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Surgical Hand Antisepsis, Gloving & Gowning?

MEDIC E-Learning

PowerPoint content last updated 18/09/2015 10:44:49

Surgical Hand Antisepsis, Gloving & Gowning

Clinical Skills

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Aims and Outcomes

The aim of this module is to facilitate learning regarding the purpose and procedure of Surgical Hand Antisepsis, Gloving and Gowning.

Learning Outcomes

At the end of the session the student should be able to:

Recognise the need for effective hand hygiene within the Health Care setting.

Demonstrate, to a level expected of the students stage of training, a degree of competence

effective hand hygiene on a ward or other care environment.


effective in the process of ‘scrub’ for theatre.

Effectively apply protective clothing within a ‘scrub’ environment.

Aims an Outcomes

At the end of this e-tutorial you will be asked to complete a graded online assessment. Marks and number ofattempts made will be recorded through Grade Centre and subsequently reviewed by the Clinical Skills andSimulation Team. We expect you to have completed the assessment before attending your scheduled Oncology –Surgical Scrub, Suturing and Anaesthetics session and to have attained a mark that exceeds 60%.

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Surgical Hand Antisepsis, Gloving & Gowning?Introduction (1 of 3)

Health Care Staff have the greatest potential to spread the micro organisms that cause infection.

Hands can….

Transfer the patients own micro organisms into sterile areas of the patients body during care or treatment

Transfer micro organisms from one patient to other patients

Transfer micro organisms from the environment and equipment to a patient

Acquire micro organisms as a result of the contact with patients which places health care staff at risk of infection

NPSA (2008)

Introduction (1 of 3)

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Surgical Hand Antisepsis, Gloving & Gowning?Introduction (2 of 3)

Health Care Associated Infection (HCAI) is a critical patient safety issue. At any one time up to eight percent of inpatients in England and Wales have HCAI (Smythe et al 2008).

Statistics for England and Wales show that 5,109 deaths involved MRSA and 13,189 involved Clostridium difficile during the period 2001-2006 in patient care establishments (NPSA, 2008).

Evidence shows that improving Hand Hygiene contributes significantly to the reduction of HCAI.

Gloving and Gowning is an essential part of infection control procedures in certain environments such as surgical theatre.


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Hand washing is one of the single, most important things you can do to help

reduce the spread of infections.

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Surgical Hand Antisepsis, Gloving & Gowning?Before you start

Attend to your personal needs

Apply cap and mask if in theatre setting

Hair should be inside cap

Mask should cover nose, mouth cheek and chin

Sleeves of scrubs should be above elbow

Remove all hand and wrist jewellery

Check fingernails-they should be clean and short

Check if liquid antiseptic agent e.g. Betadine or Hibiscrub (if in theatre), or liquid soap (if on

ward) are available

Check sterile brush is available (if in theatre)

The surgical scrub will last 5 minutes (not including rinsing time).

Before you start

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Surgical Hand Antisepsis, Gloving & Gowning?Procedure – Surgical Hand Antisepsis (1 of 17)

Surgical Hand Antisepsis

Open a sterile brush if using, and lie it on the scrub shelf within the opened packet. Only use a brush on the nails. It can be detrimental to scrub the skin.

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Get water running to a reasonable flow and temperature.Wet the lower arms and hands.

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Apply a generous (5ml) amount of liquid soap or antiseptic hand wash.

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For the initial wash lather up the hands and forearms thoroughly.

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If using a sterile brush, scrub fingernails thoroughly.

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Rinse thoroughly. Be very careful to ensure the water runs away from the hand and towards the elbow.

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Then – Apply more liquid soap or antiseptic hand wash and use a systematic method (WHO guidance for Hand washing) to cleanse the hands and forearms. First rub hands palm to palm.

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Right palm over left dorsum and fingers interlaced and vice versa.

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Palm to palm with fingers interlaced.

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Backs of fingers to opposing palms with fingers interlaced.

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Rotational rubbing of left thumb clasped in right palm and vice versa.

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Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa.

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Wash the wrists by rotational rubbing with opposing hands.

Rotate all the way up to the elbow. Rinse, then do the whole thing again but next time rotate to mid arm, then on the third time, just finish on rotating the wrist. You will therefore have repeated the steps three times.

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Rinse thoroughly. Be very careful to ensure the water runs away from the hand and towards the elbow. The whole scrub should have taken at least 5 minutes.

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Turn off taps using the elbows.

Ensure hands remain upward to drain away surplus water from unwashed areas.

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Dry the hands thoroughly using paper towels or if gloving and gowning go straight to previously opened sterile gown pack, and use sterile towel supplied.

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Dispose of used towels in an ordinary pedal waste bin.

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Surgical Hand Antisepsis, Gloving & Gowning?Procedure – Gloving & Gowning

Procedure – Gloving & Gowning

Open a sterile glove pack on to a clean trolley or other suitable surface (this will have been done prior to the scrub).

The pack should contain the wipe for the hands post scrubbing, sterile gloves, and a gown.Ensure the pack contains the correct size gloves and gown.Sterile hat and mask will have been fitted prior to the scrub.

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Following a thorough hand washing , keep hands lifted upwards, and pick up sterile towel.

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Dry hands thoroughly using the sterile towel, using one towel per hand.

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Now watch the following YouTube clip showing how to apply a gown and gloves correctly:

If the link doesn’t work, type the following into your web browser:http://www.youtube.com/watch?v=L8OLnyJ3mAc

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http://www.youtube.com/watch?v=L8OLnyJ3mAc




Helpful Tips

When rinsing the hands use one direction only. Start

from the hand, going towards the elbow. Take care

not to touch the sink.

A person with a cut or burn should not scrub because

of the high bacterial count.

The hands and arms can never be rendered sterile no

matter how strong the antiseptics.

The surgical scrub is most effective when firm motion

is applied.

The gown must be put on immediately after the

surgical scrub.

Helpful Tips

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Surgical Hand Antisepsis, Gloving & Gowning?Summary

Students should now be able to:

Recognise the need for effective hand hygiene within the Health Care setting.


effective hand hygiene on a ward or other care environment.


effective in the process of ‘scrub’ for theatre.

Effectively apply protective clothing within a ‘scrub’ environment.

Summary

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Bandolier provides evidenced based thinking about Healthcare http://www.medicine.ox.ac.uk/bandolier/band67/b67-3.html#Heading4

A link to a WHO summary document on Hand Hygiene in Health Care

http://whqlibdoc.who.int/hq/2009/WHO_IER_PSP_2009.07_eng.pdf

Cardiff and Vale University Health Board – Infection Control Procedure for Hand Decontamination

E-tutorial review completed by SH August 2015

Helpful Links

Helpful Links

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http://www.medicine.ox.ac.uk/bandolier/band67/b67-3.html#Heading4

http://whqlibdoc.who.int/hq/2009/WHO_IER_PSP_2009.07_eng.pdf

https://learningcentral.cf.ac.uk/bbcswebdav/institution/Medic/Undergraduate/Handwashing Gloving and Gowning/src/docs/HAND DECONTAMINATION PROCEDURE.pdf

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