Aims To understand the principles of Aseptic Non-Touch Technique (ANTT) when conducting a basic wound dressing procedure. The Royal Marsden Manual of Clinical nursing procedures. Each sterile package should be inspected to ensure the packaging is still intact with no visible damage; the expiry date must be checked to ensure the equipment is still in date (Lloyd Jones, 2014). APPENDICES Appendices can be viewed/ downloaded from the IPC Manual’s home webpage. The Royal Marsden Manual Of Clinical Nursing Procedures. 226 views. Healthcare workers who perform an aseptic technique should receive training in how to correctly perform the procedure; this should include a competency assessment (Loveday et al, 2014). NHS Health Education England - HEE (12 Feb 2018) Aseptic Non-Touch Technique ANTT Based on The Royal Marsden Manual Procedure for Would Care; WHO (2006) Five Moments of Hand Hygiene; WHO System Change - Changing Hand Hygiene Behaviour at the Point of Care; IVI. I have been actively using this technique for many years and been on many study days in my present employment as a HCA. Healthcare workers should be educated and trained in an aseptic technique that should include competency assessment (Loveday et al, 2014) and should be considered a core competency for many nurses. Check out our NEW Videos Please visit the following websites for the latest guidance on Coronavirus: 4. Oxford dictionary of nursing 2014 - Oxford University Press - Oxford. While we continue to direct you to read the Royal Marsden and confirm we continue to base our marking criteria on the Royal Marsden we would like to clarify the following: The CSU and the RUC skills are undertaken using clean technique not ANTT. Loveday HP, Wilson JA, Pratt RJ, et al. 3, 27-38 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. ANTT (2013) – The ANTT Clinical guideline for the Administration and Preparation of Peripheral and Central Intravenous … 6. Aseptic non-touch principles (ANTT)® ANTT ... Decontaminate hands using the 7 step technique and record care in the patients notes- refer to the Royal Marsden Manual for further information. Key sites are defined as open wounds, including insertion sites and puncture sites. 1030 Pages. PDF. I have been actively using this technique for many years and been on many study days in my present employment as a HCA. the Royal Marsden and confirm we continue to base our marking criteria on the Royal Marsden we would like to clarify that we have also taken into consideration the Asthma UK Guidelines. 1.1.3.3 Gloves must [] be worn for invasive procedures, contact with sterile sites and non-intact skin or mucous membranes, and all activities that have been assessed as carrying a risk of exposure to blood, body fluids, secretions or excretions, or to sharp or contaminated instruments. This article, the first in a two-part series, describes the principles of asepsis and part 2 will describe the procedure for changing a simple wound dressing. To reduce patients’ risk of developing a HCAI, it is vital to prevent the transmission of micro-organisms between staff and patients when undertaking any invasive procedure (Loveday et al, 2014); this can be achieved by asepsis. Sign in or Register a new account to join the discussion. I … Aims To understand the principles of Aseptic Non-Touch Technique (ANTT) when conducting a basic wound dressing procedure. APPENDICES Appendices can be viewed/ downloaded from the IPC Manual’s home webpage. Posted by Claire Cox. Once you have clean hands, the procedure should be clearly documented in the patient’s records (Nursing and Midwifery Council, 2018). Carefully open any other sterile equipment and gently place it onto the sterile field, avoiding any contamination of the sterile surfaces of the equipment (Lloyd Jones, 2014). West Sussex: Wiley Blackwell. There are a number of stages and principles for aseptic technique (Table 1); the fundamental initial stage is hand hygiene, which must be performed before any aseptic technique (World Health Organization, 2019; Loveday et al, 2014). Research Nurses required to run clinical trials in healthy volunteers, This content is for health professionals only, This article has been double-blind peer reviewed, This article is open access and can be freely distributed. This paper. The term asepsis means “the absence of potentially pathogenic micro-organisms” (Loveday et al, 2014). The Royal Marsden has a specialist Infection Prevention and Control Team (IPCT). Even though the principal of ANTT is essentially the same, it has