How aseptic is aseptic technique conducted by nurses outside the operating room environment? A critical review

Aseptic technique is integral to infection prevention and control, but there is no agreement concerning its aims, how it is undertaken outside operating rooms, and related terminology. In addition, there is a lack of concordance in international guidelines. This critical review was undertaken to explore breaches of asepsis that could occur during aseptic procedures outside of the operating room environment. There was little direct research evidence, leading to low levels of certainty in outcomes. This review established that low levels of contamination are exhibited by some materials not marketed as sterile. Contents of sterile procedure packs become contaminated rapidly after opening. Large, unwieldy procedure packs and the method of opening result in contamination. Surface contamination occurs as soon as colonized and infected wounds are exposed, and is persistent. Few studies have compared different approaches to conducting aseptic technique. Non-sterile disposable gloves may reduce the risk of microbial acquisition and transmission, but there are no data on how quickly sterile gloves become contaminated. In conclusion, there is a lack of evidence to underpin practice. Many non-sterile products are functionally sterile; conversely, sterile products become contaminated quickly. Relatively simple methods, such as the use of non-sterile disposable gloves and non-touch technique, could reduce the risk of microbial transmission significantly. Further research is needed to corroborate these findings.