The “Prescription Without Description” Conundrum: Making The Case for a Standard Practice of The Aseptic Technique

Vascular access devices (VADs) are the cause of nearly 1.7 million infections in US hospitals every year. The Centers for Disease Control and Prevention (CDC) also estimate a yearly average of 99,000 associated deaths. The worst part about these numbers is that healthcare-associated infections (HAI) are almost entirely preventable.

Healthcare professionals have the main responsibility in protecting patients from infection during invasive procedures. The most effective proven way to ensure patient safety during the insertion and maintenance of IVAD’s is the aseptic technique.

Despite its importance, the literature and education for the aseptic technique are historically ambiguous.

This situation is often referred to as the “prescription without description” problem. A study by the Association for Safe Aseptic Practice has found that healthcare facilities almost universally prescribed the aseptic technique without actually describing what it is or how it needs to be applied. Nurses and other healthcare workers often face conflicting approaches and end up confused by interchangeable terminologies.

Following the international standard for the Aseptic Non Touch Technique (ANTT®) is a growing recommendation. It is currently used in over 30 countries and is increasingly being mandated by governments within national standards. The technique is based on a unique concept of Key-Part and Key-Site Protection, designed for all clinically invasive procedures and maintenance of indwelling medical devices.

Key-Part refers to any equipment that, if contaminated, is likely to contaminate the patient, such as a syringe tip, IV port, and injection needle.

Key-Site is any portal of entry into the patient, such as an open wound, cannula, or injection site.

These concepts are followed by three major practice standards:

Critical Aseptic Field: To ensure asepsis, all procedure equipment is placed upon a sterilized drape and procedure Key-Parts are subsequently managed collectively.

Micro Critical Aseptic Field: Key-Parts must be individually protected. This includes sterilized caps, covers, and the inside of recently opened sterilized packaging.

General Aseptic Field: A decontaminated and disinfected procedure tray, working surface or pulp tray is essential to promote asepsis.

It’s time for organizations and professionals to make a joint effort for reducing healthcare-associated infections. Standardized education and procedures can highly improve patient safety.

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