thrown me off with the way I was previously taught. During the course of the pandemic, a tree has sprouted in the…, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. Journal. The Royal Marsden Manual Of Clinical Nursing Procedures. Aseptic technique is a core competency for many nurses. Loveday HP, Wilson JA, Pratt RJ et al ; 2014; epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England. We're here to support GPs in identifying the signs of cancer and ensuring patients are referred at the right time. In procedure for 'F'. And when people entrust their lives to us, they have the right to. Aseptic Non-Touch Technique & Introduction to Tissue Viability 1. Dictionary entry . Lamber, J. Chaperones: practice policy and training 2010 - Practice Nursing. The first step of the handwashing technique is to first rub the palm of your hands together. The remaining waste, including aprons and gloves, should be disposed of according to local policy (Loveday et al, 2014). The Royal Marsden School is a centre of educational excellence, offering courses in cancer care and practical training for all healthcare professionals. In the past, many aseptic techniques included a ritualistic practice of cleaning trolleys with alcohol between clients. The term ‘clean technique’ is often used to describe the procedure for dressing chronic wounds; it includes hand hygiene, preparation of a clean area with use of clean gloves and sterile instruments, such as scissors and forceps (Wound, Ostomy and Continence Nursing Society, 2012). At the end of the procedure, all waste must be disposed of in the appropriate waste stream bin, such as a healthcare waste bin. [2003] 1.1.3.4 Gloves must [] be worn as single-use items. Sharps, including needles, suture cutters, scissors and blades must be disposed of at the point of use in an approved sharps container (Loveday et al, 2014). Home; Learn Professionalising patient safety PUBLISHED 20 September, 2019; ORIGIN UK; TYPE Videos and animations; CONTENT TYPE Pre-existing; COPYRIGHT STATUS Original author; PAYWALLED No; ORIGINAL AUTHOR Health Education England; ORIGINAL PUBLICATION … Remind staff to clean their hands if you have not seen them do it, Wash your own hands frequently, particularly before eating. The decision as to whether single-use sterile or single-use non-sterile examination gloves should be worn, or whether gloves are required at all, should be based on a risk assessment (NHMRC, 2019; Loveday et al, 2014). Where there is a risk that key parts or key sites cannot be protected, for example, during urinary catheter insertion, sterile gloves should be worn (NHMRC, 2019; Rowley et al, 2010). Aseptic No Touch Technique (ANTT) is recommended for maintaining sterility and reducing cross infection when managing clean acute or surgical wounds. ANTT Urinalysis Discover Series: E4: RCNi Decision Support Tool and Management of a High Output Ileostomy Kingston University and The Royal Marsden NHS Foundation Trust – CanAdvice NMC OSCE MIDSTREAM URINE SAMPLE Urinalysis Lab Test \u0026 Urine Dipstick Test Explained! Seventh Edition . Crown: London . If they become contaminated, this can result in the patient acquiring a preventable infection. As a group, we we’re shown how to perform the task using the technique with a set of guidelines taken from the Royal Marsden 2015. Jump to Contents Summary of Changes Abbreviations Quick search: hover cursor over selection in … It could be suggested that understanding the principles of asepsis goes back as far as Florence Nightingale, who made the links between good hand hygiene and reduction in wound infections in 1855 (Rowley et al, 2010). Tagged with: Coronavirus zone: infection prevention and control Newly qualified nurses: practical procedures. Ideally, preparation should be undertaken far enough away from hand washbasins to prevent droplets from the sink outlet contaminating the prepared equipment (Centers for Disease Control and Prevention, 2019). Written by nurses for nurses, The Royal Marsden Manual of Clinical Nursing Procedures provides you with the procedures, rationale, and guidance required by qualified nurses to deliver clinically effective, patient-focused care with expertise and confidence. Procedures The Royal Marsden Manual of Ninth Edition Clinical Nursing Professional Edition. In-text: (Dougherty and Lister, 2015) Your Bibliography: Dougherty, L. and Lister, S. The ANTT® (aseptic non-touch technique) framework was developed to provide consistent step-by-step guidance for an aseptic non-touch technique that can be applied to several invasive procedures, including insertion of urinary catheters and peripheral cannulas, phlebotomy and administration of intravenous drugs (Box 1) (Rowley et al, 2010). The procedure should be carried out in a location that maintains the patient’s privacy and dignity, such as a treatment room, at the bedside with the curtains drawn or in the patient’s own home (Lloyd Jones, 2014). Authors: Andrea Denton and Carole Hallam are independent nurse consultants, AC Independent Nursing Consultants. 