Steps to Scrubbing In

Introduction If you have the opportunity to assist in an operation, you will need to adhere to several principles. The “surgical field” is a sterile area surrounding the patient that is free from any microorganisms. To maintain this sterility, you need to correctly scrub in, put on your gown and pull on your gloves in addition to wearing your scrubs, cap and facemask.

Preparing to Scrub Turn on the faucet and adjust to a comfortably warm and adequate flow of water. Scrubbing begins at the fingernails, using a nail file and brush from a sterile pack.

Three Scrub Cycles A surgical scrub occurs in three cycles:

1 Hands and arms extending to two inches above the

elbow

2 Hands and

halfway up the forearms

3 Hands only

Backs of fingers to opposing palms

with fingers interlocked

Rotational rubbing of right

thumb clasped in left and vice versa

Rotational rubbing, backwards and forwards with

clasped fingers of right hand in left

palm and vice versa

Three Scrub Cycles These steps ensure that all areas of the hand are cleaned thoroughly. Each cycle of the hand scrub should be repeated for each of the three washing cycles. This follows the principle of washing from a clean area (the hand) in the direction of the less clean area (the arm). Your hands should be held above the level of your elbows at all times to prevent dirty water from dripping from the upper arm onto lower sterile areas.

1 2 3

4 5 6

Palm to palm

Right palm over left dorsum and left palm over right dorsum

Palm to palm fingers interlaced

Gowning The gown is packed and folded in a specific way so that the openings of the arm sleeves are clearly visible and accessible. The image shows the steps to correct “gowning.”

1 2 3 4 5 6 7

Dry Hands Pick up gown Let gown unfold

Slip arms into sleeves

Hold arms out and slightly up

Circulator pulls gown on

Open to locate sleeves/armholes

Gloving There are two main techniques used to pull on sterile gloves: the open glove technique and the closed glove technique. Here the closed technique is described. At no point during this procedure should your bare hands extend beyond the gown cuffs, or touch the outside of the gloves.

1 2 3

4 5 6

Pick up one glove with thumb and

forefinger Pull glove on hand

Slip partially gloved hand under cuff of

second glove

Pull second glove over other hand and

pull glove up to gowned wrist

Slip fingers of completely gloved hand under cuff of first hand,

pull glove to gowned wrist

Gloving procedure completed

Conclusion This has given you insight about protecting the sterile field by demonstrating techniques for properly scrubbing in, gowning and gloving. The main aim of these meticulous procedures is patient safety and infection prevention.

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Sources: http://www.medscape.com/viewarticle/725336_7, http://medical.tpub.com/14295/css/14295_109.htm, http://medical.tpub.com/14295/css/14295_110.htm

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