University of Negros Occidental – Recoletos

College of Allied Medical Health Sciences

Bacolod City, Philippines 6100
Tel. 433-2449 LOCAL 1111

NAME: AEIRA ANGELIQUE R. LAGDAMEN

COURSE & SECTION: BSN N31 (B)

"Infection Prevention in Action: The Role of Surgical Hand Scrubbing"

INTRODUCTION:

An essential role for hand antisepsis is in the prevention of surgical site

infections. The objective of this study was to comprehensively analyze the studies
comparing the effectiveness of both the technique and the antiseptics employed during
surgery. Despite the fact that surgical hand washing has been normal procedure for
many years, there is still no recognized standard protocol that explicitly outlines the
scrubbing technique and the antiseptic solution to be used.

According to numerous research, any antiseptic agent can be used in

conjunction with nail cleaning and scrubbing. However, numerous studies indicate that
using a nail cleanser or cleaning is unnecessary and that scrubbing with a good
antiseptic would be sufficient.There is ongoing discussion about the procedure and
products employed in surgical hand cleaning. In this assessment, we looked at
experimental and randomized controlled studies comparing the effectiveness of surgical
hand washing techniques and the antiseptics employed. After thoroughly considering all
of the data that was available, I made the decision to pursue this issue for health
promotion.
SUMMARY 1

“Impact of methods and duration of surgical hand scrub on bacterial count: A

randomized controlled trial”
Parlak EA, Iyigun E, Albay A, Bedir O. (2021 May 23)

The surgical cleaning process isn't controlled by a set protocol. By examining

their impacts on bacterial count, this study compares the efficiency of surgical hand
scrub time and procedure. 180 surgical nurses and surgeons participated in the study.
Group I participants utilized a nail brush, whereas Group II participants did not, during
the one-minute surgical hand scrub in Groups I and II. Both Groups III and IV scrubbed
their hands for two minutes, however Group III used a nail brush whereas Group IV did
not. All participants' hands were counted for bacteria before and after a surgical hand
scrub and following surgery using the glove juice technique.

After a surgical hand scrub, Group III participants had a considerably higher
bacterial count on their hands than Group IV participants (P .001). When comparing the
bacterial count on the hands before and after a surgical hand scrub, Group II and Group
IV did not show any statistically significant differences. According to this study, brushing
hands after a surgical hand scrub made them more contaminated. Additionally, both a
one-minute surgical hand scrub and a two-minute scrub were equally successful at
reducing the amount of bacteria on the hand.

SUMMARY 2:
 “Alcohol-based surgical hand preparation: translating scientific evidence into
clinical practice”
Gaspar, G.G., Menegueti, M.G., Lopes, A.E.R. et al (2018).

Implementation may be difficult due to surgeons' refusal to changing their

practices, even though alcohol-based surgical hand preparation offers potential
advantages over the conventional surgical scrubbing procedure. In order to avoid
surgical site infections, we wanted to introduce alcohol-based surgical hand preparation
in the hospital setting. We next evaluated the effects on the procedure's length and
quality.a quasi-experimental study carried out in a university hospital providing tertiary
care from April 1 to November 1, 2017. Participants included patients treated by
orthopedic and cardiac surgical teams. Making alcohol-based hand rub available in the
operating room, persuading and instructing surgical teams to use it, encouraging direct
observation of surgical hand preparation, and providing collective feedback on the
preparation's caliber comprised the intervention.

534 surgical hand preparation activities were observed. In the pre-intervention

period and the intervention period, we saw 100% compliance with all the steps indicated
in the WHO approach in each of the 33 subjects for whom complete data were available
for both study periods. The length of the preparation was shorter after the intervention
than it had been before. Between the pre-intervention and the intervention phases,
there was no discernible difference in the individual risk of acquiring a surgical site
infection.

Results show that alcohol-based surgical hand preparation is at least as effective

at preventing surgical site infections as the conventional surgical scrub, with better
quality and shorter preparation times.

SUMMARY 3:
 “What is better for surgical hand disinfection: scrubbing or rubbing?”

Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert

Koch-Institut (RKI) (2016)

Only hand rubbing with 60% propanol maintained a substantial reduction of the
bacterial load after 3 hours, despite an immediate drop being observed for both
products, according to a recent study comparing hand scrubs and rubs. Sustained
effectiveness is as crucial to rapid activity in surgical procedures because they can last
longer than 3 hours. Aside from their obvious effectiveness, volatile alcohols are
perfectly capable of having the same long-lasting impact on germs as microbicidal
agents. However, employing the scrubbing sink comes with the risk of sink
contamination.

Scrubbing has a lot of potential for causing skin irritation, allergies, and, in rare
instances, anaphylactic reactions when CHG-containing products are used often.
However, repeated surgical hand disinfection over extended periods of time is
necessary to protect patients from SSI. The skin-drying impact of ABHR can be
lessened by the addition of glycerol, in contrast to CHG, and they are characterized by
good skin compatibility. The World Health Organization claims that humectant-
containing alcohol-based solutions or gels are substantially less drying and irritating to
the skin than soaps or antimicrobial detergents.

Analysis and Reaction

 Surgical hand scrubbing is essential because healthcare workers' hands can
harbor harmful microorganisms that may lead to post-operative infections. Scrubbing
helps reduce the microbial load on the hands. Proper technique and duration are vital
for effective hand scrubbing. Healthcare workers should use an antimicrobial soap and
scrub their hands and forearms for a specific duration.

Recognizing the critical role of hand scrubbing in patient safety, healthcare

professionals must adhere to strict protocols and guidelines to ensure effective hand
hygiene. Healthcare workers should undergo rigorous training and periodic
assessments to ensure they adhere to correct techniques and timing. This helps
maintain consistency and effectiveness in hand scrubbing.

Recommendation:

Surgical hand scrubbing is a crucial step in maintaining aseptic conditions in the

operating room. Proper hand scrubbing helps reduce the risk of surgical site infections.
Health workers should must use an antimicrobial surgical scrub solution that meets
regulatory guidelines. Wash your hands and forearms thoroughly with an antimicrobial
soap for at least 2-5 minutes, paying close attention to all areas, including under the
nails. Rinse your hands and forearms with warm water, allowing the water to flow from
your hands to your elbows.

Remember that the specific protocols for surgical hand scrubbing may vary by
institution, so it's essential to follow the guidelines and procedures established by your
hospital or surgical center. Adhering to proper hand hygiene practices is critical in
preventing surgical site infections and maintaining a safe surgical environment.