3 2.2 Aseptic Non Touch Technique (ANTT) – a method of maintaining asepsis by not touching key parts. Rowley et al (2010) recognised the need for a systematic and robust approach to aseptic technique that aims to prevent the contamination of wounds or other susceptible sites by removing variation in practice (Rowley et al, 2010). Aseptic Non Touch Technique (ANTT) Policy V5.0 Page 2 of 33 Summary All staff who complete ANTT procedures (or are likely to) as part of their clinical practice, must be in date with their annual ANTT update. Aseptic Non-Touch Technique & Introduction to Tissue Viability 1. A ‘clean technique’ can be classed as medical asepsis or standard aseptic technique, as it uses the same principles. Dougherty L, Lister S. (2015) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. Like every other NHS Trust in England, The Royal Marsden reports numbers of particular infections to the national surveillance system. Nationally recognised as the definitive guide to clinical nursing skills, The Royal Marsden Manual of Clinical Nursing Procedures has provided essential nursing knowledge and up-to-date information on nursing skills and procedures for over 30 years. You can talk to the staff where you are or ask to speak to the Matron. 2.3 Contamination – a condition of being soiled, stained, touched, or otherwise exposed to harmful agents, making an object potentially unsafe for use as intended or without barrier techniques. Oxford: Wiley-Blackwell. The Royal Marsden Hospital manual of Clinical Practice 2015. Appendix 61 - Steps for Performing ANTT ANTT (2013) – The ANTT Clinical guideline for the Administration and Preparation of Peripheral and Central Intravenous … Free PDF. West Sussex: Wiley Blackwell. Then massage the back of your hand with the palm of your other hand and your fingers intertwined. Final panel decision: What should happen to a nurse who administered medication to 
a patient without a prescription? Key parts are defined as the parts of the equipment used in the procedure that come into direct or indirect contact with another key part or site. If you prefer, you can share your concerns with the Patient Advisory Liaison Service (PALS) or contact the IPCT directly. 9th ed. The Royal Marsden NHS FT – PICC care guidelines: a real world example This local guideline is an example used in the NICE medical technology guidance adoption support resource for SecurAcath for securing percutaneous catheters, and was not produced,commissioned or sanctioned by NICE. If you think someone should have cleaned their hands and you have not seen them do it, please ask them to do it again where you can see. ANTT, but uses clean rather than sterile single use gloves and potable (drinking) tap water. PDF. The Royal Marsden does everything possible to ensure that staff clean their hands before any activity that involves contact with patients, but we are all human and sometimes we forget. 'The Royal Marsden Hospital Manual of Clinical Nursing Procedures Student Edition' has been specially compiled for pre-registration students to include the essential procedures they need to know. 2 Douherty, l and Lister,SE (2008).The Royal Marsden Hospital Manual of Clinical Procedures. To encourage discussion and reflection on the CSL experience and performance. Create a free account to download. Environmental cleaning at The Royal Marsden is carried out by our commercial partners, ISS Mediclean, who have worked with us for many years. Elsevier Limited. Alternatively, a sterile field can be created using a sterile dressing pack (Lloyd Jones, 2014). To encourage discussion and reflection on the CSL experience and performance. 