ANTT tips

[MatthewCanUK]

Hi,

I am looking for some advice on how to do "clean hand, dirty hand" when doing asceptic non-touch technique for a dressing change. When I trained we used forceps, but recently I was being tested and there were no forceps to be found so you could only use your hands (with sterile gloves of course). One of the things I was cited on was not using the "hands" idea.

Is it really just as simple as only using one hand to cleanse the wound while leaving the other sterile? (I would think that this would contaminate the sterile field when you went back to get the next wet gauze). Am I over-thinking this?

[Shellieanne]

Hi,

Yeah, the hand closest to the patient is your dirty hand and the one closest to your sterile field is the clean one. The dirty hand is the only one that touches your patient and vice versa. From what I understand, the point of ANTT is that you do not touch the sterile part of the dressings at all. The way it was explained to us was that as soon as the sterile pack is opened, it's no longer sterile therefore it is ANTT is advocated. Hope this helps!

[MatthewCanUK]

Thanks Shellie-anne. That does help.

My one question is: what about when you have used your "dirty hand" to do something to the patient. In this case it is holding a gauze to clean a surgical wound. Can you then use the same hand to take the next gauze from the sterile field? I guess I get hung up on the word "dirty". When I went to school if your hand was dirty/contaminated there was no way you were ever bringing it back to the sterile field for fear of contaminating it. Is the assumption here that as long as you are holding the gauze, and only the gauze (not your glove) touches the patient, you can then go back and take the next item from your field?

Sorry to be picky and to quiz you like this.

[Pippynurseuk]

We were taught to take gauze from sterile field using clean hand and then literally drop it into dirty hand so you do not touch dirty hand. Then dirty hand is used to clean wound. Clean hand goes back to sterile field to get next gauze, drop, repeat and so on.

[MatthewCanUK]

So. Pick up the wet, sterile gauze in the non-dominant/clean hand then drop it into the dominant/dirty hand. That is hopefully easy enough.

Are there any tricks to actually placing the dressing? Or can you just use both hands as long as you don't touch the bandage/pad part of the dressing?