Anatomical Surgical Hand Scrub

Summary

This training video instructs on the proper surgical hand scrub technique using the brush stroke method to reduce the risk of surgical site infections. It emphasizes the importance of removing jewelry, ensuring skin and nails are in good condition, and wearing personal protective equipment. The scrub procedure involves using a hospital-approved antiseptic sponge to clean hands and arms methodically, with specific strokes and rinse techniques. The video concludes with instructions for turning off the water with a knee control, drying hands, and preparing for gowning and gloving.

Takeaways

• 👨‍⚕️ Proper surgical hand scrub is crucial for reducing surgical site infections.
• ⏰ The scrub procedure should take about 3 to 5 minutes to ensure effectiveness.
• 💍 Remove all jewelry and ensure nails are clean and intact before starting the scrub.
• 👕 Wear personal protective equipment, including a surgical head covering, eye protection, and mask.
• 🧼 Use hospital-approved antiseptic solutions like chlorhexidine or povidone-iodine for scrubbing.
• 🚿 Pre-wash hands and arms if it's the first case of the day or if hands are visibly soiled.
• 🪥 Clean under the fingernails with a disposable nail pick before discarding it.
• 🖐️ Scrub the fingertips with the abrasive side of the sponge and the rest of the hand with the non-abrasive side.
• 🔄 Apply ten strokes to each section of the hand and arm, and avoid going back over scrubbed areas.
• 💧 Rinse hands and arms from fingertips to elbow in one direction without moving arms back and forth.
• 👉 Turn off the water with a knee control to prevent contamination and dry hands with a sterile towel.

Q & A

What is the primary purpose of the video?

The primary purpose of the video is to provide training on proper surgical hand scrub techniques to decrease the incidence of surgical site infections.

What are the essential steps before starting the surgical hand scrub procedure?

Before starting the surgical hand scrub procedure, one must remove all jewelry from hands and arms, inspect the skin and nails for cuts or wounds, ensure nails do not extend past fingertips, and nail polish is intact without chips or scratches. Acrylics, artificial nails, and nails with foreign bodies are not allowed.

Why is it important to wear personal protective equipment during the scrub process?

Wearing personal protective equipment, including proper eye protection and a surgical mask, is important to prevent contamination and maintain a sterile environment in the operating room.

What type of antiseptic solutions are recommended for the surgical hand scrub?

The recommended antiseptic solutions for the surgical hand scrub are chlorhexidine or povidone-iodine, also known as betadine.

How should the surgical sponge be prepared before scrubbing?

The surgical sponge should be moistened under running water by squeezing and releasing it with fingertips together, using a light but firm pressure.

What is the correct technique for scrubbing the fingertips?

The abrasive brush side of the sponge should be used to stroke the nails in a back-and-forth motion approximately 30 times.

How should the rest of the hand and arm be scrubbed after the fingertips?

After scrubbing the fingertips, the non-abrasive side of the sponge should be used to scrub the palm, dorsal surface, and the outside surface of the thumb and fingers, applying ten strokes to each area.

What is the correct way to rinse hands and arms after scrubbing?

Rinsing should start at the fingertips and continue to the hand, forearm, and elbow, moving in one forward direction through the water, always keeping the elbow at a right angle and hand raised above the elbow level.

Why is it important to turn off the water with the knee control after rinsing?

Turning off the water with the knee control after rinsing is important to avoid contamination of the hands, which should remain sterile.

How should the residual water on the hands and arms be removed before donning a sterile surgical gown and gloves?

Residual water should be allowed to drip off the elbows into the sink, and hands should be dried with a sterile towel before donning a sterile surgical gown and gloves.

Why is it necessary to walk backward through the operating room door after the hand scrub procedure?

Walking backward through the operating room door helps to maintain sterility by minimizing contact with non-sterile surfaces and reducing the risk of contaminating the scrubbed hands and arms.

Outlines

00:00

👨‍⚕️ Surgical Hand Scrub Procedure

This video script outlines the essential steps for a surgical hand scrub using the brush stroke method to prevent surgical site infections. It emphasizes the importance of proper hand hygiene before surgery. Key points include removing jewelry, inspecting skin and nails, wearing personal protective equipment, and following a detailed scrubbing technique with an antiseptic sponge. The procedure should take three to five minutes and involves scrubbing the fingertips, palms, and arms with specific brush strokes, followed by thorough rinsing and drying with sterile materials before donning a surgical gown and gloves.

