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ADMINISTRATIVE APPROVAL

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Last Date Revised:

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Purpose

To provide guidance to perioperative personnel for performing hand hygiene. The expected outcome is that the patient is free from signs and symptoms of infection.

Policy

It is the policy of [insert name of facility] that:

• Before donning a sterile gown and gloves for operative or other invasive procedures, perioperative personnel will perform surgical hand antisepsis using a surgical hand antiseptic or an alcohol-based surgical hand rub designed and intended for use as a surgical hand antiseptic and provided by the health care organization.

Procedure Interventions

Surgical Hand Scrub

• Perform a traditional surgical hand scrub in the following manner:

o Remove jewelry from hands and forearms.

o Don a surgical mask.

o If hands and forearms are visibly soiled, wash with soap and water.

o Clean subungual areas of nails under running water using a disposable nail cleaner.

o Rinse hands and forearms under running water.

o Apply the amount of surgical hand scrub product recommended by the manufacturer to the hands and forearms using a soft, nonabrasive sponge.

o Scrub for length of time recommended by the manufacturer. The scrub should be timed to allow adequate product contact with skin.

o Visualize each finger, hand, and arm as having four sides to be scrubbed.

o Beginning with one hand and keeping the hand elevated, scrub all four sides of each finger, hand, and arm.

o Repeat the process for the opposite hand and arm.

o If possible, turn water off when not in use.

o Avoid splashing surgical attire.

o Discard sponges in appropriate containers.

o Rinse hands and arms under running water in one direction from fingertips to elbows.

o Hold hands higher than elbows and away from surgical attire.

o In the OR or other invasive procedure room, dry hands and arms with a sterile towel before donning a sterile surgical gown and gloves.

• Perform surgical hand antisepsis using an alcohol-based surgical hand rub product in the following manner:

o Remove jewelry from hands and forearms.

o Don a surgical mask.

o If hands and forearms are visibly soiled, wash with soap and water.

o Clean subungual areas of nails under running water using a disposable nail cleaner.

o Rinse hands and forearms under running water.

o Dry hands and forearms thoroughly with a disposable towel.

o Apply the surgical hand rub product to the hands and arms according to the manufacturer's instructions for use (eg, amount, method, time).

o Repeat applications as directed.

o Rub hands and forearms thoroughly until completely dry.

o In the OR or other invasive procedure room, don a sterile gown and gloves.

Competency

Perioperative personnel assisting with or performing operative or other invasive procedures will receive education and complete competency verification activities on the principles and processes of surgical hand antisepsis.

Quality

Perioperative personnel assisting with or performing operative or other invasive procedures will participate in quality assurance and performance improvement activities related to surgical hand antisepsis.

Glossary

Subungual: Under the nail (eg, fingernail).

Surgical hand antiseptic: A product that is broad-spectrum, fast acting, and nonirritating preparation containing an antimicrobial ingredient designed to significantly reduce the number of microorganisms on intact skin. Surgical hand antiseptics demonstrate both persistent and cumulative activity.

References

Petersen C, ed. Infection. In: Perioperative Nursing Data Set. 3rd ed. Denver, CO: AORN, Inc; 2011:254-276.

Guideline for hand hygiene. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2016.

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