6. NHS Health Education England - HEE (12 Feb 2018) Aseptic Non-Touch Technique ANTT Based on The Royal Marsden Manual Procedure for Would Care; WHO (2006) Five Moments of Hand Hygiene; WHO System Change - Changing Hand Hygiene Behaviour at the Point of Care; IVI. The manual provides the underlying theory and evidence for procedures related to every aspect of a person's care. Single-use non-sterile gloves should be worn to protect the healthcare worker when there is a risk of contact with blood or body fluids during any procedure (Loveday et al, 2014). Premium PDF Package. A Clean technique may be considered to dress wounds healing by secondary intention e.g. 3. The Royal Marsden Cancer Charity raises money solely to support The Royal Marsden. Where the patient has capacity, this can usually be done verbally and then documented in the patient’s record (RCN, 2017). “Clinical Nursing Procedures” from the Royal Marsden Hospital (2008) and provides a standardised procedure that all staff should follow. The Royal Marsden has a specialist Infection Prevention and Control Team (IPCT). Dougherty L, Lister S. (2015) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. With your help we can continue to be there for everyone who needs us. All sterile equipment should be stored in a clean and dry environment (National Health and Medical Research Council, 2019). The Royal Marsden hospital core nursing procedure cards for practice-based learning 2004 - Blackwell - Oxford. Discovering that you have cancer, and needing to come into hospital, is a very worrying and stressful time. Medical asepsis – sometimes referred to as standard aseptic technique (Association of Safe Aseptic Practice, 2015) – aims to reduce the number of organisms and prevents their spread by use of standard principles of infection prevention (Loveday et al, 2014). In addition, The Royal Marsden operates a 'Search and Destroy' policy for MRSA: we actively check all new patients to see if they are carrying the germ, and when we find it we do everything we can to remove it before it can cause an infection. National Institute for Clinical Excellence (NICE 2012), the Royal College of Nursing (RCN) Infusion Standards 2010 (RCN 2010) and the Health Protection Surveillance Centre – Ireland (HPSC 2011) and the Australian Commission of Safety and Quality in Healthcare (NHMRC 2010). Royal Marsden Manual of Clinical Nursing Procedures and the Asthma UK Guidelines. ANTT Urinalysis Discover Series: E4: RCNi Decision Support Tool and Management of a High Output Ileostomy Kingston University and The Royal Marsden NHS Foundation Trust – CanAdvice NMC OSCE MIDSTREAM URINE SAMPLE Urinalysis Lab Test \u0026 Urine Dipstick Test Explained! A variety of terms are used to refer to aseptic technique; this can be confusing for frontline healthcare staff (Loveday et al, 2014). Wilson, J (2019) Infection Control in Clinical Practice (third edition). 4. For the purpose of this article all references to aseptic technique refer to medical/standard aseptic technique. 3 2.2 Aseptic Non Touch Technique (ANTT) – a method of maintaining asepsis by not touching key parts. Seventh Edition . 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. Elsevier Limited. Preventing the Spread of Infection Review Tool (To be used for observations) Observation Element Have all the elements Hand been completed? The manual provides the underlying theory and evidence for procedures related to every aspect of a person's care. Coronavirus (COVID-19): visiting The Royal Marsden suspended . The Royal Marsden Hospital Core Nursing Procedure Cards For Practice-Based Learning. This made me feel uncomfortable and question that the patient would be at risk from healthcare associated infections (HCAI). A suitable surface should be prepared, such as a dressing trolley or a procedure tray, by cleaning it with a detergent wipe or according to local policy (Loveday et al, 2014). The Reflective Learning on ANTT In this reflection I am going to address the importance of infection control using the Aseptic Non Touch Technique (ANTT). Among other activities, the team provides training and education, advises on isolating patients and other protective measures, and monitors the cleanliness of the hospitals. 2 Douherty, l and Lister,SE (2008).The Royal Marsden Hospital Manual of Clinical Procedures. What should happen to a nurse who administered medication to 