05:02

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Keywords

💡Surgical Site Infections (SSIs)

Surgical Site Infections, or SSIs, refer to infections that occur after surgery in the part of the body where the surgery took place. These infections pose a significant threat to patient safety and can lead to complications, extended hospital stays, and increased healthcare costs. The video emphasizes the importance of proper surgical hand hygiene to decrease the incidence of SSIs, as hands are the primary mode of transmission for pathogens causing these infections.

💡Surgical Hand Scrub

The surgical hand scrub is a meticulous cleaning process that surgeons perform before surgery to remove dirt, grease, and microorganisms from their hands and arms. The video outlines the procedure using the brush stroke method, which is a technique that involves using a sterile sponge with an abrasive side for fingertips and a non-abrasive side for the rest of the hand. The scrub is crucial for preventing the spread of infections in the operating room.

💡Antiseptic

Antiseptic agents, such as chlorhexidine or povidone-iodine (betadine), are substances that are applied to living tissue to reduce the possibility of infection. In the context of the video, antiseptic is used during the surgical hand scrub to further disinfect the hands and arms of the surgical team, ensuring a higher standard of cleanliness before entering the operating room.

💡Sterile Surgical Sponge

A sterile surgical sponge is a single-use, disposable tool used for scrubbing during the surgical hand preparation. The sponge is designed to be sterile to avoid introducing contaminants into the surgical environment. The video instructs that the sponge should be moistened and used with specific strokes to ensure thorough cleaning of the hands and arms.

💡Personal Protective Equipment (PPE)

Personal Protective Equipment, or PPE, includes garments and tools worn to minimize exposure to hazards or infectious agents. In the video, PPE is mentioned in the context of preparing for surgery, which includes wearing a surgical head covering, eye protection, and a surgical mask to protect both the wearer and the patient from potential contamination.

💡Nail Polish

Nail polish is a lacquer applied to the nails to provide a decorative or protective layer. The video specifies that nail polish must be intact without chips or scratches before a surgical procedure, as damaged nail polish can harbor bacteria and compromise the sterility required in the operating room.

💡Acrylics and Artificial Nails

Acrylics and artificial nails are types of nail extensions that are not permitted in the operating room as they can harbor bacteria and are difficult to clean thoroughly. The video emphasizes that only natural nails, kept short and clean, are acceptable to maintain the highest standards of hygiene during surgery.

💡Sterile Towel

A sterile towel is a clean, non-linting cloth that has been sterilized to be free from living microorganisms. After the surgical hand scrub, the video instructs using a sterile towel to dry the hands and arms. This is important to maintain sterility before donning a surgical gown and gloves, ensuring that no contaminants are transferred during the procedure.

💡Rinsing Technique

The rinsing technique described in the video is a methodical approach to washing hands and arms under running water, starting from the fingertips and moving towards the elbow. This technique is designed to prevent contamination and ensure that all soap and antiseptic are rinsed away, maintaining the cleanliness required for surgery.

💡Knee Control

Knee control refers to the use of a foot pedal or knee lever to operate faucets, thus avoiding hand contact with potentially contaminated surfaces. The video mentions turning off the water with knee control after rinsing to prevent any cross-contamination and to keep the hands sterile before proceeding with the surgical gown and gloves.

💡Sterile Surgical Gown and Gloves

A sterile surgical gown and gloves are personal protective equipment specifically designed for use in surgery. They are made from materials that create a barrier against the transfer of microorganisms. The video concludes with the instruction to don a sterile surgical gown and gloves after hand drying, which is the final step in preparing for surgery and maintaining a sterile field.

Highlights

Surgical site infections (SSIs) are a prevalent threat to patient safety.

Proper surgical hand scrub or rub techniques are essential to decreasing SSIs.

Instructions provided for anatomical surgical hand scrub using the brush stroke method.

Correct procedure should take three to five minutes.

Remove all jewelry from hands and arms before beginning the surgical hand scrub.

