PERIOPERATIVE NURSING

SURGICAL SCRUBBING
DEFINITION: This is the process of removing as many microorganisms as possible from hands
and arms by both mechanical friction and chemical antisepsis.
Other terms:
·   Surgical Handwashing, Hand Scrubbing
 
PURPOSE:
1. To protect the personnel and patient from possible infection or contamination.
 
SPECIAL CONSIDERATIONS:
1. Prior to surgical handwashing, the nurse must;
a. Wear the following:
1. Scrub suit
2. Surgical shoe covers (booties)
3. Cap
4. Face mask
5. Protective eyewear
b. Remove the following
1. Ring
2. Bracelet
3. Watch
2. Use deep sink with foot pedals or knee controls for dispensing soap and controlling
water temperature and flow.
3. Only recommend antimicrobial solutions should be used during the surgical scrub.
4. Avoid splash of water (scrub agent) on scrub suit.
5. Time interval: 5 – minutes scrub = 2 ½ minutes for each extremity.
6. If contact is made with unsterile surfaces during the scrub procedure, the entire scrub
procedure must be repeated.
 
EQUIPMENT/SUPPLIES:
1. Surgical scrub items:
a. antimicrobial soap
b. two (2) brushes
c. nail file (orange stick)
d. antiseptic detergent

 
 
IMPLEMENTATION:

Suggested Action Rationale

1. Wear a cap, covering hair Protective wear prevents exposure to blood and body
completely. Contain pierced ear with fluid splashes during the procedure.
cap.

2. Wear a face mask, making certain Mask prevents contamination of the sterile field.
 to cover nose and mouth snugly.

3. Adjust water flow. To prevent splatter of water.

4. Wet arms and forearms liberally, Washing a wide area reduces risk of contaminating
keeping arms and hands above elbow overlying gown that the nurse later applies.
level during the entire procedure.
 
Note: Scrub suit r uniform must be kept
dry. Water runs by gravity from
fingertips to elbows. Hands become
cleanest part of upper extremity.

5. Dispense liberal amounts of soap Bacterial are removed both by mechanical friction and
into hands and lather hands and arms chemical antisepsis.
to 5 cm (2in) above elbows, applying
friction.

6. With arms flexed, rinse from Keeping hands elevated allows water to flow from least
fingertips to elbow in one motion, to most contaminated areas.
allowing water to run off the elbow. Do
it one arm at a time.

7. Wet brush and apply Scrubbing loosens bacteria that adhere to skin
antimicrobial soap. Scrub surfaces. Ensures coverage of all surfaces. 
fingernails, hands and arm in the Scrubbing is performed from cleanest area (hands)
following manner: to marginal area (upper arms).

      a. Scrub nails of one hand using  

30
           strokes

      b. All sides of each finger using 20  

           strokes.

      c. The back of the hand using 20  

strokes.

      d. Maintaining the lather, scrub the  

palm
            of the hand using 30 strokes.

        e. The arm using 20 strokes for  

each third
           of the arm, to 2 inches above the
elbow.

Suggested Action Rationale

      8.  Perform to the other hand. To be assured of following accordingly the
  practices of asepsis that keep both hands
free of all microorganisms.
 
To observe principles of asepsis.

9. With arms flexed, rinse thoroughly from Fluid flows in the direction of gravity.
fingertips to elbow in one motion, allowing
water to run off at elbow.
 
Note: Keep hands upright and elbows
down.

10. Keeping arms flexed, allow water to drip To avoid contamination of the hands which
off elbows, maintaining proper position are considered as the cleanest area.
before entering the procedure room.

11. Pick up sterile towel found on top of To prevent contamination of the sterile field.
sterile gown pack. Be sure no one is within
arm reach.

12. Open towel in full length, holding one To prevent contamination of towel that will
side away from scrub suit. be utilized for drying the hands.

13. Dry the hand and arm of the non- To dry one arm, hold towel with opposite
dominant hand, using a rotating motion, draw towel
from fingers to elbow.  Drying prevents
chapping of hands.

14. Carefully reverse towel and dry hand To avoid contamination.

and arm of the dominant hand.

15. Discard towel appropriately. To prevent accidental contamination.

DOCUMENTATION:  

No recording is required for hand washing.  

Record area and description of surgical site
postoperatively to provide baseline for
monitoring wound.

SURGICAL SCRUBBING
Suggested Actions Correctly Partially Not Remarks
Done Done Done
 1. Wear cap, covering hair completely. Contain /      
pierced ear with cap.

2. Wear face mask, making certain to cover nose /       

and mouth snugly.

3. Adjust water flow. /      

4. Wet arms and forearms liberally, keeping arms /      

and hands above elbow level during entire procedure.
 
Note: Scrub suit or uniform must be kept dry. Water
runs gravity from fingertips to elbows. Hands become
cleanest part of upper extremity.

5. Dispense liberal amounts of soap (2 to5 ml) into /      

hands and lather hands and arms to 5 cm (2 in) above
elbows, applying friction.

6. With arms flexed, rinse from fingertips to elbow in /       

one motion, allowing water to run off the elbow. Do it
one arm at a time.

7. Wet brush and apply antimicrobial soap.  Scrub /       

fingernails, hands and arm in the following manner:

        a. Scrub nails of one hand using 30 strokes /       

      b. All sides of each finger using 20 strokes. /       

        c. The back of the hand using 20  strokes. /      

        d. Maintaining the lather, scrub the palm of /       

             the hand using 30 strokes.

        e. The arm using 20 strokes for each third of /      

            the arm, to 2 inches above the elbow.

 
 
 
 

Suggested Actions Correctly Partially Not Remarks

Done Done Done
 8. Perform to the other hand. /       

9. With arms flexed, rinse thoroughly from fingertips /       

to elbow in one motion, allowing water to run off at
elbow.
 
Note: Keep hands upright and elbows down.

10.  Keeping arms flexed, allow water to drip off /       

elbows, maintaining proper position before entering the
procedure room.

11.  Pick up sterile towel found on top of sterile gown /       

pack. Be sure no one is within arm’s reach.

12.  Open towel in full length, holding one side way /      

from scrub suit.

13.  Dry the hand and arm of the non-dominant hand /      

with the dominant hand.

14.  Carefully reverse towel and dry hand and arm of /       

the dominant hand.

15.  Discard towel appropriately. /       

DOCUMENTATION:        

No recording is required for handwashing. Record area and        

description of surgical site postoperatively to provide
baseline for monitoring wound.

 
 
ATTITUDE CRITERION
  3 2 1 Scor Remarks
e

Behavior /        

Compliance to prescribed uniform /        

 Completion of other Tasks (assignment, reflection, journal, etc.) /        

Time Efficiency /        

Total Score  

EQUIVALENT  

Score: 3 x 20__________ = Total Weight/ 20__________ = __________

60__________

    2 x __________ = __________          (no. of items)

    1 x __________ = __________ SCORE:  3=  100__________________________

K (30_____%)   = 25_______%

S (_50____%)   = 50_______%  

A (_20____%)   = 20_______%  

Total         = 95_______%  

            

GABRIELLE ANGELA EVANGELISTA 08/24/2020

Signature of Student Over Printed Name                                     Date

Ma. Francia C. Nismal, RN,MN

Signature of Clinical Instructor Over Printed Name                      Date