handwashing for operation theater and surgical scrubbing

handwashing is an important technique performed before any aseptic procedure

1. HANDWASHING, SCRUBBING, GOWNING AND GLOVING PREPARED BY: ANU LAMA

2. HANDWASHING Hand washing  also known as hand hygiene, is the act of cleaning one's hands with soap and water to remove viruses/bacteria/microorganisms , dirt , grease, or other harmful and unwanted substances stuck in hands.

3. METHOD OF HANDWASHING By soap and water (HANDWASH) 40-60 seconds When hands are visibly dirty, blood or any other fluids After using the toilet If exposure to Clostridium difficile , hand washing is preferred By rubbing with alcohol-based formulation (HANDRUB) 20-30 seconds Better tolerated by hands than washing with soap and water

4. FIVE MOMENTS FOR HANDWASHING

5. SURGICAL SCRUB The surgical scrub is a systematic washing and scrubbing of the hands and forearms using especially developed techniques and the most effective antibacterial cleansing agent available in order to render the hands and arms as free as possible from micro-organism.

6. PURPOSE OF SURGICAL SCRUBING To remove debris and transient micro-organisms from the nails, hands and forearms. To reduce resident microbial count to a minimum. To inhibit rapid rebound growth of micro-organisms.

7. PREPARATION BEFORE SCRUBING Nails (short, free from dirt and nail polish) Remove jewelry Scrub suit Clean cap

8. PREPARATION BEFORE SCRUBING Surgical mask Clean pair of shoes Open gown pack Open glove packet

9. TYPES OF SURGICAL SCRUB Time method Complete scrub 5-7 minutes Short scrub 3 minutes

10. PROCEDURE OF HANDWASHING Surgical scrub will be 5 minutes in length at the beginning and 3 minutes after the first long surgical hand washing. Think of the fingers, hands and arms as having four sides. Regulate the flow and temperature of the water. Tear brush package (it is sterile) lay the brush on the back of the scrub sink.

11. Wet hands and arms for an initial pre-scrub wash. Use several drops of surgical detergent. Work up heavy lather, then wash the hands and arms to a point about two inches above the elbow. Rinse hands and arms thoroughly, allowing the water to run from the hands to the elbow. Do not retrace or shake the hands and arms, let the water drip from it. Remove the sterile brush and file, moisten brush and work up a later

12. (one stoke=back and forth motion ) Soap fingertips -30 strokes Surface of the palm -10 strokes T urn the hand over in dorsal surface-10 strokes Outside surface of the palm from -10strokes wrist to tip of the thumb Other side of the thumb and each -10strokes sides of the fingers

13. After scrubbing that area, do not go back Divide arms in three inch increments from wrist up to two inches above the elbow When scrubbing each third of forearm apply 10 strokes to the top bottom in both sides in each section Repeat the scrub on other hand and arm

14. Once both hands and arms are complete discard the surgical sponge Start rinsing from fingertips and continue to the hand and arm. Always keep elbow at right angle and hand raised above the level of elbow Don’t move arms back and forth in the water

15. DRYING HANDS AND ARMS Use one half of towel for each hand

16. GOWNING Gowning is the process of wearing protective garment used in surgery as a barrier between the patient and the operating personnel.

17. TYPES OF GOWNING Non-assisted gowning Assisted gowning

18. NON-ASSISTED GOWNING

19. NON-ASSISTED GOWNING

20. NON-ASSISTED GOWNING

21. ASSISTED GOWNING

22. GLOVING Gloving is the process of wearing special garment’s which covers the hands to protect from contamination.

23. TECHNIQUES OF GLOVING Closed gloving technique Open gloving technique Assisted gloving technique

24. CLOSED GLOVING TECHNIQUE

25. CLOSED GLOVING TECHNIQUE

26. CLOSED GLOVING TECHNIQUE

27. CLOSED GLOVING TECHNIQUE

28. CLOSED GLOVING TECHNIQUE

29. FINAL TIE

30. FINAL TIE

31. OPEN GLOVING TECHNIQUE

32. OPEN GLOVING TECHNIQUE

33. OPEN GLOVING TECHNIQUE

34. ASSISTED GLOVING TECHNIQUE