Key Part or Not?
A syringe cap is removed and placed face-up on a clean bedside table, then reapplied later. Is this a key part breach?
Yes, inside the cap protects a key part and is now contaminated.
PIV insertion in a stable patient using clean gloves and no sterile field/
What level of ANTT is required?
Standard ANTT
Appropriate for low-risk, short duration access
During a central line dressing change, sterile gloves touch the patient's gown, then continue procedure. Is this a breach?
Yes, gloves are no longer sterile.
A colleague accesses a PICC after a 5-second hub scrub. Would you speak up?
Yes! Options on how this could be addressed.
Can we pause for a full 15 second scrub? I want to make sure we're protecting the line.
In the middle of changing a PICC dressing the nurse notices that they forgot the Statlock, they step away after covering the insertion site with sterile gauze and tell the patient not to move, leaving the field unattended. They go to their cart for the Statlock, drop it on their sterile field and continue with the dressing change. Is this acceptable?
No, loss of aseptic control.
A clinician stabilizes a catheter hub by holding the sides of the luer connection while attaching tubing (Jloop). Is this a key part breach?
Depends, if contact avoids connection point it is acceptable. If fingers touch the open lumen and sterile gloves are not worn, then it is a breach.
PICC line placement requires what level of ANTT?
Surgical ANTT is required for PICC placement.
During a PICC dressing change, the clinician performs a thorough chlorhexidine prep. The site appears dry, but there are faint steaks of moisture at the edges. The clinician proceeds with dressing application. Is there a breach?
Yes, incomplete dry time reduces the efficacy of the antiseptic. Moisture can facilitate microbial transfer under the dressing and cause irritation to the skin.
You're observing a vascular access colleague placing a difficult PIV. After appropriate skin prep, they re-palpate the vein without recleaning, then proceed to insert. Would you speak up?
Yes, this is a aseptic breach of key site.
During a sterile procedure, a clinician reaches over the sterile field with a non-sterile arm to grab equipment. Is there a breach?
Yes, reaching over the field introduces droplet and particulate contamination risk.
During a PICC insertion using surgical ANTT, the inserter drops their sterile gloved hands below waist level while discarding packaging. without changeing gloves, they proceed to handle and flush the PICC catheter prior to insertion. Does this represent a breach of aseptic technique involving a key part? Explain your reasoning.
Yes, this is a breach of ANTT involving a key part.
The PICC is a key part
Hands below waist level is considered out of the controlled sterile field and no longer reliably sterile.
Using potentially contaminated gloves to handle the catheter creates a direct risk of contaminating the sterile fluid pathway and insertion system.
Accessing an IVAD requires what level of ANTT?
Standard ANTT with sterile gloves and mask. Since a head-to-toe drape is not used for access, this is considered standard ANTT.
During PICC insertion, sterile supplies are dropped on the sterile field. One saline syringe partially hangs off the edge but does not fall. It is later used. Is there a breach?
Yes, the edge of the field is a high-risk zone for contamination. 1" around the sterile field is considered "non-sterile", so items should be dropped away from the edge.
During an USGPIV insertion, you notice a physician uses a cleaned probe without a sterile cover, maintaining careful technique and avoiding direct contact with the insertion site. Would you speak up?
Yes, best practice is still to use a sterile probe cover
A patient requests to keep their fan on during their central line dressing change. Is this an environmental risk?
Yes, because it increases airborne particle movement.