title: Performing an aseptic technique in a community setting: fact or fiction?
abstract: BACKGROUND
  Maintaining the principles of asepsis when performing wound care and other invasive procedures is one of the fundamental approaches of preventing healthcare-acquired infection. Such an approach has been advocated for community practitioners.
  
  
  METHODS
  The performance of an aseptic technique is an under-researched area. The few studies that have been conducted have identified how strict adherence to the technique is difficult and contamination of hands/gloves is common and that community nurses often have a fatalistic view about whether asepsis is possible in a community setting.
  
  
  OBJECTIVE
  The overall aim of this research project was to examine how experienced practitioners have adapted the aseptic technique within a community setting and to what extent the changed procedure still adhered to the principles of asepsis.
  
  
  METHODS
  This study used a mixture of non-participant observation and individual semi-structured interviews to examine adherence to the principles of the aseptic technique among the district nurses. Data were collected from one Trust in England with a total of 10 district nurses taking part and 30 aseptic procedures been observed.
  
  
  RESULTS
  The results show that almost all of the staff understood the principles of asepsis and had adapted the standard procedure for use in a patient's home. Common challenges included wound cleaning using a single nurse procedure, the contents of the pack and the home environment. The research also identified misconceptions about clean versus aseptic procedures and a lack of training for staff.
  
  
  CONCLUSIONS
  This study highlights the challenges of maintaining the principles of asepsis in a home environment and the fact that district nurses are often relied upon to find creative solutions to such challenges. The study also highlights issues around the implementation of evidence-based practice and the need for clearer guidance about how evidence should be used alongside existing procedures.
authors.affiliation: School of Health Community and Education Studies, Northumbria University, Newcastle-upon-Tyne, UK. john.unsworth@northumbria.ac.uk
authors.forename: John
authors.initials: J
authors.lastname: Unsworth
authors.forename: Joan
authors.initials: J
authors.lastname: Collins
mesh_terms: D000328:Adult; D001207:Asepsis / Q000379:methods*; D003153:Community Health Services / Q000379:methods*; D017714:Community-Acquired Infections / Q000451:nursing / Q000517:prevention & control*; D004739:England; D004777:Environment; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D036301:Qualitative Research; D014945:Wound Healing