PAMANTASAN NG LUNGSOD NG MAYNILA

COLLEGE OF NURSING

Medical- Surgical Nursing 1

SKILLS LABORATORY CHECKLIST

Procedure: SURGICAL HANDWASHING

(HAND SCRUB w/ water)

Name: _______________________________________ _Date:______________________________

Year Level and Block:_______________________ Clinical Instructor:________________
Rating scale:
3 Performed correctly, systematically according to standard with correct rationale.
2 Performed correctly, with correct rationale but not systematic.
1 Performed correctly, but not systematic and with inadequate rationale.
0 Performed incorrectly.
I. Surgical scrub technique:
Introduction: All sterile team members should perform the hand and arm scrub before entering the surgical suite.
The basic principle of the scrub is to wash the hands thoroughly, and then to wash from a clean area (the hand) to
a less clean area (the arm). A systematic approach to the scrub is an efficient way to ensure proper technique.
There are two methods of scrub procedure. One is a numbered stroke method, in which a certain number
of brush strokes are designated for each finger, palm, back of hand, and arm. The alternative method is the timed
scrub, and each scrub should last from three to five minutes, depending on facility protocol.
The steps below are for the numbered stroke method.

Performance Remarks
Preparation Rationale
3 2 1 0
1. Before performing the surgical hand scrubbing
procedure, you must first check the following:
- Sink with water flow control with foot, leg, or
infrared actuator element.
- Surgical brush.
- Antiseptic solution.
- Adequate knowledge of the technique of
surgical hand washing.
2. Prepping for the scrubbing procedure
- Enter the designated changing room.
- Check on fingernails, it must be cut short and
remove artificial nails
- Remove all jewelry (rings, watches, bracelets).
- Fix and cover your hair (use standard surgical
hair cover/ hood)- make sure all scalp and hair
is covered
- Put on surgical mask
- Put on prescribed, clean scrub suit- make sure
scrub shirts are tucked in and pants are tied
securely
- Pull/ fold arm sleeves up to shoulder level-
Scrubbing procedure
3. Open the surgical brush package (check if it is
embedded in an antiseptic solution. Check for the
nail pile /cleaner. ( if absent from the package ask
for it to the personnel. Keep the scrub brush and
nail pick in the packaging for now).
4. Position yourself at the sink area, make sure to
keep considerable distance to keep your surgical
attire dry and be free from flushes from the sink.
5. Open the water. Regulate the flow to prevent
splashes. If with temp regulator, set the water at
warm temperature.
6. perform regular hand washing.
- Wet hands and arms with water Let the water
run to moisten all the skin of fingers, hands, and
forearms; the water should drain from the
fingers to the elbows.
- Dispense antimicrobial liquid soap/whatever is
available, at least 2 pumps (approx. 5 ml) on to
your palms.
- Spread over the hands and arms. Make a lather
- Work into lather and rub surfaces from fingers
up to 3 inches above elbows.
- Rinse fingertips to elbows. Place your hands
under the tap with the tips of your fingers
towards the ceiling and the elbows towards the
bottom of the sink.
8. Get the nail cleaner from the package with your
hands. Clean under fingernails and around
nailbeds under running water.
- Allow the water to flow between your fingertip
and fingernail as you remove dirt with the nail
cleaner.
- Repeat this process with each finger on both
hands.
- Discard the nail cleaner appropriately.
9. Soap up both hands and arms with antimicrobial
solution/soap. (if the surgical brush is embedded
with a microbial solution use the brush to soap up
the hands, if not, make two pumps of microbial
solution (approx. 5 ml) from a dispenser on the
rough side of the brush)
10. Place all, finger together, with the surgical
brush begin to brush across nail tips for at least 30
strokes per hand in circular stroke. The right-hand
brushes to the left.
11. mentally divide each fingers and thumbs into 4
planes. Scrub each side separately for 20 strokes,
make sure to scrub all areas of the finger: including
the web.
12. Scrub the front of the hands/ palm for 20
strokes
13 scrub the back of the hands for 20 strokes, make
 sure to hit all areas of the back of the hand.
14 repeat steps 10 to 13 with the other hands
15. mentally divide arms from wrist to 3 inches
above elbows into 4 planes and divide these planes
into 3 segments:
 wrist segment (lower third of the forearm)
 middle forearm segment (middle third)
 upper forearm segment up to 3 inches from
the elbow (upper third)
Then scrub each segment with 20 strokes per
plane.
Do the same on the other arms. then discard the
brush properly
16., Start rinsing your hands then to the arms.
- One hand at a time.
- Start with your fingers to above elbows.
- Keep your arms tilted upward, maintain your
hands on an upright position.
- Let the water drip down to your elbows. No
water must drip back to the hands that was just
cleaned.
- Make sure not to let your hand or arms touch
any part of the sink.
- If in case accidentally you touch any unclean
area, or any part of the sink then you start
scrubbing back again.
17. Turn off the water. Make sure that you will not
use your cleaned hands when turning the water
off. If incase it’s the traditional faucet that was
available then you ask for help to close it for you.
18. Back away from the sink towards the operating
room door using your back to enter.
- Keep an eye on your cleaned hands, as you
enter the operating room/ theater.
- Keep your hands away from your body. You can
keep your both hands close together
19. Pick up one hand towel from the top of the
gown pack and step back from the table. Grasp the
towel and open it fully.
- Do not allow the towel to touch any unsterile
object or unsterile parts of your body.
- Hold your hands and arms above your elbow
and keep your arms away from your body.
20. Holding one end of the towel with one hand dry
the fingers of the opposite hand using a blotting
rotational motion.
- Move to the dry area of the towel and continue
in this manner down the forearm to the elbow.
- DO NOT retrace any areas. Discard this towel in
an appropriate receptacle.
- Repeat with the other towel from the pack for
the other hand/arm.