Skill 2 : Surgical Scrubbing, Gowning and Gloving

Task: perform surgical scrubbing, gowning and gloving correctly

Criteria for satisfactory completion of the task: when all relevant aspects
of the task, governed by the following principles, are demonstrated:
• adequate preparation of the patient and the tools for the procedure
• conduct of the procedure adheres strictly to principles of asepsis and
standard precautions
• consideration of patient safety and comfort
• adequate documentation of the procedure
• recognition of limitations and possible complications

Checklist

Expected Actions

1 Preparation prior to scrubbing

• Fingernails should not reach beyond the fingertips
• No watch, rings and jewelry
• Wear face mask
• Sleeves of scrub suit folded up to 4 – 5 cm above the elbow

2 Surgical Scrubbing - consist of 3 steps

Step 1 – Perform initial hand washing

• Wet both hands and forearms until 5 cm above the elbows

• Dispense a small amount of antimicrobial cleaning agent on palms of the
hand
• rub and lather well with friction of both palms and in between fingers in
circular motion up to 5 cm above the elbows
• rinse thoroughly under running water, always keeping the hands upwards

Step 2 – Perform surgical scrub

• pick a sterile brush
• dispense anti-microbial cleansing agent on the sterile brush
• brush nails of one hand in 10 strokes
• rinse finger nails
• repeat for the other hand
• discard the brush
• thoroughly rinse both the fingernails
• dispense antimicrobial cleaning agent on the palms
• rub both palms
• proceed to the fingers by rubbing with friction all sides of each finger including
the web spaces
• proceed to the palm with circular rubbings until the wrist
• do the same to the dorsum of hand with circular rubbings until the wrist
• Now, proceed from wrist to 5 cm above the elbow in circular motion
• proceed to opposite hand using the same techniques
• rinse both hands and arms thoroughly
 Step 3 Perform effective hand wash
• dispense antimicrobial cleansing agent on the palm
• rub palm to palm
• rub right palm over left dorsum and vice versa
• rub palm to palm with fingers interlaced
• then the back of fingers to opposing palms with fingers interlocked
• rotational rubbing of right thumb clasped in left palm and vice versa
• rotational rubbing backwards and forward with clasped fingers of right hand in
left palm and vice versa
• rotational rubbing of right wrist to about 5 cm below wrist and vice versa
• rinse thoroughly and shake off the water from both hands

3 DRYING OF HANDS
nd
• request the scrub nurse to open the 2 layer of sterile gown pack
• with one hand, pick up a towel by its corner
• grasp the opposing corner of the towel with the other hand
• Open towel full length
• Use one end of the towel to dry the hand and forearm in circular motion
towards the elbow (always keeping the hands upwards)
• Use the other end of the towel to dry the other hand and forearm in a similar
manner

4
CLOSED GOWNING
• Grasp collar of sterile gown and hold it up
• Step back and away from the operating table or any non- sterile object
• Allow bottom of gown to unfold downwards while still holding the collar
• Locate the neck band
• Hold just below neck band with both hands, keeping the inside of the gown
towards the wearer
• Locate the arm hole
• Slip one hand at a time into the arm hole of the gown
• Allow a nurse to secure gown at the back by fastening the tape at the neck,
back and waist

5 CLOSED GLOVING

• Keep hands well within the sleeves

• Pick the right side glove using the left hand
• Place glove on the palm of right hand, with the fingers of gloves pointing
towards wearer
• Keep the right thumb of glove parallel to right thumb
• Stretch and unfold the cuff to cover the sleeve
• Tie sterile gown with the help of an operating team member

Reference: National Operating Room Nursing Audit : Mac 2012 YAW/RL Aug 2013