Operating Room Checklist

HANDWASHING – SURGICAL TECHNIQUE

DEFINITION  Type of handwashing used in the operating room. PURPOSE  To remove soil and most transient microorganisms from the skin. EQUIPMENT  Brush  Sink with faucet and running water  Liquid soap  Sterile towel  Nail cutter PROCEDURE RATIONALE 1. Inspect hands for cuts in the  Breaks in skin skin and cuticles. Do not facilitate development scrub if there are open lesions of infection. or breaks in the skin. 2. Remove rings, chipped nail  To decrease resident polish, and watch and push and transient long sleeves above the elbow. microorganisms. 3. Put on cap or hood, shoes  To prevent cover and a mask. introduction of contaminants into environment. 4. Use a deep sink with side foot  To prevent hands and pedal. forearm form touching a soiled surface. 5. Turn on water using foot or  Warm water removes knee control and adjust less of the protective

temperature to be comfortably warm. 6. Wet hands starting from the tips of fingers to forearms keeping hands higher than elbows. 7. Apply soap to a scrub brush or open a pre-packed scrub brush if available. 8. With brush on your dominant hand, using a circular motion, scrub nails and all skin areas of non-dominant hand and arm (ten strokes to each of the areas).

oil of the skin than hot water.  Water will drain off your elbow, flowing from cleanest area to less clean area.  To remove resident bacteria from the skin surfaces.  The circular motion mechanically removes microorganisms, scrubbing the nondominant hands first sets a routine you can remember to prevent contamination.  Same as above.

9. Take second scrub brush and repeat actions in No. 8 on your dominant hand and arm. 10. Keep the hands and  Allows flow of water arms above elbow level, place from the area of least the fingertips under running (hand) contamination water and thoroughly rinse to the area of most the fingers, hands and the contamination (elbow) arms. 11. Keep arms flexed and  Prevents water from proceed to operating or flowing from least procedure room. clean area (elbows) to most (hands) clean area. 12. Secure a sterile towel by  Maintain sterility of grasping it on one edge, the towel. opening it at full length

making sure it does not touch your uniform/ 13. Dry each hand and arm separately, extend one side of the towel around finger and hands and dry in a rotating motion up to the elbow. 14. Reverse towel and repeat same action on the other hand and arm, thoroughly drying the skin. Discard towel into linen hamper.

 Prevents contamination by drying from cleanest to least clean area.

 To prevent contamination of gown.

CHECKLIST ON HANDWASHING – SURGICAL TECHNIQUE Student Name: ________________________________Year Level: _________________ Inclusive Date: _____________________

PROCEDURE Assessment 1. Assess the hands for visible soiling, breaks or cuts in the skin and cuticles Planning 2. Assemble the equipment. Implementation 3. Remove rings, chipped nail polish and watch and push long sleeves above the elbow. 4. Put on cap or hood, shoes cover and a mask. 5. Use a deep sink with side foot pedal. 6. Turn on water using foot or knee control. 7. Wet hands starting from the tips of fingers to forearms keeping hands higher than elbows. 8. Apply soap to a soap brush or open a pre-packed scrub. 9. With brush on dominant hand, scrub nails and all skin areas of nondominant hand and arm using circular motion ( ten stroke to each of the areas) 10. Repeat actions in No. 9 on dominant hand.

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11. Place the fingertips under running water and thoroughly rinse the fingers, hands and the arms and keeping hands and arms above elbow level. 12. Keep arms flexed and proceed to operating room. 13. Secure a towel by grasping it on one edge, and open it at full length. 14. Extend one side of the towel around finger and hands and dry in a rotating motion up to the elbow. 15. Reverse towel and repeat same procedure on the other hand. 16. Discard towel into linen hamper. Evaluation 17. Inspect hands and nails for cleanliness. Documentation 18. Record time when handwashing was done.

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GLOVING TECHNIQUE

DEFINITION  It is a method where sterile gloves are worn aseptically. PURPOSE  To prevent any accidental contact of a substance that could carry a blood-borne pathogen with small breaks in the skin. EQUIPMENT  Sterile gloves (appropriate size for individual) PROCEDURE 1. Remove jewelry particularly rings.

RATIONALE  Rings may tear the gloves and can harbor organism. 2. Wash hands.  To minimize the transfer of organism 3. Remove outer wrapper carefully  To prevent inner by separating and peeling apart glove package from sides and lay it on clean, flat accidentally opening surface. and touching the contaminated objects. 4. Open inner wrapper and  The outer portion of touching only the outside, the inner wrapper is secure both flaps in open contaminated. Inner position. portion of the wrapper is sterile. 5. Identify right and left glove. Each  Proper identification glove has cuff approximately 5 of gloves cm and 2 inches wide. Glove contamination by

dominant hand. 6. With thumb and first two fingers of non –dominant hand, grasp the inner fold of the cuff. Lift the glove, holding away from the body. Slip dominant hand touching only the inner surface of the glove. 7. With gloved dominant hand, slip four fingers underneath second glove cuff. Lift the glove away from the body. Slide the second hand into the second glove, touching only the inner part of the glove. 8. Adjust fingers of both gloves using gloved hand.

