RLO Transcript: Aseptic Non-Touch Technique: Video Demonstration Narration
This is a transcript of the narration for the Video Demonstration in the Reusable Learning Object (RLO) entitled "Aseptic Non-Touch Technique", online at:

http://www.nottingham.ac.uk/nursing/sonet/rlos/placs/antt

The ANTT procedure can be adapted according to the clinical situation. So for instance, a district nurse working in a patient’s home alone will be able to adapt the procedure but still comply with the principle of not introducing micro-organisms to the patient. In all situations, it is preferable to conduct the procedure with two healthcare workers – one person is responsible for undertaking the procedure and the other person for assisting with it.

Before starting the procedure, it should be explained to the patient. Wherever possible, the patient should consent for the procedure to go ahead. If the procedure is likely to cause discomfort or pain, it may be helpful to administer prescribed analgesia twenty minutes before the procedure is to take place.

Both healthcare workers should wash and dry their hands, and then one of them should clean the dressing trolley with detergent and water, which should then be dried thoroughly. The cleaning and drying of the trolley should be performed just before the ANTT procedure.

Assemble all the equipment that is likely to be used and place on the bottom shelf of the trolley. Take the trolley to where the procedure is going to be performed.

Both healthcare workers should decontaminate their hands with alcohol hand rub before putting on clean, disposable aprons. The assistant should use the alcohol hand rub again before checking each piece of sterile equipment for the expiry date, and that each is intact and is not damaged. If expired, or there is any possibility of any damage to the equipment, it should be discarded and replaced. The dressing pack should be removed from the outer wrapper and dropped onto the top shelf of the dressing trolley.

The healthcare worker undertaking the procedure should open the dressing pack ensuring that they only touch the corners of the paper. The assistant checks the expiry date of all other equipment, making sure that the packaging is intact, before opening and dropping it onto the sterile field. 

The healthcare worker undertaking the procedure puts on their sterile gloves using the appropriate technique. The clinical waste bag is passed to the assistant who adheres this to the side of the trolley. If irrigation of the wound is likely, the assistant wipes the opening strip of the irrigation fluid with an alcohol impregnated swab and allows it to dry for 30 seconds before pouring the contents into the sterile receiver.

The assistant decontaminates their hands before putting on a pair of non-sterile gloves and removing the patient’s wound dressing, ensuring the open wound is exposed for a minimal amount of time. The wound dressing and the gloves are then disposed of in the clinical waste bag before the assistant decontaminates their hands.

The healthcare worker undertaking the procedure places a sterile protective sheet near the wound site, making sure their sterile gloves do not become contaminated. They then draw up the irrigation fluid and irrigate the wound before drying, using a light and gentle touch. The wound is covered with an appropriate dressing and is secured firmly.

Checks should be made to ensure the patient is comfortable before leaving the patient. All clinical waste should be discarded appropriately, and gloves and aprons should be removed and discarded before leaving the area. Hands should be decontaminated. Finally, the procedure should be documented in the patient’s notes.