Surgical Handwashing Lecturette

NOTRE DAME OF MARBEL UNIVERSITY
COLLEGE OF ARTS AND SCIENCES

Nursing Department
Surgical Handwashing
INTENDED LEARNING OUTCOMES:
At the end of the lecture-demonstration, the students can:
1. Determine the basic principles of surgical handwashing;

2. Discuss the purpose of surgical handwashing in conjucntion with handling a delivery;
3. Demonstrate the step-by-step process of performing surgical handwashing with mastery and
dexterity.
Definition:
Surgical hand scrub is the systematic way of cleaning the hands, fingernails, and forearms before
undertaking a surgical procedure. Closed gloving method in donning of sterile gloves, is used by the
scrub personnel to ensure that the sterility of the surgical attire/gown and sterile field is maintained.
The process of scrubbing, gowning, and gloving is requisite that all members of the surgical team must
complete before each operation. In the surgical scrub, the hands and forearms are decontaminated. A
sterile surgical gown and pair of gloves are subsequently donned, creating an aseptic environment.
Purpose:
The purpose of surgical hand scrub is to sterilize the hands prior to gowning and gloving.
Sterile gowns and gloves are worn to prevent the migration of microbes from the skin and scrub attire
of the sterile team member to the sterile field.
Concept/ Principles to Remember:

• Start from cleanest to dirtiest
• Aseptic principle is applied during this procedure.
• Anything below your waist and above your shoulder is considered unsterile.
• If in doubt throw out.
• Only the front of your sterile Gown is sterile.
• If you accidentally contaminate an area or yourself, you may be asked to don sterile attire
again.
• Practice your surgical conscience.
Materials Needed:
1. Surgical cap (if available)
2. Face mask
3. Shoe cover ( if available )
4. Surgical scrub brush
5. Providone Iodine 7.5% or alcohol-based solution for asepsis
6. Sterile gloves
7. Sterile Surgical Gown
PROCEDURE
Surgical Hand Scrubbing Rationale
1. Put on surgical cap, shoe covers, a This is done to protect the sterile area from
mask, and if necessary, protective eye possible contamination. To make sure that no hair
gear. will fall on the sterile field.
a. Cap or hood – all facial and
head hair must be completely
covered by a cap or hood.
b. Shoe covers are worn.
c. Mask should cover the nose and
the mouth snugly.
2. Examine hands and forearms for cuts This is done to protect the scrub personnel to deter
and abrasions. the possible entry of microorganisms through the
cut. Usually, a nurse is not encouraged to scrub in
if there is a break in the skin integrity especially in
the hands.
3. Remove all jewelry. Microorganisms may lodge in the surface
especially the grooves of jewelry
4. Turn on water using knee or foot Water source are usually foot, knee or sensor
controls and adjust to proper water flow operated so as not to contaminate the hands once
washed. Adjusting to appropriate water flow
prevents the scrub suit form getting wet.
5. Perform medical hand washing. Medical is done as a prelude to the surgical hand
scrub as an initial way to clean the hands of the
scrub personnel.
6. Clean fingernails with a nail cleaner or This ensures that are less microorganisms in the
orange stick under running water and hands.
discard after use.
7. Rinse hands and arms thoroughly under This position of the hands allow the water to run
running water. Keep hands above the from the cleanest to the least clean portions of the
elbows. Open the packaging of a hand including the forearms up to the elbow.
disposable surgical scrub brush and
slightly moisten the sterile brush over
running water.
8. If reusing a surgical scrubbing brush,
pick up the sterile brush form the
dispenser and apply antiseptic to the
brush.
9. Scrub nails of the non-dominant hand This is done to ensure that all areas are covered.
first with thirty (30) strokes.
10. Scrub all sides of the fingers, five (5)
strokes per side, starting from the
thumb to small finger.
11. Scrub the back of the hand in circular
motion, 20 strokes.
12. Scrub the palm of the hand in circular
motion, 20 strokes.
13. Continue scrubbing the arm in circular
motion with friction for 15 strokes each
in the lower, middle and upper arm.
14. Rinse the brush. Reapply antiseptic.
15. Repeat steps 9 to 14 for the dominant
hand.
16. After scrubbing the second arm, drop Dropping the brush reduces the possibility of the
the brush. hands from getting contaminated.
17. Rinse the hands, keeping the fingertips This position of the hands allows the water to run
higher than the elbow. from the cleanest to the least clean portions of the
18. Turn off water with foot or knee control. hand. This position helps in maintaining the
19. Leave the scrub area with hands higher cleanliness of the newly washed hand.
than the elbows.

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NOTRE DAME OF MARBEL UNIVERSITY

COLLEGE OF ARTS AND SCIENCES

At the end of the lecture-demonstration, the students can:

1. Determine the basic principles of surgical handwashing;

Concept/ Principles to Remember:

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