Surgical Hand Washing Procedure PDF

Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ Surgical hand washing Introduction: Skin is a major source of microorganisms an...

Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ Surgical hand washing Introduction: Skin is a major source of microorganisms and a major source of contamination in the OR setting. Since skin cannot be sterilized, members of the surgical team must wear sterile gloves. The purpose of the surgical hand scrub is to significantly reduce the number of skin bacteria found on the hands and arms of the OR staff. Studies have shown that skin bacteria rapidly multiply under surgical gloves if hands are not washed with an antimicrobial soap, whereas a surgical hand scrub will inhibit growth of bacteria under gloved hands. Definition: It is hand washing with antiseptic soap or alcohol-based hand rub before operations by surgical personnel. Types of hand washing:  Medical hand washing: A hand wash performed before and after examining a patient.  Surgical Hand washing: Hand washing performed before performing a surgical procedure. Purpose of surgical scrub :  To remove transient and resident bacteria from fingers, hand and forearms.  To prevent transmission of infection to patient.  To reduce the risk of transmission of infection organisms to oneself.  To prevent cross infection among clients. Consideration for surgical hand scrub:  Remove rings, watches, and bracelets before beginning the surgical hand wash.  Remove debris from underneath fingernails using a nail cleaner under running water.  Keep nails short as far as possible.  Artificial nails should not be worn 28 Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________  Skin on hands and arms should be intact.  The selected antimicrobial hand scrub agent should: - Significantly reduce selected microorganisms on intact skin - Contain a nonirritating antimicrobial preparation - Be broad spectrum - Be fast acting - Have a residual effect  Surgical hand scrub agents should be stored in clean, closed containers  If hands touch anything during cleaning, the entire procedure must be started from the beginning. Equipment:  Surgical scrub item (anti septic solution – scrub brush and nail brush)  Protective barrier (overhead, eye wear, mask, over shoes(  Sterile gown and proper size sterile gloves.  Sterile towel Procedure: Steps Rational 1. Inspect hands for sores or abrasions; Open sores can harbor microorganisms. cover or report to supervisor as required 2. Gather necessary supplies, stand in front To facilitate procedure and prevents clothes from becoming moist. of the sink. Do not allow your clothing to touch the sink during procedure. 3. Ensure sleeves are at least two to three This step prevents sleeves from becoming inches above the elbows moist. 4. Remove Jewelry and secure in safe place Jeweler‘s harbors‘ microorganisms. 5. Turn on water and adjust force, regulate Warm water is recommended to prevent the temperature until water is warm. drying out of hands. 29 Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ 6. Wet hands and wrist area.keep hands lower than elbow to allow water to flow toward fingertips. 7. Use about 1 teaspoon antimicrobial agent A good amount of soap is required to from dispenser. Cover all areas of hands create lather for a three- to five-minute with antimicrobial agent scrub. 8. With firm rubbing and circular motions, Keeping hands above the wrist allows for wash the palms and backs of the hands, the microorganisms to slide off the hands each finger, the areas between the fingers, into the sink wrists and forearms 9. Use fingernails of the opposite hand to Nail files work more effectively than a clean under fingernails nail brush. Clean the sub nail area (under the fingernails) with a nail file. 10.Repeat the entire process with the other hand and forearm. 11.Continuous this friction motion for 2 – 5 Use an equal amount of time to wash minutes. each hand. 12.Rinse thoroughly with water flowing This step allows for all the soap to be toward fingertips. rinsed off from cleanest to dirtiest area. 13.Dry hands with a paper towel, beginning This step prevents contamination of the with the fingers and moving upward hands and adheres to the principles of toward forearms, and discard it sterile technique. immediately. Use another clean towel to turn off tape water. Proceed into the operating room (keep hands above the waist). 30