Australian and New Zealand nurses' understanding and application of aseptic technique in clinical contexts: a cross-sectional mixed-method study.

Abstract

Introduction: Aseptic technique remains fundamental in nursing practice and is essential in reducing hospital-acquired infections. Research shows that opportunities for nurses to update their knowledge and skills of aseptic technique are limited, and understanding of core principles can be inconsistent across healthcare and educational settings. Our aim was to capture the current understanding and application of aseptic technique among nurses in Australia and New Zealand.

Method: We undertook a cross-sectional mixed-method survey design. Registered and enrolled nurses working in Australian or New Zealand healthcare or nursing education facilities were eligible to participate and were recruited between December 2024 and February 2025. Participants completed an anonymous online survey, informed by outcomes of a scoping review and adapted from existing surveys. Descriptive analysis was performed, with thematic analysis undertaken for open-ended questions.

Results: In total 328 responses were received, primarily from Australia (n=275) and New Zealand (n=53). Respondents were predominantly from the public sector (62%), with 65% having more than 10 years of experience. While nearly all recognised the importance of aseptic technique for infection prevention, considerable variation was evident in how principles were described and applied. Terminology such as 'clean', 'sterile' and 'aseptic' was commonly misunderstood, and 48% of participants were unsure if their facility used a framework to guide aseptic technique. Less than half (47.2%) of nurses reported being reassessed on their aseptic technique skills in the past 5 years.

Conclusions: These findings reveal variability in nurses' understanding and practice of aseptic technique, highlighting opportunities for system-level improvement. Establishing standardised, evidence-based definitions and principles, supported by governance, may strengthen education, policy and clinical practice and promote patient safety. Further research is needed to reach a consensus on these definitions and principles.