2. OBJECTIVES
To understand the importance and
principles of surgical hand
antisepsis. Techniques.
To understand the principle of
surgical gown and glove
To reinforce techniques of donning
sterile gowns and gloves.
4. Also called the
Surgical Scrub.
The process of removing as many
microorganisms as possible
from the skin of the hands
and arms by mechanical
washing and chemical antisepsis
before participating in a surgical
procedure.
5. Done before gowning
and gloving.
!Skin is never
rendered sterile. The
process of scrubbing
is not a sterile
procedure.
6. ? ? ? ? ? ? ? ?...
Purpose: is to remove or
deactivate soil, debris,
natural skin oils, hand
lotions, and transient
microorganisms from the
hands and forearms of the
sterile team members.
27. Scrubbed hands and arms
are contaminated if they fall
below waist level or touch
the body.
Keep hands and arms above the
waist and away from the body
and at an angle of about 20 to 30
degrees above the elbows
29. After donning the surgical
gown, the only parts of the
gown that are considered
sterile are the;
sleeves and from the
front from waist level to a
few inches the neck
opening.
36. 3. With one hand, pick up the
entire folded gown from the
sterile table wrapper by
grasping the gown through
all layers and step back
from the table.
!Being careful to touch only the
inside top layer, which is exposed.
37. 4. Hold the gown with both
hands away from the body
and allow it to unfold with
the inside toward the
wearer.
!Being careful that it does not
touch either your body or other
38. 5. Grasp the inside
shoulder seams and
open the gown with
the armholes facing
the wearer.
39. 6. Slip both hands into
the open armholes,
keeping the wearer
hands at shoulder
level away from the
body.
40. 7. Push the hands and
forearms into the sleeves
of the gown, advancing
the hands onto to the
proximal edge of the cuff
for closed gloving
technique.
41. Position the gown over your shoulders by
grasping the inside surface of the gown at
the shoulder seams.
The Circulator adjusts the gown over the
Scrub's shoulders and side seams.
Note that the Circulator's hands are in
contact with only the inside aspect of the
gown.
42. CLOSED-GLOVING
TECHNIQUE
1. Pick up a glove by its folded
cuff edge with a sleeve-
covered hand.
!Note that gloves are packaged with a
wide folded cuff so the nurse can don
the gloves without touching the
outside surfaces with bare fingers.
43. 2. Place the glove on the
opposite gown sleeve, palm
down, with the glove fingers
pointing toward your
shoulder.
!The palm of your hand inside the gown
sleeve must be facing upward toward the
palm of the glove.
44. 3. Place the glove’s
rolled cuff edge at
the seam that
connects the sleeve
to the gown cuff.
45. 4. Grasp the bottom
rolled edge of the
glove with your
thumb and index
finger.
46. 5. While holding the glove’s
cuff edge with one hand,
grasp the uppermost edge
of the glove’s cuff with the
opposite hand.
!Take care not to expose the bare
fingers while doing this.
48. 7. Using the opposite sleeve-
covered hand, grasp both the
glove cuff and sleeve seam
and pull the glove onto the
hand.
!Pull any excessive amount of gown
and sleeve from underneath the cuff of
the glove.
49. 8. Repeat the procedure
to the other hand.
(Steps 4, 5, 6, and 7)
!Check to make sure that each gown
cuff is secured and covered
completely by the cuff of the glove.
50. 4. Grasp the bottom
rolled edge of the
glove with your
thumb and index
finger.
51. 5. While holding the glove’s
cuff edge with one hand,
grasp the uppermost edge
of the glove’s cuff with the
opposite hand.
!Take care not to expose the bare
fingers while doing this.
53. 7. Using the opposite sleeve-
covered hand, grasp both the
glove cuff and sleeve seam
and pull the glove onto the
hand.
!Pull any excessive amount of gown
and sleeve from underneath the cuff of
the glove.
54. REMOVING OF GOWN
1. Grasp the shoulders
of the gown, pulls it
downward from the
shoulder and off the
arms, and turns the
sleeves inside out;
63. 2. After surgical hand
scrubbing.
Pick up the sterile
towel and pat dry the
hands.
64. 3. With one hand, pick up the
entire folded gown from the
sterile table/ wrapper by
grasping the gown through
all layers and step back from
the table.
!Being careful to touch only the
inside top layer, which is exposed.
65. 4. Hold the gown with both
hands away from the body
and allow it to unfold with
the inside toward the
wearer.
!Being careful that it does not touch
either your body or other unsterile
objects.
66. 5. Grasp the inside
shoulder seams
and open the gown
with the armholes
facing the wearer.
67. 6. Slip both hands into
the open armholes,
keeping the wearer
hands at shoulder
level away from the
body.
68. 7. Push the hands and
forearms into the sleeves
of the gown, advancing
the hands completely
through the cuffs of the
gown, for open gloving
technique.
69. The circulator must continue to
assist at this point.
Positions the gown over your shoulders by
grasping the inside surface of the gown at
the shoulder seams.
The Circulator adjusts the gown over the
Scrub's shoulders and side seams.
Note that the Circulator's hands are in
contact with only the inside aspect of the
gown.
Tie the neckline, back waist ties of the
gown.
70. OPEN-GLOVING
TECHNIQUE
1. Take one glove from inner
glove wrapper by placing
thumb and index finger of
opposite hand on fold of
everted cuff at a point in line
with glove’s palm and pulls
glove over hand, leaving
cuff turned back.
71. 2. Take second glove
from the inner glove
wrapper by placing
gloved fingers under
everted cuff.
72. 3. Introduce free hand into
glove and draws it over
cuff of gown and upper
part of wristlet by slightly
rotating arm externally
and internally.
73. 4. Bring turned-back cuff
on other hand over
wristlet of gown and
draws it over cuff of
gown and upper part of
wristlet by slightly
rotating arm externally
74. REMOVING OF
GOWN
1. Grasp the shoulders
of the gown, pulls it
downward from the
shoulder and off the
arms, and turns the
sleeves inside out
81. Assisted gowning- The scrub
person may assist another
member in drying, gowning, and
gloving.
Assisted gloving- To glove
another team member, the scrub
person always gloves the other
person's right hand first
83. 2. Open the towel
that the other
member will use
to dry his/her
hands.
84. 3. Lay the towel on
the team member's
hand without
touching his/ her
hands;
85. 4. Hold the gown
at the neckband
and carefully
unfolding it.
86. 5. Keep the hands on the
outside of the gown,
forming a protective cuff
of the neck and shoulder
area as the person being
gowned holds both arms
outstretched.
87. 6. Offer the inside of
the gown to the other
member so he or
she can slip his or
her hands into the
sleeves;
89. The circulator must continue
to assist at this point.
Positions the gown over your shoulders by
grasping the inside surface of the gown at
the shoulder seams.
The Circulator adjusts the gown over the
Scrub's shoulders and side seams.
Note that the Circulator's hands are in
contact with only the inside aspect of the
gown.
Tie the neckline, back waist ties of the
gown.
101. REQUIREMENT/S
What is Perioperative and
Perianesthesia Nursing
What are the following:
PHASE of Perioperative Nursing
SURGICAL Classifications
Categories of Surgery Based on
Urgency
102. Surgical Team
Surgical Environment
Types of Anesthesia and
the Method of Anesthesia
Administration