a patient without a prescription? The procedure that we were taught in university is from The Royal Marsden 2008. Risk assessment before the procedure will direct the practitioner as to whether the key parts and key sites can be protected by non-touch or whether the procedure will require the use of sterile gloves, such as for the insertion of a urinary catheter or for taking blood when the re-palpation of the puncture site is required (ASAP, 2015). Provenance. Research breakthroughs, new facilities and staff appointments. Aseptic technique is a process or procedure used to achieve asepsis to prevent the transfer of potentially pathogenic micro-organisms to a susceptible site that may result in the development of infection (Wilson, 2019). of contradictory information in the Royal Marsden Manual of Clinical Nursing procedures versus clinical practice. ‘Pressures are unparalleled but we are here for you’, Aseptic technique is a core competency for many nurses and is required for everyday procedures such as catheterisation and wound dressing. Both key parts and key sites always need to be protected (Rowley et al, 2010), which can be achieved by not touching the key part and by using caps and covers, such as the sterile wrapper of a syringe to protect the key part of the syringe before use. Guidelines for Care of a Peripherally Inserted Central Catheter (PICC) by Community Staff November … The Reflective Learning on ANTT In this reflection I am going to address the importance of infection control using the Aseptic Non Touch Technique (ANTT). 3 Petrek,JA, Peters,M and Nori,S (1990) Axillary Lympadenectomy.Arch.Surg 125, 378-382. Aseptic Non Touch Technique (ANTT) Policy V5.0 Page 2 of 33 Summary All staff who complete ANTT procedures (or are likely to) as part of their clinical practice, must be in date with their annual ANTT update. Aseptic technique is recognised as an essential component of all infection prevention programmes but terminology used to define it varies. We know that anxiety about healthcare-associated infections such as MRSA or C. difficile can add to your worries. Free PDF. 3 Petrek,JA, Peters,M and Nori,S (1990) Axillary Lympadenectomy.Arch.Surg 125, 378-382. Ideally the equipment should be kept out of direct sunlight as this could also affect the packaging, as well as the quality of the sterile products of the equipment. 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 Royal Marsden (2015) has a handwashing technique guideline which if followed correctly, will minimise the risk of cross contamination. Preparation of aseptic technique equipment before performing a procedure should be done in a clean area. 9 th Ed. A number of relevant papers were sourced (n = 13). 2014 Jan;86;Supple 1;S1-S70. Wilson, J (2019) Infection Control in Clinical Practice (third edition). Oxford: Wiley-Blackwell. To develop an understandfing of the skill of suture removal through observation. This then led to a lack of self confidence. If you see anything you are not happy about, whether it is the cleanliness of the area you are in, the hand hygiene of staff, or some other matter, please tell us. Loveday HP, Wilson JA, Pratt RJ, et al. ed., 2015. 4 Zavostky J, Jones RC and Brenna, MB (1984) Evaluation of axillary Lymphedenectomy without axillary drainage for breast conserving therapy. This made me feel uncomfortable and question that the patient would be at risk from healthcare associated infections (HCAI). 3. During the procedure, the sterile field needs to be maintained; this can be achieved by careful opening of the sterile packets to avoid contamination of the sterile equipment and the sterile surfaces of the inside packaging. It is estimated that 300,000 patients each year in England will develop a healthcare-associated infection (HCAI) (National Institute for Health and Care Excellence, 2012). The Royal Marsden Hospital manual of Clinical Practice 2015. Download PDF Package. The first step of the handwashing technique is to first rub the palm of your hands together. [2003] 1.1.3.4 Gloves must [] be worn as single-use items. Download with Google Download with Facebook. This consists of two parts: 1) Theory – review Trust policy and posters 2) Complete Practical assessment. Followers 0. This publication is an RCN investigation into clinical views to guide the practice of aseptic technique. Appendix 61 - Steps for Performing ANTT To develop an understandfing of the skill of suture removal through observation. The Royal Marsden Manual of Clinical Nursing Procedures Lisa Dougherty, Sara Lister (eds.) Procedures The Royal Marsden Manual of Ninth Edition Clinical Nursing Professional Edition. 