Aseptic Non Touch Technique for Vascular Access Devices

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Introduction
Vascular Access Devices are he devices commonly inserted through veins or arteries for
the purpose of administering fluids into or from the body through peripheral or central vascular
location(McGuire, 2015). Vascular access devices are used for therapeutic reasons like
administration of medication, blood sampling, total parenteral nutrition, reading central venous
pressure, blood transfusions and intake of fluids(Harrington, 2014). Vascular access devices can be
inserted centrally or peripherally. The choice of the device depends on the patient’s needs, its
requirement reasons, the duration for its use and the knowledge and the skills the operator has in
regard to the device (Moureau, 2013). Manufacturer’s guidelines, material and the size of the
device should also be looked into before the device can be put into use(Zhang, Keogh & Rickard,
2013). There are many devices available. Standardizing them will help avoid confusion and
increase their familiarity and consequential competence for their use(Moureau, 2013)(McGuire,
2015). The devices inserted peripherally are midlines and cannulae. Centrally inserted devices are
non-tunnelled central venous catheters, implantable ports, peripherally inserted central catheters,
and tunneled central venous catheters. Handling of any equipment must be met with training and
competency to do so. This is according to Medicines and Healthcare products Regulatory
Agency (Loveday, et al, 2014).
Vascular access devices guidelines are important in ensuring that the devices are
consistently and efficiently used to enable proper patient care(Moureau, 2013). This is because if
they are not handled properly they can be the root cause of infections such as bloodstream
infections which in turn can cause prolonged hospitalization, morbidity and even death (Chopra,
et al, 2013). The longer they are in use the higher the risk of infection. Aseptic non touch
technique as a national policy is used by the healthcare workers to reduce the number of

infections associated with the healthcare(Technique, 2016)(Conley, et al, 2017). This guideline is
part of the nursing skill that encompasses on prevention and control methods as well as
precautionary methods required during clinical procedures to prevent introduction of
microorganisms to sterile body sites of the patient by the health professionals, immediate
environment or the equipment to be used (Austin&Elia, 2013). Aseptic non touch technique is a
standard technique used in accessing all venous access devices whether inserted peripherally or
centrally(Loveday, et al, 2014)(McGuire, 2015). Lack of proper use of the technique is the major
cause of infections acquired in the healthcare(Marschall, et al, 2014). The purpose of the technique
is to lower infection chances of microorganism during preparation, administration and delivery
of intravenous therapy(Loveday, et al, 2014)(Conley, et al, 2017). The technique also reduces
potential contamination through wearing of non-sterile gloves, effective hand washing, use of
alcohol-based solutions in decontamination of key parts of the devices through adequate cleaning
and allowing alcohol to evaporate naturally(Austin &Elia, 2013).
Aseptic non touch technique is the most effective way of reducing healthcare associated
infections through a standardized procedure(Dougherty & Lister, 2015) (Zhang, Keogh &
Rickard, 2013). Healthcare associated infections can cause harm or death to the patients. The
clinical guideline has been backed up by health departments with the aim of preventing infection
to the sites by the pathogens (Loveday, et al, 2014). Asepsis can be medical or surgical. The
main aim of asepsis is sterility. Surgical asepsis aims at eliminating all the pathogenic organisms
on an area or object prior to the surgical procedure(Harrington, 2014). It is a sterile technique.
Medical asepsis is about maintaining cleanliness to prevent and reduce the number of pathogens.
Aseptic non touch technique can be used in achieving medical asepsis(Conley, et al, 2017). Its
principle is that body sites susceptible or sterile should not come into contact with non-sterile

items. During clinical procedures only non-contaminated key parts or sterile fluids should come
into contact with key sites (Moureau, et al, 2013). Key parts should not be in any way directly or
indirectly touched. The principles of aseptic non touch technique are on protection of key parts
and key sites which is now applied to all types of IV therapy. The focus is on the equipment used
and protection of key equipment parts. The equipment parts are those parts that are in direct
contact with the patient with a high potential of pathogens transmission and the parts are also in
direct contact with infusate (Marschall, et al, 2014). Efficiency and safety of aseptic non touch
technique is needed. Hence surgical aseptic non touch technique should be used in complicated
areas while standard aseptic non touch technique should be used in procedures that are
uncomplicated(Harrington, 2014). The choice is determined by the risk assessment of the key parts
and key sites asepsis. Health professionals should assess the risks in every procedure for the level
of aseptic technique and prevention and control measures of infection required to enable
asepsis(Conley, et al, 2017).
Key sites in aseptic non touch technique are insertion sites and wounds(Moureau, et al,
2013).Central Venous Access Devices(CVADs), catheters and veins are the insertion sites.The
parts of the equipment are the key parts needed in the process and have direct contact with the
aseptic parts of the patient, key sites and liquid infusions(Moureau, et al, 2013). Any
contamination of key sites leads to direct transmission of micro-organisms(Megeus, et al, 2015).
When a procedure requires key areas of the equipments to be directly touched,sterilized gloves
can be worn. This reduces contamination risks. Non-sterile gloves can be used during the
procedure if the key parts do not necessarily need to be touched. Principles of carrying out
aseptic technique include; Always wash hands and decontaminate effectively, Never contaminate
key parts of the equipment or the key sites, Touch the non-key parts with confidence, Take