The New CPR? Why ANTT is a Must-Know for Nurses

The concept of an aseptic technique has been around for more than a century, but there was no comprehensive model for explaining how to put it into practice until Stephen Rowley, RN RSCN BSc (Hons) MSc, originated the Aseptic Non Touch Technique^® (ANTT^®) framework.

We spoke with Rowley from his home base in London to learn more about the growth and goals for the ANTT framework.

Q. When did you first establish ANTT?

A. I originated a framework for aseptic technique about 20 years ago. ANTT was and still is the only framework that provides a comprehensive model for explaining how to practice aseptic technique. It gained a lot of traction in the UK in the mid ‘90s, because of high infection rates across the UK, then began to spread quite widely internationally, and we created the nonprofit clinical-based Association for Safe Aseptic Practice, or ASAP, to oversee and disseminate the ANTT project.

Q. You’ve compared the goal of ANTT to CPR. Why?

A. Our mission was to replicate the single standard approach globally to aseptic technique that we see in CPR, and that remains our mission today. Whenever I teach, I always ask the audience two questions: Who’s had training in CPR? If there are 200 people, everyone will hold up their hands. And then I ask the same 200 people with their hands up to put them down if they have not used CPR in the last year as a competency—about three or four hands remain up. And then I repeat the questions for aseptic technique, and nobody would put their hands up when asked about training, but everybody would put their hands up for having used it.

Q. Why is this so important for the frontline staff to know?

A. Before I answer that question, I would probably say it’s more important to the patients. First and foremost, there’s a general acceptance that a significant proportion of healthcare-associated infection is considered preventable. And that largely boils down to a breakdown in the interaction between the healthcare worker and the patient while performing aseptic technique procedures, because that’s the moment where patients are exposed to organisms they ordinarily wouldn’t be through a part of their body that wouldn’t ordinarily be breached. It’s also important to frontline and primary care staff because they need to be supported properly with education, training and assessment. To use ANTT, the model now providing this so widely internationally, means the healthcare sector is increasingly talking the same practice language for matters of aseptic practice, whether that be clinical practice, education or research. That’s got to be a good thing for patient safety.

Q. When did the evaluation aspect launch?

A. As the traction started to grow in the UK, the big players in the industry noticed that when their clinical staff approached hospitals with products, staff would ask, ‘Does that work with ANTT?’ or ‘Is that ANTT compliant?’ And they were thinking, ‘What’s ANTT?’ So we started to see requests from the big companies to tell them more about ANTT and how they could align their products with it to support best practice and improve patient safety. Our main mission is a jigsaw, and ANTT provides a very important piece of it, but we realize that industry has an important part too, because they’re making products that people are using every day that can help improve aseptic technique. So we created an independent process for evaluating products that support aseptic technique, that doesn’t involve us having any vested interest in product sales or shares.

Q. What standards do you apply when evaluating a product for ANTT compliance?

A. We evaluate many different types of products that are used in the pursuit of effective aseptic technique. There’s no exhaustive list, but there are principles that we look for: Is the product fit for purpose? Is it made with high enough quality materials? What design factors inhibit or support aseptic practice?

Q. How did Medline’s SmartStep^® CVC dressing change kit measure up?

A. First and foremost, it met the normal expectations of a sterile drape that can support PICC line insertion. But Medline goes over and above that by thinking of the next steps of the dressing change process, in making sure staff have the right equipment in the right place. And then you’ve thought about another step: You’ve organized the equipment in a way that makes it easier to follow the right sequence than the wrong sequence. And then over and above that, you are individually protecting Key-Parts, with individual pockets, reducing risk of contamination. Altogether, the Medline SmartStep was assessed to be highly supportive of ANTT Principles.

Q. How do you see the progress in getting ANTT to a point like CPR?

A. The world’s a big place and time is short. It’s always going to be a work in progress, but I think we’re well on the way now with over 35 countries using ANTT to different levels. The aim feels possible now and I think we will get there, hopefully in my lifetime!