Surgical Hand Washing

Principles

1Handwash from the Hands down to the elbows

2Do not scrub with an abrasive scrubbing brush.Vigorous scrubbing may cause abrasions of the skin and bring bacteria to the surface of the skin.

Use a Synthetic Sponge. This will clean the skin without causing these problems

3Keep the hands above the elbows at all time so that the water runs from the hands down to the elbow carrying bacteria with it

4At the end of Handwashing before the hand have been dried keep the hands above the elbows to prevent water running down to the hands.

5Shake the hands and arms to shake off surplus water before Hand drying

6Do not allow water to run from the Elbows down to the Hands

This allow microorganisms to travel back towards the hands

The Items required

1The Handwashing Sink

The water spout must be high enough to allow the hands to be rinsed while keeping the elbows below the hands

2The Tap controls must be operated using Elbow Tap Controls

3Warm not hot water

4Antibacterial Soap Chlorhexidine Soap such as Hibiscrub

5A Synthetic Sponge kept in a Disinfectant Liquid

6Fingernail Cleaners

7Caps or Green Mop Caps

8Mouth masks

9A Sterile Towel for hand and arm drying

(Usually included in the Sterile Gown Pack)

10Surgical Instruction Sheets to be followed during surgical Handwashing

Surgical Handwashing

Stage 1

1Before surgical Handwashing, put a Cap for Short Hair or a Mop Cap for Long Hair

2Take off Watches and Rings

3Put on Spectacles if worn and Eye protection

4Put on a Mask

5Tuck the Front of the Scrub Suit Top into the Front and Back of the Trousers

When hand drying this lessens the Possibility of the Sterile Towel touching the non-sterile Front of the Scrub Suit top at Waist Level

6Turn the Taps on to the correct temperature

7Identify a Synthetic Sponge

8Identify the Fingernail Cleaner

Stage 2

Initial Handwashing

using the Routine Handwashing Technique

  1. Clean Fingernails
  1. Wet your hands with water
  1. Apply two squirts of disinfectant soap
  1. Rub hands palm to palm
  1. Rub the Right palm over the back of the Left hand with fingers interlaced
  1. Rub the Left palm over the back of the Right hand with fingers interlaced
  1. Rub Palm to palm with fingers interlaced
  1. Rub the Backs of fingers to opposing palms with fingers interlocked
  1. Rotational rubbing of Left thumb clasped in Right hand
  1. Rotational rubbing of Right thumb clasped in Left hand
  1. Rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice versa
  1. Rinse well with warm water

Stage 3Final Surgical Handwash

Using a Disinfectant Soap such as Hibiscrub in a Pump Dispenser

1Check that all fingernails are clean

Clean as necessary

2Wash the hands and arms in Warm water

3Dispense Disinfectant Soap onto hands and arms by pressing on the pump bottle of disinfectant with an arm.

4Spread the Soap from the hands down to the

From now on keep hands above the elbows allowing all liquid to flow from the hands and arms

5Sponge the Tips of the Fingers of One Hand

6With the Fingers together sponge the Backs of each Finger of One Hand 10 Times.

7With the Fingers together sponge the Backs of the Hand down to the Wrist of One Hand 10 Times.

8Turn the Hand over

9With the Fingers together sponge the Inside of each Finger, on the Palm Side, of One Hand 10 Times.

10Sponge the Palm of the Hand 10 Times

11Sponge the Sides of the Hand, both sides, 10 Times

12Sponge up and down between each Finger 10 Times

13Sponge the Thumb up and down 10 Times dividing the Thumb into 4 Surfaces

14Sponge down the Forearm down to the Elbow

15Do not sponge from the Elbow back up towards the Hand

Stage 4 Repeat for the Other Hand

1Dispense more Disinfectant Soap onto hands and arms using an elbow on the pump bottle

2Soap from the hands down to the elbows

3Sponge the Tips of the Fingers of the other Hand

4With the Fingers together sponge the Backs of each Finger of One Hand 10 Times.

5With the Fingers together sponge the Backs of the Hand down to the Wrist of One Hand 10 Times.

6Turn the Hand over

7With the Fingers together sponge the Inside of each Finger, on the Palm Side, of One Hand 10 Times.

8Sponge the Palm of the Hand 10 Times

9Sponge the Sides of the Hand, both sides, 10 Times

10Sponge up and down between each Finger 10 Times

11Sponge the Thumb up and down 10 Times dividing the Thumb into 4 Surfaces

12Sponge down the Forearm down to the Elbow without going back up the arm

13Discard the Sponge to the Sink

14Keeping the Hands Upwards rinse the Hands and Arms thoroughly

Ensure that the Water runs from the fingers down from the Hands and Arms, to the Elbows.

The water should flow from the clean area of the hands to the unclean area of the elbows

Stage 5The Final Stage

1Keeping the Hands together and pointing upward shake excess Water into the Sink

2Turn the Taps off with the elbows

Check that You have put a Cap and Mask on

If not put a Cap and Mask on and Start Handwashing again

3Keeping the Hands raised and together. Walk to the Gowning Area

Repeat Surgical Handwashing Technique

To be used if the Full Handwashing Technique has already been performed and another patient is to be treated

This reduced technique may be used of there has been no significant contamination of the hands since the previous procedure

1Clean Fingernails

2Wet hands with water

3Apply two squirts of disinfectant soap

4Rub hands palm to palm

5Rub the Right palm over the back of the Left hand with fingers interlaced

6Rub the Left palm over the back of the Right hand with fingers interlaced

7Rub Palm to palm with fingers interlaced

8Rub the Backs of fingers to opposing palms with fingers interlocked

9Rotational rubbing of Left thumb clasped in Right hand

10Rotational rubbing of Right thumb clasped in Left hand

11Rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice versa

12Rinse well with warm water

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