1. Surgical Hand Scrub & Gowning and Gloving

2. Surgical Hand Scrub
Intended to remove as many microorganisms as possible from the hands and arms.
Transient flora
Resident flora
Antimicrobial soap that leaves a film of protection is ideal.

3. Surgical Hand Scrub Two methods: Timed Counted brush stroke
More thorough method for individuals learning to scrub.

4. Surgical Hand Scrub Don all PPE
Inspect the integrity of the hands and arms to rule out presence of infection.
Inspect nails and cuticles.
Open the brush package and place in a convenient location.
Turn on the water and adjust temperature.

6. Surgical Hand Scrub
Wet hands and arms, apply antiseptic, and lather to 2” above the elbow.
Obtain nail cleaner.
Clean each nail and cuticles under running water.
Discard nail cleaner.
Rinse hands and arms.

8. Surgical Hand Scrub
Keep hands above the elbows and keep elbows bent to allow water to run off the elbows.
Obtain the scrub brush; wet and lather.
Begin scrubbing the first hand’s nails and cuticles 30 brush strokes.
Scrub each finger 10 strokes by diving it into four planes.

10. Surgical Hand Scrub Scrub each web space as a separate plane.
Progress in an orderly fashion to ensure that all surfaces receive adequate chemical exposure and mechanical action.
Add water and soap as needed.
Scrub the hand by dividing it into four planes; use 10 circular motion strokes.

11. Surgical Hand Scrub Divide the arm into three sections.
Further divide each section into four planes and scrub individually using 10 circular strokes.
Continue to 2” above elbow.
Rinse brush and transfer to the other hand, and repeat the process.

13. Surgical Hand Scrub Discard the brush.
Rinse one arm from the fingertips to the elbow, keeping the elbow bent.
Repeat rinse on the opposite arm.
Allow excess water to drip into sink.
Enter O.R. with elbows bent and arms at mid chest.
Use hip/back to open O.R. door.

15. Gowning and Gloving Drying hands:
Approach sterile field, keeping arms bent.
Pinch and lift towel without touching any other surface or dripping water.
Step away from the field and unfold the towel without it dropping below waist level.

17. Gowning and Gloving Drying hands:
Bend slightly at the waist so the towel does not come in contact with scrubs.
Hold the towel in the palm of one hand while drying the other using a patting motion.

18. Gowning and Gloving Drying hands:
Transfer the towel to the opposite hand without crossing the hands.
Dry the opposite hand and arm.
Discard the towel.

19. Gowning and Gloving Gowning
Approach the sterile field and grasp gown at the center near the neck without touching the gloves.
Lift gown from the wrapper and step back.
Hold the inside of the gown near the shoulders and allow the gown to unfold.

21. Gowning and Gloving Gowning
Begin donning the gown by slipping the hands and arms into the sleeves.
Slide the gown over the arms using a swimming motion.
Keep hands within the gown cuffs.
Flex elbows to hold the gown in place.
Allow circulator to secure the neck and back of gown.

23. Gowning and Gloving Closed Gloving
Approach the sterile field, grasp the first glove, keeping fingers inside of the gown cuffs.
Align the glove to the gown; palm to palm, and cuff to cuff.
Pull the cuff of the glove over the cuff of the gown.

24. Gowning and Gloving Closed Gloving
Unfold the cuff of the glove to completely cover the gown cuff.
Grasp the glove and gown at the wrist, and work fingers and hand into the glove.
Secure the second glove using the same technique.

26. Gowning and Gloving Turning the Gown Remain facing the sterile field.
Secure the tag in the right hand and the gown tie in the left hand and separate.
Pass the tag, so that the circulator can grasp it at the right side.

27. Gowning and Gloving Turning the Gown
Circulator will move around to the left side.
Receive the gown tie from the circulator.
Circulator retains and discards the tag.
STSR secures both ties together.

31. Review
Surgical Hand Scrub
Self Gowning and Gloving