Gowning, gloving and scrubbing

Scrubbing, Gowning and Gloving

Universal precautionDisinfections and sterilization

Physical Lay-out

WHAT IS A SURGICAL SCRUB

TYPES OF MICROORGANISM PRESENT IN SKIN

Resident

natural habitat is the skin gram-positive and gram-

negative bacteria fingernails and in the

deeper layers of the skin (such as the hair follicles, the sweat glands, the sebaceous glands).

 Transient

CONTACTS

PURPOSE OF SURGICAL SCRUB

PREVENT WOUND

INFECTION

TYPES OF BRUSH

Characteristics of ANTISEPTIC

Antimicrobial ActionPersistent ActivitySafetyAcceptance

TYPES OF ANTISEPTICCHG (chlorhexidine gluconate)

TYPES OF ANTISEPTICiodophor

TYPES OF ANTISEPTICPCMX (parachlorometaxylenol)

ScrubbingPREPARATION PRIOR TO SCRUB

Skin and nails Fingernails No fingernail polish. No skin abrasion No jewelleries. Wear cap and mask eyeglasses Water sink

Scrubbing

LENGTH OF SCRUBBING

The length of scrub varies from

institution to another.

Scrubbing

TWO TYPES OF SURGICAL SCRUB

A.TIME METHODCOMPLETE SCRUB- 5-7 minutes

SHORT SCRUB- 3minutesB.BRUSH STROKE METHOD

Scrubbing

INDICATIONS of short Scrub

Scrubbing

In the morning before the first gowning and gloving.

Following a clean case if the gloves have been removed before the gown.

Following a clean case if glove have had punctured.

Following a clean case if hands have been contaminated in any other way.

Before an emergency case at anytime.

ScrubbingB. BRUSH STROKE METHOD

NAILS-30SIDE OF FINGERS-20BACK OF THE HAND-20ARMS-20

Scrubbing PROCEDURE:1. Turn on the water faucet and get an antiseptic solution.2. Wash hands prior to scrub.3. Clean the fingernails under running water.4. Scrub/lather the left hand.5. Close-up scrubbing left fingertips.6. Scrub the left arm.7. Scrub the left elbow area.8. Rinse the brush and transfer to other hands.9. Scrub/lather the right hand. 10. Close-up scrubbing right fingertips.11. Scrub the right arm.12. Scrub the right elbow area.13. Rinse the left hand and brush.14. Rinse the left arm and elbow area.15. Rinse the right hand.16. Rinse the right arms and elbow area.17. Turn the water faucet with brush if water faucet is hand

control.19. Walk in the operating room.

DRYING HAND AFTER SURGICAL SCRUB

Purpose: to prepare hand prior to gloving to prevent soiling of sterile drape

DRYING HAND AFTER SURGICAL SCRUB

PROCEDURE: Pick up sterile towel to dry hands from gown pack Unfold towel Place a third over right hand; two third will be

hanging toward left hand Dry left hand Dry left arm Transfer dry end of towel to left hand, a third over

left hand, two thirds toward right hand. Dry right hand Dry right arm Fold towel into thirds Dry right elbow area Transfer towel, keeping hands on underside of towel Dry elbow area

DEFINITION/PURPOSE

Cuffs

Neckband

Belt

Sleeves

Body

PROCEDURE

GLOVING/DEFINITION & PURPOSE

GLOVING

GLOVING

Types

1. Open method

2.Closed Method

Serving of Gloves

“universal precautions” applied to all clients performed whenever there is a

possibility of contact with: blood body fluids (except sweat) secretions mucus membrane breaks in skin

Sterilization Consists of physical and

chemical techniques that destroy all microorganism including spores.

STERILE

free of living microorganisms, including spores

Asepsis absence of

disease producing

microorganisms

Medical Asepsis – procedures used to reduce the number of microbes and prevent spreadSurgical Asepsis – procedures use to eliminate any microorganisms (sterile technique)

Disinfection

The process of killing the

pathogenic microorganism

1. Saturated Steam under Pressure (3-10’)

e.g. autoclave

2. Gas Chemical Sterilization (3-7⁰)

e.g. Sterrad, Ethylene oxide

Liquid Chemical Sterilization

▪ 2% activated aqueous glutaraldehyde solution (10⁰)

▪ ( e.g. cidex).

Physical Lay-out

Surgical Environment

a surgical suite is designed to promote

safe therapeutic environment for the

patient.

OR

A specialized room where the actual surgery

takes place

Substerile rooma room with a double sink

that is separated from the OR by a door and where select

clean case and contaminated activities take place during

the process of surgery

Suite a collection of rooms that are used interactively during surgical procedure wherein each room has a specific purpose. (e.g. OR, substerile, scrub sink, sterile storage.)

prevent wound

infection

Construction or Renovation Planning

MULTIDICIPLINARY

TEAM APPROACH

Criteria for Designs, construction or Renovation

1.Number, type, and length of the

surgical procedure to be

performed

Criteria for Designs, construction or Renovation

2.Type and distribution by

specialties of the surgical staff and

equipment for each

Criteria for Designs, construction or Renovation

3. Proportion of elective inpatient and

emergency surgical procedures to

ambulatory patient and minimally invasive

procedures.

Criteria for Designs, construction or Renovation

4.Scheduling policies r/t the number of

hours per days per week the suite will

be in use and staffing needs.

Criteria for Designs, construction or Renovation

5. Systems and procedures

established for the efficient flow of

patients, personnel, and supplies.

Criteria for Designs, construction or Renovation

6.Consideration of volume changes

and need for future expansion

capabilities.

Criteria for Designs, construction or Renovation

7.Technology to be implemented and plan for potential technology to be

develop.

Criteria for Designs, construction or Renovation

8. Safety of staff, patients, and other personnel during construction or

renovation.

Principles in Construction or Renovation Planning

1.Strategic

planningERMTERUEL 2011

Principles in Construction or Renovation Planning

2. Plans for emergencies Power Communications Medical gases Vacuum system Waste gas scavenger Air handlers Water

ERMTERUEL 2011

Principles in Construction or Renovation Planning

3. Exclusion of contamination from outside the suite with sensible traffic patterns to and from the suiteERMTERUEL 2011

Principles in Construction or Renovation Planning

4.Noise control

ERMTERUEL 2011

Type of Physical Plant Design

4 basic Design:1. Central Corridor, or hotel plan2. Central core, or clean core plan

with peripheral corridor3. Combination central core and

peripheral corridor, or racetrack plan

4. Grouping, or cluster plan with peripheral and central corridor

3 ZONESUnrestricted

street clothesSemi-

restrictedscrub suit and cap

Restricted scrub suit, cap, shoe covers, gloves

Traffic pattern

ss

SCRUB

ss

SCRUB

SEMI

OR ATTIREUnrestricted

OR ATTIRESemi-restricted

OR ATTIRERestricted