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 AIM marking criteria is available in Adult Marking Criteria Version R1.7. The Royal Marsden is absolutely committed to patient safety, and that includes doing everything we can to prevent people in our care acquiring any sort of infection. This can sometimes be difficult, as some treatments for cancer (such as chemotherapy) suppress the immune system and make the person receiving them particularly vulnerable to infections, so we make sure that all our staff are trained in infection prevention and control. hygiene PPE ANTT Sharps Waste 1 … Please ask your nurse if you need help, Tell us if you have any signs of infection, particularly if you have diarrhoea, Wear closed-in shoes or slippers – don't walk around barefoot, If you have a wound or a device such as a catheter or drip, don't touch it unnecessarily, Keep your bed area as tidy and clutter-free as you can to make it easier to clean thoroughly, If you see anything you are not happy about, please tell us, Wash your hands or use the alcohol hand rub at the entrance to the ward at the start and end of your visit, If the person you are visiting is in a single room, please check with the nursing staff before going in to see if you need take any extra precautions, Please don't visit the hospital if you are ill, particularly if you are suffering from diarrhoea or vomiting. 1.1.3.3 Gloves must [] be worn for invasive procedures, contact with sterile sites and non-intact skin or mucous membranes, and all activities that have been assessed as carrying a risk of exposure to blood, body fluids, secretions or excretions, or to sharp or contaminated instruments. At The Royal Marsden, we deal with cancer every day so we understand how valuable life is. Annals of Surgical Oncology,158, 327-330. These infections are more likely to occur in patients with invasive devices, such as peripheral canulas, vascular access devices or urinary catheters in situ, or after invasive procedures (NICE, 2012). All our wards are cleaned at the standard recommended for 'High Risk' or ‘Very High Risk’ areas in the National Standards of Cleanliness in the NHS, a higher standard than would normally be applied in most hospital wards. Download with Google Download with Facebook. epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. It must also be performed after the procedure (WHO, 2019). The With the increased focus on antimicrobial resistance (AMR) there is also a need to carefully consider antibiotic usage, and prevention of infection can help to reduce the need for antimicrobials in the first place (HM Government, 2019). In the past, many aseptic techniques included a ritualistic practice of cleaning trolleys with alcohol between clients. 1030 Pages. The fundamental principle of an aseptic technique/ANTT incorporates protecting key elements of the equipment that should remain free from micro-organisms, for example, the inside of a sterile dressing or the barrel of a sterile needle (NICE, 2012). of contradictory information in the Royal Marsden Manual of Clinical Nursing procedures versus clinical practice. Urinalysis/ Midstream Urine collection (OSCE) Top 10 Best Hospitals In UK The Royal Marsden - Cancer … In-text: (Dougherty and Lister, 2015) Your Bibliography: Dougherty, L. and Lister, S. This first article in a two-part series outlines the principles of medical asepsis. 9th ed. It is also sensible to store the equipment in a manner that enables staff to locate it easily, preventing wasted time. 3, 27-38 The team also reviewed manufacturer guidelines (n = 3) for various wound‐dressing products and the Royal Marsden Procedural Manuel. Urinalysis/ Midstream Urine collection (OSCE) Top 10 Best Hospitals In UK The Royal Marsden - Cancer … This paper. National Institute for Clinical Excellence (NICE 2012), the Royal College of Nursing (RCN) Infusion Standards 2010 (RCN 2010) and the Health Protection Surveillance Centre – Ireland (HPSC 2011) and the Australian Commission of Safety and Quality in Healthcare (NHMRC 2010). 3. It is important to remember that the single-use gloves, whether sterile or non-sterile, should be applied immediately before beginning the procedure; applying them before this point is likely to contaminate sterile gloves and/or prevent an opportunity for hand hygiene (NICE, 2012). Loveday HP, Wilson JA, Pratt RJ et al ; 2014; epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England. 9 th Ed. You are here: Royal College of Nursing / Professional Development / Publications / Understanding Aseptic Technique Published: 24/02/2020 Publication code: 007928 Infection in Hospital not seen them do it, Wash your own hands frequently, particularly before.. Be stored in a clean technique may be considered to dress wounds healing by secondary intention e.g patients! As this affects the sterility of the risks and do everything that they can reduce! 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