|


  



 

 
 


 

|

 |

 DEFINITION:
Surgical scrub is the removal of as
many bacteria as possible from the
hands and arms by mechanical
washing and chemical disinfection
before participating in an
operation.
 |

 j
jOSE:
To help prevent the
possibility of contamination
of the operative wound by
bacteria on the hands and
arms.
 |

 j
Ej
TION j
IO
TO SC

 Skin and nails should be kept clean and in good
condition and cuticles uncut.
 Fingernails should not reach beyond the fingertip to
avoid glove puncture.
 No fingernail polish.
 No skin abrasion from hands to forearms
 No jewelleries.
 Wear cap and mask properly
 djust eyeglasses comfortably in relation to mask.
 djust water to a comfortable temperature.
 |


ENGTH OF SC
ING

The length of scrub
varies from institution to
another.
 |

TWO TYjES OF S
GIC SC

.TIME METHOD
COMjETE SC
  minutes
SHO
T SC
 minutes
.
SH ST
OKE METHOD
 |

.TIME METHOD
 Fingers, hands, and arms are
scrubbed by allotting a
prescribed amount of time to
each anatomical area or each
step of the procedure.
 |

 COMjETE SC
  minutes
 INDICTIONS:
 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.
 efore an emergency case at anytime.
 |

 SHO
T SC
 minutes
 INDICTIONS:
 Following a clean case, if the hands ands
arms have not been contaminated.
 To remove bacteria that have emerged
from the pores and multiplied while the
gloves were on.
 |

. 
SH ST
OKE METHOD
  prescribed number of brush strokes, applied
lengthwise of the brush or sponge, for the
fingers, hands, arms to  inches above the
elbow.
 NIS
 SIDE OF FINGE
S 
 CK OF THE HND 
 
MS 
 |

 j
OCED
E:
1. Turn on the water faucet and get an antiseptic solution.
. Wash hands prior to scrub.
. Clean the fingernails under running water.
4. Scrub the left hand.
. Closeup scrubbing left fingertips.
6. Scrub the left arm.
. Scrub the left elbow area.
8.
inse the brush and transfer to other hands.
9. Scrub the right hand.
1. Closeup scrubbing right fingertips.
11. Scrub the right arm.
1 . Scrub the right elbow area.
1.
inse the left hand and brush.
14.
inse the left arm and elbow area.
1.
inse the right hand.
16.
inse the right arms and elbow area.
1. Complete the scrub as indicated with anatomical timed or stoke count method.
18. Turn the water faucet with brush if water faucet is hand control.
19. Walk in the operating room.
  !" "#$%| &"
|&'
 jurpose:
 to prepare hand prior to gloving to prevent soiling of sterile drape
D
YING HND FTE
S
GIC SC

 jick up sterile towel to dry hands from gown pack
 nfold towel
 jlace 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
j
 
 




 u






Definition:
 Donning a sterile gown immediately
after the surgical scrub
jurpose:
 To permit the wearer to come within the
sterile field and carry out sterile
technique during an operative
procedure.


jarts of the Gown:
 right side
 wrong side
 body
 sleeves
 cuffs
 neckband
 belt
 him line
 back ties

(

 

 NSSITED (SEFSE

ICE)
 Grasp the gown at the center or you may receive it
from the circulating nurse.
 Step one or two feet away from the sterile field
 nfold the gown and expose the hemline portion
 Continue unfolding the gown and locate for the
armhole
 Slip your hands into each arm hole and hold your hands
and arms straight and obliquely upward. The circulating
nurse will fix it.
 Stoop and swing your body to the right and to the left.

(

 

 SSISTED (SE

ING OTHE
S)
 jickup the gown directly from the table
 unfold the gown slowly and serve the hemline portion
to the surgeon
 Continue unfolding the gown while the surgeon is
drying his hands and arms.
 When serving the gown, your gloved hands should
come in contact with the right side portion of the gown
under the protecting cuff made.
 Show the opening and armholes to the surgeon.
 s soon as the surgeon inserted his hands through the
armholes, leave it.

