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.

BACKGROUND

Aseptic technique is an important infection prevention competency for protecting patients from healthcare-associated infection (HAI). Healthcare providers using the Aseptic Non Touch Technique (ANTT®) aseptic technique have demonstrated reduced variability and improved compliance with aseptic technique.

OBJECTIVES

The primary aim of this study is to determine whether standardizing aseptic technique for invasive IV procedures, using the ANTT® - Clinical Practice Framework (CPF), increases staff compliance with the infection prevention actions designed to achieve a safe and effective aseptic technique, and whether this is sustainable over time.

METHODS

A pragmatic evaluation using a mixed-methods approach consisting of an observational audit of practice, a self-report survey and structured interviews with key stakeholders. Compliance with aseptic technique before and after the implementation of ANTT® was measured by observation of 49 registered healthcare professionals.

RESULTS

Mean compliance with competencies was 94%; each component of practice was improved over baseline: hand hygiene = 63% ( ≤ 0.001); glove use = 14% ( ≤ 0.037); Key-Part protection = 54% ( ≤ 0.001); a non-touch technique = 45% ( ≤ 0.001); Key-Part cleaning = 82% ( ≤ 0.001); and aseptic field management = 80% ( ≤ 0.001).

CONCLUSIONS

Results show implementation of ANTT® improved compliance with the prerequisite steps for safe and effective aseptic technique as defined by the ANTT®-CPF. Improvements in compliance were sustained over four years.