1. PERFORMING A SURGICAL HAND SCRUB
Definition: Surgicalhandwashingis a procedure by whichdirtand microorganismare destroyed and
removed from handsand fingers by chemicalaction andmechanicalfriction.
Purposes:
To remove dirtand transient microorganisms from hands.
To reduce the risk of transmission of microorganisms to patients.
To reduce the risk of cross infection among patients.
To reduce the risk of transmission of infectious agents to oneself.
To preventiatrogenic infections.
Requirements:
Soap/antiseptic
Running water
Nail brush in antiseptic lotion
Towels (sterile)
Mask and cap
Nail pick
Procedure
Nursing action Rationale
Ensure thatall nails are short. Remove artificial
nails if any.
Shortnails are less likely to harbor
microorganisms, scratch the patientor puncture
gloves.
Remove nailpolish Nail polish harbors microorganisms
Inspecthands for abrasions, cuts, or open lesions. These conditions increaselikelihood of more
microorganisms residingon skin surfaces
Remove jewellery of any type Microorganisms accumulate in jewellery
After medical hand wash, wear cap and mask
Turn on water using knee/foot/elbow
Wet hands and arms under running lukewarm
water and lather with soap/detergentto 5CM
above the elbows (Hands need to be raised/held
Water flows from fingertips to elbows. Tips are
considered to be cleaner than the elbows.
2. above elbows atalltimes). Use firm circular
movements to wash palms, back of hands, wrists,
forearms and inter-digitalspaces for 20-25
seconds.
Rinse hands and arms thoroughlyunder running
water (remember to keep hands above elbows)
Rinsing removes transientbacteria from hands
Clean under nails of both hands with nailpick/nail
brush
Removes dirtand microorganisms
Scrub nails of each hands with 15 strokes using
antimicrobialagent
Holding the brush perpendicular scrubpalm, each
side of thumb and fingers and posterior side of
hand with 10 strokes each.
Scrubbing loosens residentbacteria thatadhereto
skin surfaces
Scrub from wristto 5CM above each elbowthatis
lower arm, upper forearm and antecubitalfossa to
marginalarea above elbows.
Scrubbing is performed from cleaner are to less
lean are (upper arms)
Entire scrub should lastfor 5-10minutes Scrubbing time can be lengthened according to
agency policy/accordingto the degree of
contamination of hands
Discard brush and rinse handfrom fingertips to
elbows.
Take care notto touch the tap or sides of the sink
during the procedure.
Taps and sides of sink are considered to be
contaminated
Use a sterile towelto dry one hand moving from
fingers to elbow. Dry from cleanestto leastclean
area.
Drying prevents facilitates donning/puttingon of
gloves.
Repeatdrying of the other hand usinga different
towel. Use one side to dry one hand and reverse
side for other hand, if only one towelis available.
Discard towel
Proceed with sterile gowning
