SURGICAL
ASEPSIS (SCRUB) :
Definition
:
Surgical
hand washing is a procedure by which dirt and micro organism are destroyed and
removed from hands and fingers by chemical and mechanical friction.
Purpose
:
·
To remove dirt and
transient micro-organism from hands.
·
To reduce the risk of transmission
of micro-organisms to patients.
·
To reduce the risk of
cross-infection among patients.
·
To reduce the risk of
transmission of infectious agents to oneself.
·
To prevent iatrogenic
infections.
Articles:
·
Soap /antiseptic
detergent
·
Running warm water
·
Nail brush in
antiseptic lotion
·
Towel (sterile)
·
Mask and cap
Procedure
:
Surgical scrubbing
S.No |
Steps of
Procedure |
Rationale |
1. |
Ensure
that the nails are short. Remove artificial nails if any . |
Short
nails are less likely to harbour organisms, scratch ,scratch the patient or
puncture gloves. |
2 |
Remove
nail polish . |
Nail
polish harbours micro-organisms |
3 |
Inspect
hands for abrasion ,cuts or open lesions. |
These
conditions increase likelihood of more micro-organism residing on skin
surfaces. |
4 |
Remove
jewellery of any type. |
Micro
–organism accumulate in jewellery |
5 |
After
medical hand wash wear cup and mask. |
Micro-organism
accumulate in jewellery |
6 |
Turn
on water using elbow /foot |
To
prevent spread of micro-organisms |
7 |
Wet
hands and lather with soap/detergent
to 5cm above the elbows (hand need to be raised /held above elbows at
all times. Use firm circular movement to wash palms, back of hands, wrists
forearms and inter digital spaces fo 20-25 second |
Water
flows from finger tips to elbows finger tips are considered to be cleaner
than the elbows. |
8 |
Rinse
hands arms thoroughly under running water . |
Rinsing
remove transient bacteria from hands. |
9 |
Clean
under nails of both hands I with nail pick/nail brush |
Removes
dirt and micro –organisms |
10 |
Scrub
nail of each hand with 15 stroke using antimicrobial agent. |
|
11 |
Holding
the brush perpendicular scrub palm, each side of thumb and fingers and
posterior side of hand with 10 stokes each. |
Scrubbing
loosens resident bacteria that adhere to skin surfaces. |
12 |
Scrub
from wrist to 5cm above each elbow that is lower arm, upper forearm and
antecubital fossa to marginal area above elbows |
Scrubbing
is performed from cleaner area to less clean area (upper arms). |
13 |
Entire
scrub should last for 5 to 10 minute. |
Scrubbing
time can be lengthened according to the degree of contamination of hands. |
14 |
Discard
brush and rinse hands from fingertips to elbows. |
|
15 |
Take
care not to touch the tap or sides of the sink during the procedure. |
Tap
and sides of sink are contaminated. |
16 |
Use
of sterile towel to dry one hand moving from finger to elbow. Dry from
cleanest to least clean area. |
Drying
prevent chapping and facilitates donning of gloves |
17 |
Repeat
drying of the other hand using a different towel. Use one side to dry one
hand and reverse side for other hand, if only one towel is available. |
|
18 |
Discard
towel. |
|
19 |
Proceed
with sterile gowning |
|
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