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Challenges faced by nurses in complying with aseptic non-touch technique principles during wound care: a review

12 March 2020
15 min read
Volume 29 · Issue 5



Surgical and wound site infections (SWSIs) are the second most frequent type of healthcare-associated Infection. One way of preventing SWSIs is by adhering to the principles of asepsis. However, many nurses struggle to apply the principles of aseptic non-touch technique (ANTT) during wound management.


To identify the barriers and enablers that influence nurses' adherence to the principles of ANTT during wound care.


A literature search using a systematic approach was carried out. Four databases were searched to identify relevant studies published between January 1993 and December 2018. Titles and abstracts were reviewed. Studies that met the inclusion criteria were reviewed for quality. The extracted data were then synthesised.


A total of seven studies fulfilled the requirements for inclusion. Three themes emerged and were found to be the most dominant factors influencing adherence to the principles of ANTT: material and resources, nurse education, and nurses' behaviour.


Nurses' compliance with aseptic practice is directly influenced by environmental and psychological factors. Ensuring compliance to ANTT may require an integrated approach involving local, national and worldwide organisations, in collaboration with higher education institutions that teach nurses and similar healthcare professionals.

Surgical and wound site infections (SWSIs) are the second most common type of healthcare-associated infection (HAI) in Europe (European Centre for Disease Prevention and Control (ECDC), Zarb et al, 2012). The global impact of SWSIs on individuals and the economy puts major epidemiological burdens on both developing and high-income countries (Allegranzi et al, 2016). Based on data from 48 studies, a study published by Leaper et al (2004) estimated the financial cost of SWSIs in Europe to be €1.47-€19.1 billion, and the average patient stay in hospital increases by 6.5 days, which means it costs three times as much to treat an infected patient (Leaper et al, 2004). Data collected by NHS hospitals in England from April 2010 to March 2012 estimated the length of hospital stay attributed to SWSIs to increase by 7–13 days, with a total of 4694 bed-days lost over this period (Jenks et al, 2014). In 2017–2018, the incidence of SWSI was higher than it was 10 years ago (Public Health England, 2018).

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