Page 107 - policy and procedure infection control

Policies and Procedures on Infection Control

6.3.10. Surgical Hand Scrubbing (Refer to hand hygiene section)
1. A through hand wash for 5 minutes for first operation using antiseptic lotion with
brush on finger nails and followed by rubbing method to all the rest of the fingers and
hands including 2" above elbow. Rinse thoroughly with clean water.
2. Dry hands and arms using sterile towel. The top half of the sterile towel is held in one
hand while the opposite hand and forearm is dried.
3. A rotating motion beginning at the hand and working toward the elbow is used for
drying. When the first hand and forearm are dry, the towel half of the towel that is
unused is grasped with the dry hand, and the opposite hand and forearm is then
dried. Care is taken not to return to an area that is already dried.
4. For subsequent cases, a 2 minutes recommended hand rub with alcohol base is
sufficient and dry hand as stated above.

6.3.11. Gowning
1. The sterile gown is put on after drying the hands and arms with a sterile towel.
Sterile gowns may be reusable or disposable.
2. The gown should be constructed of a material that provides a barrier to prevent the
passage of microorganisms from the surgical team to the patient and vice versa. Gowns
should be lint free as possible, free from tears or holes, fluid resistant or fluid proof.
3. Reusable gowns eventually lose their barrier qualities with repeated laundering. Quality
monitoring should be in place to ensure that only gowns of appropriate quality are used.

6.3.12. Gloving
1. Gloves are donned after gowning. The sterile gloves are put on by two ways: by
closed method technique and open method technique.
2. The closed gloving method is preferred for establishing the initial sterile field.
3. The open gloving method is used when changing a glove during a surgical procedure
or when donning gloves for procedures not requiring gowns.
4. Sterile gloves donned should be rinsed or wiped with sterile water or sterile saline
prior to the surgical incision in order to remove the glove powders.

6.3.13. Draping
1. Drapes serve as a barrier to prevent the passage of micro-organism between sterile
and non-sterile area. Sterile drapes are used to create a sterile surface around the
incision site. Draping is also use for sterile supplies and equipments. This area is
referred to as a sterile field.

2. The sterile field includes the patient, furniture and other equipment that is covered
with sterile drape. The sterile field is isolated from unsterile surface and items.
3. Draping should always be done from a sterile area to an unsterile area. Draping the
area nearest to the scrub person first. Once the drape is applied, it should not be
adjusted.

96 Ministry of Health Malaysia