Scrubbing, gowning and
Scrubbing, gowning and
gloving technique
gloving technique
MAMC Surgical Post
MAMC Surgical Post
Graduate Surgical Skill
Graduate Surgical Skill
Course
Course
Aims and Objectives
Aims and Objectives
Effectively reduce the
Effectively reduce the
number of micro-
number of micro-
organisms on the skin
organisms on the skin
by mechanical washing.
by mechanical washing.
Microorganisms on skin
Microorganisms on skin
 Transient :-Introduced by soil, dirt,
Transient :-Introduced by soil, dirt,
contamination
contamination
 Resident:- under finger nails, deeper
Resident:- under finger nails, deeper
layers of skin i.e. sweat gland, hair follicles
layers of skin i.e. sweat gland, hair follicles
& sweat glands
& sweat glands
Scrubbing removes
Scrubbing removes
-most of transient bacteria
-most of transient bacteria
-resident bacteria from surface & just
-resident bacteria from surface & just
beneath skin
beneath skin
Theatre Etiquettes
Theatre Etiquettes
Preparation for scrubbing
Preparation for scrubbing
 Personal Hygiene
Personal Hygiene
 Shower
Shower
 Healthy skin on hands, fingers, nails &
Healthy skin on hands, fingers, nails &
arms.
arms.
 No boil, abrasion or wound on hands
No boil, abrasion or wound on hands
 Free from cold or URTI
Free from cold or URTI
Finger Nails
Finger Nails
 Short
Short
 Not over tips of fingers
Not over tips of fingers
 Short nails
Short nails
- Easy to clean
Easy to clean
- Will not puncture gloves
Will not puncture gloves
Free from nail polish
Free from nail polish
Chipped nail polish can harbor bacteria
Chipped nail polish can harbor bacteria
No artificial nails
No artificial nails
Jewelry
Jewelry
 Remove all jewelry i.e. rings, watches,
Remove all jewelry i.e. rings, watches,
bracelets from hands & arms
bracelets from hands & arms
 Keep them at a sage place or in pocket
Keep them at a sage place or in pocket
 Dead skin & accumulate beneath them
Dead skin & accumulate beneath them
Theatre Attire
Theatre Attire
 Scrub Suit
Scrub Suit
 Surgical Cap & face mask
Surgical Cap & face mask
 Eye Wear/Wiser
Eye Wear/Wiser
 Shoes
Shoes
 Protective wearing
Protective wearing
- Plastic apron
Plastic apron
- Lead apron
Lead apron
Scrub Suit
Scrub Suit
 Street clothes not allowed
Street clothes not allowed
 Short sleeved cotton scrub suit.
Short sleeved cotton scrub suit.
 Sleeves 4 inches above elbow
Sleeves 4 inches above elbow
 Shirt tucked in trouser
Shirt tucked in trouser
 -to avoid shirt tail flapping on
-to avoid shirt tail flapping on
sterile field
sterile field
 Trouser legs not touching floor
Trouser legs not touching floor
- to avoid transport
- to avoid transport of bacteria
of bacteria
Shoes
Shoes
 Street shoes not allowed
Street shoes not allowed
 Close ended shoes
Close ended shoes
 Chappals or open ended shoes
Chappals or open ended shoes
not allowed
not allowed
 Shoe cover for single use only
Shoe cover for single use only
Surgical Cap & Face mask
Surgical Cap & Face mask
 Surgical cap cover hair
Surgical cap cover hair
completely
completely
 Including pierced ear rings
Including pierced ear rings
 Face mask cover nose &
Face mask cover nose &
mouth completely
mouth completely
Protective clothing
Protective clothing
 Lead apron if radiation exposure
Lead apron if radiation exposure
 Plastic apron in every case
Plastic apron in every case
AREAS OF THE OPERATIVE SUITE
