Is there consensus for the aims of aseptic technique undertaken by nurses outside operating theatres? Delphi survey with follow-up study day

BACKGROUND: Aseptic technique is integral to infection prevention, but is not defined clearly in international guidelines. Recommendations for practice lack concordance. AIM: To establish whether there is consensus for the aims of aseptic technique, and how it should be undertaken by nurses outside operating theatres. METHODS: Online modified Delphi survey in two rounds with a follow-up study day. RESULTS: According to the study participants, aseptic technique is necessary to prevent transmission of potential pathogens, is undertaken primarily to protect the patient undergoing the procedure, should be preceded by risk assessment, and only sterile items should enter the sterile field or contact the vulnerable site. In order to undertake risk assessment, information about the patient and venue are considered necessary. There is no consensus regarding whether the aim is to protect other patients and healthcare workers, whether aseptic technique is possible in all settings, and the appropriateness of personal protective equipment. Findings from the follow-up study day suggest that participants can undertake risk assessment when supplied with basic information related to patients and environment. The outcome of risk assessment is influenced by the venue where the procedure is undertaken, previous experience, and perceptions about the invasiveness of the procedure. Distinction is made between procedures considered highly invasive and those perceived to carry less risk. CONCLUSION: Nurses agree on some, but not all, key issues related to aseptic technique. The decision to undertake aseptic technique appears to depend on the venue, experience, and perceptions of the invasiveness of the procedure. More focus on education, delivery, and audit of aseptic procedures is needed to improve consistency of understanding and practice.