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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 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.
- 3. 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
- 5. 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
- 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 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
- 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 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
- 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 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
- 14. FOOD/ DRINK FOOD/ DRINK NO food 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 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
- 17. 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.
- 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 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
- 22. Gloving Procedure Gloving Procedure The Open Method The Open Method Closed Method Closed Method
- 23. 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
- 24. 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