AREAS OF THE OPERATIVE SUITE
(TRAFFIC PATTERNS)
(TRAFFIC PATTERNS)
 UNRESTRICTED- STREET
UNRESTRICTED- STREET
CLOTHES PERMITTED
CLOTHES PERMITTED
 SEMI-RESTRICTED- MUST HAVE
SEMI-RESTRICTED- MUST HAVE
SCRUB ATTIRE & CAP
SCRUB ATTIRE & CAP
 RESTRICTED-MASKS REQUIRED
RESTRICTED-MASKS REQUIRED
FOOD/ DRINK
FOOD/ DRINK
NO food or drinks in Patient Care
Areas
Food/ Drinks must be consumed in
Staff Lounges
Scrubbing Agents
Scrubbing Agents
- Soap 5 minutes
Soap 5 minutes
- Povidone iodine solution
Povidone iodine solution
2minutes ( 8ml required)
2minutes ( 8ml required)
- Chlor-hexidine Solution
Chlor-hexidine Solution
(Hibiclens) 2 minutes (8ml
(Hibiclens) 2 minutes (8ml
needed)
needed)
Desirable properties of scrubbing agent
Desirable properties of scrubbing agent
 Non irritating to skin
Non irritating to skin
 Leaves minimum bacteria on
Leaves minimum bacteria on
skin
skin
 Prolonged antibacterial effect
Prolonged antibacterial effect
on skin
on skin
 Should leather in hot, cold , or
Should leather in hot, cold , or
hard water
hard water
Scrubbing Procedure
Scrubbing Procedure
Nail brush for nails
Nail brush for nails
Water
Water Steady flow
Steady flow
Comfortable temperature.
Comfortable temperature.
Hands above the level of the
Hands above the level of the
elbows
elbows
Clothing should remain dry
Clothing should remain dry
Movements
Movements steady.
steady.
Scrub technique
Scrub technique
 Scrubbing do not include rinsing
Scrubbing do not include rinsing
time
time
 Set water temperature
Set water temperature
 Wet hands & forearms
Wet hands & forearms
 Hold soap in hands till scrubbing
Hold soap in hands till scrubbing
complete
complete
 Keep hands elevated above
Keep hands elevated above
elbow through out
elbow through out
Scrubbing Procedure
Scrubbing Procedure
 Turn off taps with elbows
Turn off taps with elbows
 keep hands elevated.
keep hands elevated.
 skin should be blotted dry
skin should be blotted dry
 Use 2 towels
Use 2 towels
 Towel should be folded
Towel should be folded
 Discard towel immediately
Discard towel immediately
Gowning Procedure
Gowning Procedure
 Pick up gown from opened pack
Pick up gown from opened pack
• gown is folded with the inside
gown is folded with the inside
uppermost.
uppermost.
 Slide both arms into gown
Slide both arms into gown
• Not to touch outside the gown.
Not to touch outside the gown.
 All gowns must be in a good
All gowns must be in a good
state
state
PARAMETERS OF A STERILE GOWN
PARAMETERS OF A STERILE GOWN
 GOWNS ARE CONSIDERED STERILE FROM
GOWNS ARE CONSIDERED STERILE FROM
WAIST LEVEL TO CHEST LEVEL INCLUDING
WAIST LEVEL TO CHEST LEVEL INCLUDING
SLEEVES TO 2’ ABOVE ELBOW
SLEEVES TO 2’ ABOVE ELBOW
 STOCKINETTE CUFFS MUST BE COVERED
STOCKINETTE CUFFS MUST BE COVERED
BY STERILE GLOVES
BY STERILE GLOVES
 STERILE PERSONS MUST HAVE HANDS IN
STERILE PERSONS MUST HAVE HANDS IN
SIGHT AT
SIGHT AT ALL
ALL TIMES
TIMES
Gloving Procedure
Gloving Procedure
 The Open Method
The Open Method
 Closed Method
Closed Method
Once gowned and gloved
Once gowned and gloved
 stand with hand palms together
stand with hand palms together
 Above the waist
Above the waist
 Away from the gown
Away from the gown
At the end of the sterile procedure
At the end of the sterile procedure
 First remove the gown over the
First remove the gown over the
gloved hands
gloved hands
 Then the gloves.
Then the gloves.