Inspect skin and nails to ensure they are free of cuts, wounds, and foreign bodies.

Acrylics, artificial nails, and nails with foreign bodies are not allowed in the operating room.

Wear personal protective equipment, including a surgical head covering and mask.

Use hospital-approved antiseptic sponges, such as chlorhexidine or povidone-iodine.

Pre-wash hands and arms if it's the first case of the day or if hands are visibly soiled.

Use a disposable nail pick to clean under fingernails.

Scrub fingertips with the abrasive brush side of the sponge approximately 30 times.

Use the non-abrasive side of the sponge for the rest of the scrub.

Mentally divide the forearm into thirds for scrubbing, applying ten strokes to each section.

Do not go back to previously scrubbed areas to avoid contamination.

Rinse hands and arms starting from fingertips, moving in one forward direction.

Turn off the water with the knee control to avoid contamination.

Dry hands and arms with a sterile towel before donning a sterile surgical gown and gloves.

Transcripts

this video is for training purposes only

surgical site infections or ssize remain

a prevalent threat to patient safety

proper surgical hand scrub or rub

techniques are essential to decreasing

its incidence this video provides

instructions on anatomical surgical

hands for a procedure using the brush

stroke method if done correctly this

procedure should take three to five

minutes before beginning the surgical

hand scrub procedure you must remove all

jewelry from both hands and arms inspect

your skin and nails ensure your skin is

free of any cuts and wounds nails must

not extend past your finger tips and

nail polish must be intact without chips

or scratches remember acrylics

artificial nails and nails with foreign

bodies are not allowed in the operating

room put on your personal protective

equipment make sure your hair and ears

are tucked into your surgical head

covering and that any neck jewelry is

contained in your surgical attire scrubs

dawn proper eye protection and a

surgical mask covering your nose mouth

and if applicable facial hair to begin

the scrub tear open a sponge of your

preferred hospital approved antiseptic

either chlorhexidine or betadine also

known as povidone-iodine place the open

packet on the shelf

above the sink with a tear facing the

ceiling you must pre wash your hands and

arms only if this is the first case of

the day

if your hands are visibly soiled use the

soap from the dispensers located within

the scrub sink or in a separate

container above the sink

then use the disposable nail pick and

clean under your fingernails under

running water dispose of the nail pick

in the trash can decide at the scrub

sink and rinse hands and forearms once

hands and arms have been washed remove

the sterile surgical sponge from its

wrapper and moistened sponge under

running water by squeezing and releasing

it with fingertips together use a light

but firm pressure to stroke the nails in

a back-and-forth motion with the

abrasive brush side of the sponge

approximately 30 times the abrasive

brush side is only used on your

fingertips the non abrasive side should

be used for the remainder of the scrub

next turn the surgical sponge over to

the non abrasive side place fingers side

by side including the thumb and scrub at

the surface of the palm ten strokes then

turn the hand over and scrub the dorsal

surface ten strokes next scrub the

outside surface of the thumb from wrist

to tip of the thumb ten strokes continue

to apply ten strokes to the other side

of the thumb and to each side of your

fingers once you scrub an area do not go

back now that you scrubbed your hand

it's time to scrub your arm on the same

side mentally divide the forearm into

thirds from wrist up to two inches above

the elbow when scrubbing each third of

your forearm apply ten strokes to the

top bottom in both sides of each section

like before

once you scrub an area do not

go back repeat the scrub on the other

hand and arm once both hands and arms

are complete discard the surgical sponge

in the trash can and beside the scrub

sink start rinsing at your fingertips

and continue to the hand forearm and

elbow moving in one forward direction

through the water always keep your elbow

at a right angle and hand raised above

the level of your elbow do not move arms

back and forth in the water if you need

additional rinsing completely remove

your arm from the water stream and

re-enter at the fingertips until you

reach the elbow

[Music]

once rinsing is complete and no

antiseptic remains on the hand and arms

turn off the water with the knee control

to avoid contamination keep hands above

the level of the elbow and away from

scrub attire and non sterile services

allow residual water to drip off the

elbows and into the sink do not shake or

wave hands and arms to remove excess

water walk backwards through the

operating room door and dry hands and

arms with a sterile towel before donning

a sterile surgical gown and gloves

[Music]

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