gowning, gloving and scrubbing
DESCRIPTION
Credits to Ma'am Evangeline TeruelTRANSCRIPT
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