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Scrubbing: before and after
The experfs research
Scrubbing: before and after Q. How long should a nurse scrub between cases if she does not remove her gloves until immediately prior to scrubbing? A. A simple answer giving the length of time is not possible because of the many variances in o situation. After the initial scrub of the day, according to the operating room policy, the between case cleansing of the hands may be a simple, short wash with detergent, germicide or soap, provided that the following criteria are met:
1. There ore no holes in the gloves.
2. The nurse is a consistent scrubber and the only bacteria present on the hands i s the accumulation since the previous wash. At the end of each case, we recommend all members of the OR team remove their gown and gloves before leaving the operating room. Then the scrub time for cases following all initial scrubs should be a minimum of three minutes. An OR policy covering the scrub procedure must be established and adhered to by all members of the team.
Q. In recent months we again have received numerous questions regarding handling of septic cases and methods of cleaning the OR after such cases. We shared these concerns with an expert from the Center for Disease Control, Atlanta, Georgia, where work is constantly underway on the problem of nosocomial infection. We asked what the viewpoint was based on current work there.
April 197R
0 0 A. Replying to this problem, frank S. Rhame, MD, stated, 'We do not know of direct or indirect evidence that, if adequate intracase cleaning is performed, "dirty cases" represent an increased infection hazard to patients undergoing subsequent operations. Theoretical considerations do not provide an adequate basis for requiring additional cleaning efforts. Adequate terminal cleaning generally requires sufficient time for more than four air exchanges to occur (easily met within 20 minutes in hospitals meeting minimum Hill-Burton design requirements); this will remove 99 percent or more airborne microbial contamination, which could be important if the previous patient had a disease that might be spread by the airborne route. There should be a thorough mechanical cleaning of the operating room table and floors with a fresh solution of a good disinfectant detergent and clean tools between each case." Thus, it appears that ongoing microbiological studies bear out the position taken by AORN in this matter. All cases should receive the same careful technique and the same thorough cleanup between cases. There should only be one method of handling all cases. Regardless of the type of operation, each patient deserver the same quality care and concern.
0
-A ORN Professional Advisory Commiffee
35
Scrubbing: before and after Q. How long should a nurse scrub between cases if she does not remove her gloves until immediately prior to scrubbing? A. A simple answer giving the length of time is not possible because of the many variances in o situation. After the initial scrub of the day, according to the operating room policy, the between case cleansing of the hands may be a simple, short wash with detergent, germicide or soap, provided that the following criteria are met:
1. There ore no holes in the gloves.
2. The nurse is a consistent scrubber and the only bacteria present on the hands i s the accumulation since the previous wash. At the end of each case, we recommend all members of the OR team remove their gown and gloves before leaving the operating room. Then the scrub time for cases following all initial scrubs should be a minimum of three minutes. An OR policy covering the scrub procedure must be established and adhered to by all members of the team.
Q. In recent months we again have received numerous questions regarding handling of septic cases and methods of cleaning the OR after such cases. We shared these concerns with an expert from the Center for Disease Control, Atlanta, Georgia, where work is constantly underway on the problem of nosocomial infection. We asked what the viewpoint was based on current work there.
April 197R
0 0 A. Replying to this problem, frank S. Rhame, MD, stated, 'We do not know of direct or indirect evidence that, if adequate intracase cleaning is performed, "dirty cases" represent an increased infection hazard to patients undergoing subsequent operations. Theoretical considerations do not provide an adequate basis for requiring additional cleaning efforts. Adequate terminal cleaning generally requires sufficient time for more than four air exchanges to occur (easily met within 20 minutes in hospitals meeting minimum Hill-Burton design requirements); this will remove 99 percent or more airborne microbial contamination, which could be important if the previous patient had a disease that might be spread by the airborne route. There should be a thorough mechanical cleaning of the operating room table and floors with a fresh solution of a good disinfectant detergent and clean tools between each case." Thus, it appears that ongoing microbiological studies bear out the position taken by AORN in this matter. All cases should receive the same careful technique and the same thorough cleanup between cases. There should only be one method of handling all cases. Regardless of the type of operation, each patient deserver the same quality care and concern.
0
-A ORN Professional Advisory Commiffee
35