodstream infection in children receiving parenteral nutrition at home

et al. 2015

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“…Inconsistencies in the use of terms and application of the principles of asepsis in clinical practice have been addressed in a framework referred to as 'aseptic non-touch technique'. 229 This provides a practice structure and educational materials aimed at minimising variation and developing competence in practice. 229 However, no comparative evidence indicating the effi cacy of this approach was identifi ed.…”

Section: Improving the Practice Of The Aseptic Techniquementioning

confidence: 99%

“…229 This provides a practice structure and educational materials aimed at minimising variation and developing competence in practice. 229 However, no comparative evidence indicating the effi cacy of this approach was identifi ed.…”

Section: Improving the Practice Of The Aseptic Techniquementioning

confidence: 99%

epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

Loveday

Wilson

Pratt

et al. 2014

Journal of Hospital Infection

1,063

746

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National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were first published in January 2001(1) and updated in 2007.(2) A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text. In addition, the synopses of evidence underpinning the guideline recommendations have been updated. These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimised.

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“…A number of relevant papers were sourced (n = 13). 3,[27][28][29][30][31][32][33][34][35][36][37][38] The team also reviewed manufacturer guidelines (n = 3) for various wound-dressing products and the Royal Marsden Procedural Manuel. 18 This information described how the development process should begin and what areas of the procedure the metric should focus on but did not supply the team with a tool that could be adapted.…”

Section: Review Of Literaturementioning

confidence: 99%

Acute surgical wound‐dressing procedure: Description of the steps involved in the development and validation of an observational metric

Hegarty

Howson

Wills

et al. 2019

International Wound Journal

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The aim of this study was to develop an observational metric that could be used to assess the performance of a practitioner in completing an acute surgical wound‐dressing procedure using aseptic non‐touch technique (ANTT). A team of clinicians, academics, and researchers came together to develop an observational metric using an iterative six‐stage process, culminating in a Delphi panel meeting. A scoping review of the literature provided a background empirical perspective relating to wound‐dressing procedure performance. Video recordings of acute surgical wound‐dressing procedures performed by nurses in clinical (n = 11) and simulated (n = 3) settings were viewed repeatedly and were iteratively deconstructed by the metric development group. This facilitated the identification of the discrete component steps, potential errors, and sentinel (serious) errors, which characterise a wound dressing procedure and formed part of the observational metric. The ANTT wound‐dressing observational metric was stress tested for clarity, the ability to be scored, and interrater reliability, calculated during a further phase of video analysis. The metric was then subjected to a process of cyclical evaluation by a Delphi panel (n = 21) to obtain face and content validity of the metric. The Delphi panel deliberation verified the face and content validity of the metric. The final metric has three phases, 31 individual steps, 18 errors, and 27 sentinel errors. The metric is a tool that identifies the standard to be attained in the performance of acute surgical wound dressings. It can be used as both an adjunct to an educational programme and as a tool to assess a practitioner's performance of a wound‐dressing procedure in both simulated and clinical practice contexts.

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ANTT v2: An updated practice framework for aseptic technique

Cited by 61 publications

References 14 publications

Aseptic non‐touch technique and catheter‐related bloodstream infection in children receiving parenteral nutrition at home

Aseptic non‐touch technique and catheter‐related bloodstream infection in children receiving parenteral nutrition at home

epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

Acute surgical wound‐dressing procedure: Description of the steps involved in the development and validation of an observational metric

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