SURGICAL ASEPSIS (SCRUB)

 

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