ADHERENCE TO ASEPTIC TECHNIQUES DURING CLINICAL PROCEDURES AND THE IMPLEMENTATION OF STANDARD OPERATING PROCEDURES AMONG NURSING PROFESSIONALS IN SELECTED HOSPITAL/MEDICAL COLLEGE OF BARABANKI DISTRICT, UTTAR PRADESH

Background: Aseptic technique is an essential component of safe nursing practice and infection prevention during clinical procedures. Despite the availability of infection-prevention guidelines and standard precautions, adherence to aseptic practices may vary because of workload, availability of resources, supervision and accessibility of standard operating procedures (SOPs). Direct observation provides an opportunity to identify actual clinical practice gaps that may not be evident through self-reported compliance. Aim: To assess adherence to aseptic techniques among staff nurses during clinical procedures, identify practice gaps, explore factors influencing adherence, implement a standardized SOP-based intervention, and evaluate changes in adherence following implementation. Methods: An observational interventional pre–post design was adopted among 100 staff nurses working in direct patient-care areas at Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh. Participants were selected using stratified random sampling. A 17-item observational checklist was used to assess adherence to aseptic techniques before and after implementation of SOP AT/SN/2026/01. A 10-item gap assessment tool, a seven-component SOP compliance checklist and a semi-structured interview guide were also used. Quantitative data were analyzed using frequency, percentage, mean, standard deviation and paired t-test, with additional association and correlation analyses where appropriate. Qualitative responses were analyzed thematically. Results: Before SOP implementation, 61% of nurses demonstrated moderate adherence, 34% demonstrated poor adherence and only 5% demonstrated good adherence. The mean pre-intervention adherence score was 10.38 ± 1.80 out of 17 (61.1%). Following SOP implementation, good adherence increased to 46%, moderate adherence was 53%, and poor adherence decreased to 1%. The mean post-intervention score increased to 13.35 ± 1.87 (78.5%), with a mean improvement of 2.97 ± 1.47 points. The improvement was statistically significant, t(99) = 20.158, p < 0.001, with a large paired effect size (dz = 2.02). All 17 observed practice items demonstrated improvement. The most frequent practice gap was failure to perform hand hygiene (34%), followed by non-availability/non-display of SOPs (32%) and improper PPE use (30%). Mean weekly SOP compliance increased from 74.1% in Week 1 to 89.3% in Week 4. Resource availability was significantly associated with post-assessment adherence (p = 0.011), while clinical experience showed a significant negative correlation with adherence (r = −0.272, p = 0.006). Conclusion: Implementation of a structured SOP-based strategy was associated with a significant improvement in observed adherence to aseptic techniques among staff nurses. The findings indicate that improving aseptic practice requires not only education but also visible SOPs, adequate resources, supportive supervision, monitoring and periodic reinforcement.