Aseptic non-touch technique (ANTT®)

Aseptic non-touch technique (ANTT®), a framework developed by Rowley in the 1990's, focuses on the identification and prevention of microbial contamination of aseptic parts or sites during clinical procedures. ANTT® ensures aseptic parts or sites are not touched - either directly or indirectly, ensuring sterility during procedures that can cause significant patient harm if performed incorrectly¹. Since its conception, ANTT® has been widely adopted during clinical procedures such as vascular access catheter insertion and management, for example during dressing changes^2,3.

The ANTT® framework requires competent clinicians to assess scenarios and evaluate whether tasks requiring an ANTT® approach can be done by the bedside - maintaining a completely sterile field with minimal or no analgesia for the patient; or if the task require a surgical environment such as an operating theatre or interventional radiology⁴. The ANTT® model comprises 6 key principles, (outlined in poster) based on safety, for the patient and clinician, maintenance of sterility, and use of the correct personal protective equipment based on whether contact must be made with a critical area¹.

In 2021, the Infusion Nurses Society Standards of Practice included ANTT® for the first time (Standard 18). Within the standard are key definitions, and evidence-based best practice recommendations. Key-Sites and Key-Parts form the fundamentals of ANTT®⁵. A Key-Site is defined as “any portal of entry to the patient”, meaning any point directly attached to the patient that can facilitate bacterial infiltration. A Key-Part is defined as any part of the procedure that “if contaminated, is likely to contaminate the patient”, including syringe tips, Luer ends, and administration set spikes. In Australia, in accordance with the Australian Commission on Safety and Quality in Health Care, clinicians must follow all steps of the ANTT® framework to ensure that patients are at the lowest risk of harm at all times⁴.

For more information, visit https://www.antt.org/

References

1.      Clare S, Rowley S. Implementing the Aseptic Non Touch Technique (ANTT) clinical practice framework for aseptic technique: a pragmatic evaluation using a mixed methods approach in two London hospitals. Journal of Infection Prevention 2018;19(1):6-15.

2.      The Sydney Children’s Hospital Network. Aseptic non touch technique; 2017; Available from: https://www/schn.health.nsw.gov.au/_policies/pdf/2017-007.pdf.

3.      Isaac R, Einion A, Griffiths H. Pediatric nurses' adoption of aseptic non-touch technique. British Journal of Nursing 2019;28(2):16-22.

4.      Australian Commission on Safety and Quality in Health Care. Aseptic technique risk matrix. 2018 https://www.safetyandquality.gov.au/sites/default/files/migrated/Aseptic-Technique-Risk-Matrix-Updated-November-2018.pdf.

5.      Gorski L, et al. Infusion Therapy Standards of Practice, 8^th ed. Journal of Infusion Nursing 2021;44(1).