Chapter 1. Infection Control
1.7 Surgical Hand Scrub, Applying Sterile Gloves and Preparing a Sterile Field
Sterile procedures are required before and during specific patient care activities to maintain an area free from microorganisms and to prevent infection. Performing a surgical hand scrub, applying sterile gloves, and preparing a sterile field are ways to prevent and minimize infection during surgeries or invasive procedures.
Surgical Hand Scrub
Skin is a major source of microorganisms and a major source of contamination in the OR setting (CDC, 2010). Since skin cannot be sterilized, members of the surgical team must wear sterile gloves. The purpose of the surgical hand scrub is to significantly reduce the number of skin bacteria found on the hands and arms of the OR staff (Kennedy, 2013). A surgical hand scrub is an antiseptic surgical scrub or antiseptic hand rub that is performed prior to donning surgical attire (Perry et al., 2014) and lasts two to five minutes, depending on the product used and hospital policy. Studies have shown that skin bacteria rapidly multiply under surgical gloves if hands are not washed with an antimicrobial soap, whereas a surgical hand scrub will inhibit growth of bacteria under gloved hands (Kennedy, 2013).
Types of Surgical Hand Scrubs
Surgical hand scrub techniques and supplies to clean hands will vary among healthcare agencies. Most protocols require a microbial soap-and-water, three- to five-minute hand scrub procedure. Some agencies may use an approved waterless hand scrub product. See Checklist 10 for the steps to follow when scrubbing with medicated soap.
Applying Sterile Gloves
Sterile gloves are gloves that are free from all microorganisms. They are required for any invasive procedure and when contact with any sterile site, tissue, or body cavity is expected (PIDAC, 2012). Sterile gloves help prevent surgical site infections and reduce the risk of exposure to blood and body fluid pathogens for the healthcare worker. Studies have shown that 18% to 35% of all sterile gloves have tiny holes after surgery, and up to 80% of the tiny puncture sites go unnoticed by the surgeon (Kennedy, 2013). Double gloving is known to reduce the risk of exposure and has become common practice, but does not reduce the risk of cross-contamination after surgery (Kennedy, 2013).
To apply sterile gloves, follow the steps in Checklist 11.
Checklist 11: Donning & Doffing Sterile GlovesDisclaimer: Always review and follow your agency policy regarding this specific skill. |
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Safety considerations:
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Steps |
Additional Information |
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| 1. Remove all jewelry. | Jewelry harbors more microorganisms than do hands. | ||
| 2. No artificial nails, extenders, or chipped nail polish should be worn. | Artificial nails, extenders, and chipped nail polish can harbor additional microorganisms. | ||
| 3. Inspect hands for sores and abrasions. Cover or report to supervisor as required. | Open sores can harbor microorganisms. | ||
| 4. Ens