Surgical Principles: Hand Hygiene

Method

• Traditional Scrub
  • Using Antimicrobial Scrub (Iodine vs Chlorhexidine) with Scrub Brush & Water
    • No Clear Evidence that Scrub Brush Adds Any Antimicrobial Effect
    • Use Warm Water – Not Hot (Removes Protective Fatty Acids from Skin Surface)
  • Minimum Scrubbing Time: 120 Seconds
• Aqueous Alcohol-Based Prep
  • Products:
    • “Avagard” by 3M – 1% Chlorhexidine Gluconate & 61% Ethyl Alcohol with a Skin Lotion
    • “Sterillium Rub” by Bode – 85% Ethyl Alcohol with Skin Emollient
  • General Technique:
    • Clean Under Nails for First Scrub of the Day
      • Does NOT Require a Traditional Scrub for the First Scrub of the Day Unless Visibly Soiled or Dirty
    • Dispense into Palm – Work Under Opposite Nails & Rub Over Forearm
    • Repeat with Opposite Side
    • Final Pump to Rub Over Hands Until Dry
    • *Requires 3-5 Separate Pumps, Not a Single Pump as Many Do
    • *Exact Technique Varies by Product – See Official Manufacturer Recommendations Prior to Use
  • Comparison:
    • Scrub Duration Shorter but Varies by Product
    • Less Hand Irritation
    • Shown to Be as Effective as Traditional Scrub

General Considerations

• Must Clean Under the Nails Despite Method Used
• Remove Watches & Rings
• Keep Nails Clipped
• Remove False Nails

Glove Leak-Rate

• Single-Glove: 30-50%
• Double-Glove: < 10%