Performing an aseptic technique in a community setting: fact or fiction?
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Published on: May 31, 2012
1School of Health Community and Education Studies, Northumbria University, Newcastle-upon-Tyne, UK. john.unsworth@northumbria.ac.uk
Background:
Maintaining the principles of asepsis when performing wound care and other invasive procedures is one of the fundamental approaches of preventing healthcare-acquired infection. Such an approach has been advocated for community practitioners.
Literature:
The performance of an aseptic technique is an under-researched area. The few studies that have been conducted have identified how strict adherence to the technique is difficult and contamination of hands/gloves is common and that community nurses often have a fatalistic view about whether asepsis is possible in a community setting.
Aim:
The overall aim of this research project was to examine how experienced practitioners have adapted the aseptic technique within a community setting and to what extent the changed procedure still adhered to the principles of asepsis.
Methods:
This study used a mixture of non-participant observation and individual semi-structured interviews to examine adherence to the principles of the aseptic technique among the district nurses. Data were collected from one Trust in England with a total of 10 district nurses taking part and 30 aseptic procedures been observed.
Results:
The results show that almost all of the staff understood the principles of asepsis and had adapted the standard procedure for use in a patient's home. Common challenges included wound cleaning using a single nurse procedure, the contents of the pack and the home environment. The research also identified misconceptions about clean versus aseptic procedures and a lack of training for staff.
Conclusions:
This study highlights the challenges of maintaining the principles of asepsis in a home environment and the fact that district nurses are often relied upon to find creative solutions to such challenges. The study also highlights issues around the implementation of evidence-based practice and the need for clearer guidance about how evidence should be used alongside existing procedures.
Insights
Community nurses adapt aseptic techniques for home care, facing challenges like environmental factors and training gaps. Adherence to aseptic principles in community settings requires creative solutions and clearer guidance for practitioners.
Area of Science:
- Healthcare-associated infection prevention
- Nursing practice
- Aseptic technique
Background:
- Aseptic technique is crucial for preventing healthcare-associated infections, especially in community settings.
- Adherence to aseptic technique in the community is under-researched, with studies noting difficulties and contamination.
- Community nurses often express fatalism regarding the possibility of maintaining asepsis outside hospital environments.
Purpose of the Study:
- To investigate how experienced community practitioners adapt aseptic techniques for home care.
- To evaluate the extent to which these adapted procedures maintain the core principles of asepsis.
Main Methods:
- Employed non-participant observation and semi-structured interviews with district nurses.
- Observed 30 aseptic procedures across 10 district nurses in one English Trust.
Main Results:
- Most staff understood aseptic principles and modified standard procedures for home use.
- Key challenges identified include single-nurse wound cleaning, pack contents, and the home environment.
- Misconceptions between clean and aseptic procedures and a lack of specific training were noted.
Conclusions:
- Maintaining asepsis in home environments presents significant challenges for district nurses.
- Nurses often develop innovative solutions to overcome these challenges.
- There is a need for clearer guidance on implementing evidence-based practice alongside existing community nursing procedures.
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