 Hands should then be washed and
Hands should then be washed and
dried.
dried.
 Gloves disposed of according to
Gloves disposed of according to
policy
policy
scrubbinggowningandglovingtechnique-lennah.pdf

scrubbinggowningandglovingtechnique-lennah.pdf

  • 1.
    Scrubbing, gowning and Scrubbing,gowning and gloving technique gloving technique MAMC Surgical Post MAMC Surgical Post Graduate Surgical Skill Graduate Surgical Skill Course Course
  • 2.
    Aims and Objectives Aimsand Objectives Effectively reduce the Effectively reduce the number of micro- number of micro- organisms on the skin organisms on the skin by mechanical washing. by mechanical washing.
  • 3.
    Microorganisms on skin Microorganismson skin  Transient :-Introduced by soil, dirt, Transient :-Introduced by soil, dirt, contamination contamination  Resident:- under finger nails, deeper Resident:- under finger nails, deeper layers of skin i.e. sweat gland, hair follicles layers of skin i.e. sweat gland, hair follicles & sweat glands & sweat glands Scrubbing removes Scrubbing removes -most of transient bacteria -most of transient bacteria -resident bacteria from surface & just -resident bacteria from surface & just beneath skin beneath skin
  • 4.
  • 5.
    Preparation for scrubbing Preparationfor scrubbing  Personal Hygiene Personal Hygiene  Shower Shower  Healthy skin on hands, fingers, nails & Healthy skin on hands, fingers, nails & arms. arms.  No boil, abrasion or wound on hands No boil, abrasion or wound on hands  Free from cold or URTI Free from cold or URTI
  • 6.
    Finger Nails Finger Nails Short Short  Not over tips of fingers Not over tips of fingers  Short nails Short nails - Easy to clean Easy to clean - Will not puncture gloves Will not puncture gloves Free from nail polish Free from nail polish Chipped nail polish can harbor bacteria Chipped nail polish can harbor bacteria No artificial nails No artificial nails
  • 7.
    Jewelry Jewelry  Remove alljewelry i.e. rings, watches, Remove all jewelry i.e. rings, watches, bracelets from hands & arms bracelets from hands & arms  Keep them at a sage place or in pocket Keep them at a sage place or in pocket  Dead skin & accumulate beneath them Dead skin & accumulate beneath them
  • 8.
    Theatre Attire Theatre Attire Scrub Suit Scrub Suit  Surgical Cap & face mask Surgical Cap & face mask  Eye Wear/Wiser Eye Wear/Wiser  Shoes Shoes  Protective wearing Protective wearing - Plastic apron Plastic apron - Lead apron Lead apron
  • 9.
    Scrub Suit Scrub Suit Street clothes not allowed Street clothes not allowed  Short sleeved cotton scrub suit. Short sleeved cotton scrub suit.  Sleeves 4 inches above elbow Sleeves 4 inches above elbow  Shirt tucked in trouser Shirt tucked in trouser  -to avoid shirt tail flapping on -to avoid shirt tail flapping on sterile field sterile field  Trouser legs not touching floor Trouser legs not touching floor - to avoid transport - to avoid transport of bacteria of bacteria
  • 10.
    Shoes Shoes  Street shoesnot allowed Street shoes not allowed  Close ended shoes Close ended shoes  Chappals or open ended shoes Chappals or open ended shoes not allowed not allowed  Shoe cover for single use only Shoe cover for single use only
  • 11.
    Surgical Cap &Face mask Surgical Cap & Face mask  Surgical cap cover hair Surgical cap cover hair completely completely  Including pierced ear rings Including pierced ear rings  Face mask cover nose & Face mask cover nose & mouth completely mouth completely
  • 12.
    Protective clothing Protective clothing Lead apron if radiation exposure Lead apron if radiation exposure  Plastic apron in every case Plastic apron in every case
  • 13.
