​Clinical Procedures - Aseptic Non-Touch Technique
The highest level of asepsis, designed to minimize or completely remove the chance of contamination is known as 'aseptic non-touch technique (ANTT) Although local practices and rules may differ, the principles behind it are universal.
When to use ANTT
◦ Insertion, repositioning, or dressing invasive devices such as catheters, drains, and intravenous lines
◦ Dressing wounds healing by primary intention (surgical wounds, burns)
◦ Suturing
◦ When sterile body areas are to be entered
◦ If there is tracking to deeper areas or the patient is immunocompromised.
Two-person technique
◦ An assistant can be very helpful in maintaining the position of the patient, opening packs, and decanting solutions for the person performing the procedure
◦ The 'clean practitioner' must wear the sterile glove and open the first pack to establish a sterile field. The second ('dirty) practitioner can then open all the other equipment and drop onto the sterile field.
◦ Interruptions
◦ If the sterile procedure is interrupted for more than 30 minutes, new sterile packs should be opened.
Clean Technique
◦ This is a modified aseptic technique, aiming to prevent the introduction or spread of micro-organisms and to prevent cross-infection to patients and staff. This is used when true asepsis is not required (e.g. when dealing with contaminated sites or when removing drains and catheters)
◦ Sterile equipment is not always used
◦ 'Clean technique allows the use of tap water, non-sterile gloves, multi-pack dressings, and multi-use containers of creams and ointments.
When to use clean technique
◦ Removing sutures, drains, urethral catheters
◦ Endotracheal suction, management of tracheostomy site
◦ Management of enteral feeding lines
◦ Care of stomas
Instillation of eye-drops.

You should always consider the sterility of the items to be touched before you begin each procedure. If some or all items need to remain sterile, an aseptic technique should be used.
Aseptic Non- Touch Technique Procedure
Before
◦ Wash hands with soap and water or alcohol gel
◦ Put on disposable apron and any other protective items
◦ Clean trolley/tray with wipes and dry with a paper towel
◦ Gather equipment and put on the lower shelf of the trolley
◦ Take trolley/tray to the patient.
During
◦ Wash hands with alcohol gel
◦ Remove sterile pack outer packaging and slide the contents on to the top shelf of the trolley or onto the tray, taking care not to touch the sterile pack
◦ Open the dressing pack using only the corners of the paper, taking care not to touch any of the sterile equipment
◦ Place any other required items on the sterile field ensuring that the outer packaging does not come into contact with the sterile field
◦ Put a pair of non-sterile gloves on to remove any dressings on the patient and ensure that they are positioned appropriately
◦ Discard gloves and wash hands
◦ Put sterile gloves on.
After
◦ Dispose of contaminated equipment in the rubbish bag from the dressing pack. Dispose of all packaging
◦ Dispose of aprons and gloves in the appropriate waste as per local policy
◦ Wash hands
Clean the trolley with detergent wipes and dry with a paper towel.