9. Raise gloved hand above waist level. GLOVE DISPOSAL 10. Grasp outside of one cuff with other gloved hand, avoid touching the wrists. 11. Pull glove off, turning it inside out. Discard in receptacle. 12. Take fingers of care hand and tuck inside remaining glove cuff. Pull glove of, inside out. Discard

improper fit. Gloving dominant hand first promotes efficiency.  The inner of the first glove is now

 Contact of gloved hand with exposed hand result in contamination.

 If a sterile object (first gloved hand) touches a second sterile object (second gloved hand) both remains sterile.  Below waist level is considered contaminated,

 Minimizes contamination of underlying skin.  Outside of glove should not touch skin.  This method neatly encloses the used object in the glove,

in receptacle.

making disposal more sanitary.

CHECKLIST ON GLOVING TECHNIQUE Student Name: ____________________________________ Year Level: _________________ Inclusive Date: _____________________

PROCEDURE 1. Remove jewelry, particularly rings. 2. Wash hands 3. Remove outer wrapper, peeling apart sides and lay it on clean, flat surface. 4. Open inner wrapper and touching only the outside. 5. Secure both flaps open. Identify right and left glove. 6. grasp the inner fold with thumb and first two fingers of non-dominant hand and slip the hand touching only the inner surface. 7. With gloved dominant hand, slip four fingers underneath second glove cuff. Lift the glove away from the body. Slide the second hand into the second glove, touching only the inner part of the glove. 8. Adjust fingers of both gloves using gloved hand. 9. Raise gloved hand above waist level. GLOVE DISPOSAL 10. Grasp outside of one cuff with other gloved hand, avoid touching the wrists. 11. Pull glove off, turning it inside out. Discard in receptacle. 12. Take fingers of care hand and tuck

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inside remaining glove cuff. Pull glove of, inside out. Discard in receptacle.

GOWNING TECHNIQUE

DEFINITION  It is one of the methods of wearing sterile gown when surgical asepsis is necessary. PURPOSE  To prevent the spread of the microorganisms.  To avoid the risk of infection before undergoing invasive procedures. EQUIPMENT  Sterile gown  Sterile cap  Surgical mask  Foot cover (optional)

PROCEDURE 1. Wash hands 2. If required, put on: a. Protective cap. b. Face mask. b.1. Find the top edge of mask (usually has the metal strap along edge). b. 2. Hold the mask by top

RATIONALE To prevent and limit the transfer of microorganisms To prevent the mask from failing to the front of the uniform.

two strings. Tie two upper strings at the back of head with ties above the ear. b. 3. Tie lower strings snugly around with mask well under chin. c. Foot covers. 3. Perform thorough surgical wash. 4. Open sterile pack containing gown. Holding folded gown, locate the neckband with both hand, grasp the inside front of the gown with both hands just below neckband.

To remove resident bacteria from hands and forearm. Clean hands may touch inside of gown without contaminating the outer surface. Neckband of the gown is considered sterile. Outer portion of gown is considered sterile.

5. Allow gown to unfold, keeping inside of the gown toward the body. Do not touch outer portion of the gown with bare hands. 6. With hand at shoulder level, The inside part of slip both arms into arm holes the gown is simultaneously. A second considered person or circulating nurse unsterile and this who is not sterile bring of pull may be touched by gown over the shoulders, second person. touching only the inside

surface of the gown. Pull the gown into place and tie the neckties. 7. The gowned nurse then bends forward to make the waist ties (locate waist level on the side gown. These are then tied by second person. 8. If the gown is contaminated at any point, it is discarded and steps 3 through 7 should be repeated.

Waist ties are sterile until touched by second person. Care must be taken not to touch the front of the gown. To prevent crosscontamination.

CHECKLIST ON GOWNING TECHNIQUE

PROCEDURE 1. Wash hands 2. Put on: a. Protective cap b. Surgical mask c. Foot covers 3. Tie two upper strings at the back of head. 4. Tile lower strings snugly around with mask well under the chin 5. Perform handwashing. 6. Open sterile pack containing gown. Grasp inside front of gown with both hands just below the neckband. 7. Allow gown to unfold, keeping inside of gown towards body. Do not touch outside of gown with bare hands. 8. Slip both arms into arm holes simultaneously 9. Ask another person, bring or pull gown over shoulders an tie the neck ties. 10. The gowned nurse then bends

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forward to make the waist ties. These are then tied by second person. 11. If the gown is contaminated repeat 1 2 3 4 5 steps 3 through 7.