Definition
Surgical hand washing to a procedure by which dirt and microorganisms are destroyed and removed from hands and fingers by chemical action and mechanical friction.
Purposes
- To remove dirt and transient microorganisms from hands.
- To reduce the risk of transmission of microorganisms to patients.
- To reduce the risk of cross-infection among patients
- To reduce the risk of transmission of infectious agents to oneself.
- To prevent latrogenic infections.
Articles
- Soup or antiseptic detergent
- Ranning warm water.
- Nall brush in antiseptic lotion.
- Towels (sterile)
- Mask and cap.
Procedure
| Nursing Action | Rationale | |
| 1 | Before procedure Ensure that nails are short. Remove artificial nails if any. | Short nails are less likely to harbor organisms, scratch the patient or puncture gloves |
| 2 | Remove nail polish | Nail polish harbors microorganism |
| 3 | Impact hands for abrasions, cuts, or open lesions | These conditions increase the likelihood of more microorganisms residing on skin surfaces. |
| 4 | Remove jewelry of any type. | Microorganisms accumulate in jewelry |
| 5 | After medical hand wash, wear cap and mask. | |
| 6 | During procedure Turn on water using knee/ foot/elbow | |
| 7 | Wet hand and arms under running lukewarm water and lather with soap/detergent to 5 cm above the elbows (hand need to be raised/ held above elbows at all times) use firm circular movements to wash palms, back of hands, wrists, forearms, and interdigital spaces for 20-25 second. | Water flows from fingertip to elbow. Fingertips are considered to be cleaner than the elbows. |
| 8 | Rinse hands and arms thoroughly running water (remember to keep hands above elbow.) | Rinsing removes transient bacteria from hands |
| 9 | Clean under nails of both hands with nail pick/nail brush. | Removes dirt and microorganisms. |
| 10 | Scrub nails of each hand with 15 strokes using antimicrobial agent. | |
| 11 | Holding the brush perpendicular scrub palm, each side of thumb and fingers and posterior side of hand with 10 strokes each. | Scrubbing loosens resident bacteria that to skin surface |
| 12 | Scrub from wrist to 5 cm above each elbow that is lower arm, upper forearm, and antecubital fossa to marginal area above elbows. | Scrubbing is performed from cleaner area to less area (upper arms). |
| 13 | Entire scrub should last for 5-10 minutes. | Scrubbing time can be lengthened according to agency policy/ according to the degree of contamination of hands. |
| 14 | Discard brush and rinse hands from fingertips to elbows. | |
| 15 | Take care not to touch the tap or sides of think during the procedure. | Tap and side of sink are considered to be contaminated. |
| 16 | Use a sterile towel to dry one hand moving from fingers to elbow. Dry from cleanest to least clean area. | Drying prevents chapping and facilitates donning of gloves. |
| 17 | Repat drying of the other hand using a different level. Use one side to dry one hand and reverse side for other hand, if only one towel is available. | |
| 18 | After procedure Discard towel | |
| 19 | Proceed with sterile gowning. |
Special consideration
Report any dermatitis to employee health or infection control as per agency policy.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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