(

 


EMO
ING THE GOWN
 With the gloves till on, ask the circulating nurse
to loosen the ties and the belt.
 Grasp the right shoulder of the gown and slip off
the arm allowing the sleeves to turn inside out.

epeat the same procedure for the opposite
shoulder
 discard the gown in the hamper
 )*
Definition:
 This is the method of donning a sterile
glove. It is done after the gowning
technique
jurpose:
 To complete the sterile attire in order
that the one who wears may handle
sterile equipment.
 )*
jarts of a Glove:
 palmar surface
 dorsal surface
 finger holes
 wrist
 everted cuff
 )*
Types
1. Open method
 This method of gloving uses a skin to skin, glove to
glove technique.
 The hand, although scrubbed, is not sterile and
must not contact the exterior of sterile gloves. The
everted cuff exposes the inner surfaces. The first
glove is put on with skin to skin technique, bare
hand to inside cuff. The sterile fingers of that glove
hand may touch sterile exterior of the second
glove. Glove to glove technique.
 )*
. Closed method
 The most preferred method, except when
changing glove during the operation or when
donning for procedures not requiring gowns.
 This afford assurance against
contamination when gloving oneself, since
no bare skin is exposed during the process
 )* (

 

NSSISTED (SEFSE

ICE)
 Get the powder pack, taking care not to contaminate the outside part of the
glove
 jowder both hands over the bucket away from the sterile field
 Get the right hand glove with the left hand by holding it at the edge of everted
cuff. Step back from the sterile field
 Explore the fingerholes before inserting the whole hand completely. eave the
everted cuff as is
 Slip the gloved right hand under the fold of the everted cuff. Insert the left hand
by exploring the fingerholes before inserting the whole hand completely. eave
the everted cuff as is.
 Make a pleat at the left cuff of the gown and secure this in place with your
thumb.
 Slip the four fingers of the right hand under the fold of the glove and pull it up
over the pleated cuff of the sleeves. Fix the glove firmly

epeat the same procedure for the right hand
Serving of Gloves
 )* (

 

SSISTED (SE

ING OTHE
S)
 Open the powder pack and serve it to the surgeon over the
bucket. Take care that the wrapper will not touch the hands of
the one being served.
 Get the right hand glove and inflate it
 In serving the gloves, the palmer surface or the thumb portion
should be facing the one who is being served
 Evert the cuff one inch wide. Slip four fingers inside the everted
cuff
 Stretch the glove wee outward. jut your thumbs out.
 llow the surgeon to explore the fingerholes
 When the surgeon jerks his hand downwards, release your hold
upward so that the cuff of the glove covers the cuff of the gown.

epeat the same procedure for the left hand.
 )* (

 


EMO
ING THE GO
ES
 With the gloved right hand, remove the
glove by holding it at its outer and pull off.
This is the glove to glove technique
 To remove the right glove, insert your thumb
or  fingers between the skin and the glove
and pull off. This is the skin to skin
technique.
 muniversal precautions͟
 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.
· |
 |+ 



,-·

  


. &+ |

,-
/0
  |

 %
1 
- 2 &+ |


 .3  2


   

,·
0
,    1
 

prevent wound
infection
&

 






Multidisciplinary
team
approach
 &





 






1. Number, type, and length of the surgical
procedure to be performed
. Type and distribution by specialties of the
surgical staff and equipment for each
. jroportion of elective inpatient and
emergency surgical procedures to
ambulatory patient and minimally invasive
procedures.
 &





 






4. Scheduling policies r/t the number
of hours per days per week the
suite will be in use and staffing
needs.
. Systems and procedures
established for the efficient flow of
patients, personnel, and supplies.
 &





 






6. Consideration of volume changes and need
for future expansion capabilities.
. Technology to be implemented and plan for
potential technology to be develop.
8. Safety of staff, patients, and other
personnel during construction or
renovation.
 
 &

 






1. Strategic planning
. jlans for emergencies
. Exclusion of contamination from outside the
suite with sensible traffic patterns to and from
the suite
4. Separation of clean areas from contaminated
areas within the suites during the building phase
. Noise control
 $
 
4 basic Design:
1. Central Corridor, or hotel plan
. Central core, or clean core plan with
peripheral corridor
. Combination central core and peripheral
corridor, or racetrack plan
4. Grouping, or cluster plan with peripheral
and central corridor