    AREAS OF THEOPERATIVE SUITE AREAS OF THE OPERATIVE SUITE (TRAFFIC PATTERNS) (TRAFFIC PATTERNS)  UNRESTRICTED- STREET UNRESTRICTED- STREET CLOTHES PERMITTED CLOTHES PERMITTED  SEMI-RESTRICTED- MUST HAVE SEMI-RESTRICTED- MUST HAVE SCRUB ATTIRE & CAP SCRUB ATTIRE & CAP  RESTRICTED-MASKS REQUIRED RESTRICTED-MASKS REQUIRED
  • 14.
    FOOD/ DRINK FOOD/ DRINK NOfood or drinks in Patient Care Areas Food/ Drinks must be consumed in Staff Lounges
  • 15.
    Scrubbing Agents Scrubbing Agents -Soap 5 minutes Soap 5 minutes - Povidone iodine solution Povidone iodine solution 2minutes ( 8ml required) 2minutes ( 8ml required) - Chlor-hexidine Solution Chlor-hexidine Solution (Hibiclens) 2 minutes (8ml (Hibiclens) 2 minutes (8ml needed) needed)
  • 16.
    Desirable properties ofscrubbing agent Desirable properties of scrubbing agent  Non irritating to skin Non irritating to skin  Leaves minimum bacteria on Leaves minimum bacteria on skin skin  Prolonged antibacterial effect Prolonged antibacterial effect on skin on skin  Should leather in hot, cold , or Should leather in hot, cold , or hard water hard water
  • 17.
    Scrubbing Procedure Scrubbing Procedure Nailbrush for nails Nail brush for nails Water Water Steady flow Steady flow Comfortable temperature. Comfortable temperature. Hands above the level of the Hands above the level of the elbows elbows Clothing should remain dry Clothing should remain dry Movements Movements steady. steady.
  • 18.
    Scrub technique Scrub technique Scrubbing do not include rinsing Scrubbing do not include rinsing time time  Set water temperature Set water temperature  Wet hands & forearms Wet hands & forearms  Hold soap in hands till scrubbing Hold soap in hands till scrubbing complete complete  Keep hands elevated above Keep hands elevated above elbow through out elbow through out
  • 19.
    Scrubbing Procedure Scrubbing Procedure Turn off taps with elbows Turn off taps with elbows  keep hands elevated. keep hands elevated.  skin should be blotted dry skin should be blotted dry  Use 2 towels Use 2 towels  Towel should be folded Towel should be folded  Discard towel immediately Discard towel immediately
  • 20.
    Gowning Procedure Gowning Procedure Pick up gown from opened pack Pick up gown from opened pack • gown is folded with the inside gown is folded with the inside uppermost. uppermost.  Slide both arms into gown Slide both arms into gown • Not to touch outside the gown. Not to touch outside the gown.  All gowns must be in a good All gowns must be in a good state state
  • 21.
    PARAMETERS OF ASTERILE GOWN PARAMETERS OF A STERILE GOWN  GOWNS ARE CONSIDERED STERILE FROM GOWNS ARE CONSIDERED STERILE FROM WAIST LEVEL TO CHEST LEVEL INCLUDING WAIST LEVEL TO CHEST LEVEL INCLUDING SLEEVES TO 2’ ABOVE ELBOW SLEEVES TO 2’ ABOVE ELBOW  STOCKINETTE CUFFS MUST BE COVERED STOCKINETTE CUFFS MUST BE COVERED BY STERILE GLOVES BY STERILE GLOVES  STERILE PERSONS MUST HAVE HANDS IN STERILE PERSONS MUST HAVE HANDS IN SIGHT AT SIGHT AT ALL ALL TIMES TIMES
  • 22.
    Gloving Procedure Gloving Procedure The Open Method The Open Method  Closed Method Closed Method
  • 23.
    Once gowned andgloved Once gowned and gloved  stand with hand palms together stand with hand palms together  Above the waist Above the waist  Away from the gown Away from the gown
  • 24.
    At the endof the sterile procedure At the end of the sterile procedure  First remove the gown over the First remove the gown over the gloved hands gloved hands  Then the gloves. Then the gloves.  Hands should then be washed and Hands should then be washed and dried. dried.  Gloves disposed of according to Gloves disposed of according to policy policy