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Procedure: Surgical asepsis: Hand scrub

Surgical asepsis: Hand scrub using water, a scrub sponge, and antimicrobial
Checklist:
soap
Evaluator's Name: Examinee's Name:
Evaluator's ID: Examinee's ID:
Evaluator's Dept: Examinee's Dept:
Date: Meets criteria/Does not meet criteria:
Select Evaluation Method:
Clinical Observation Documentation Review
Demonstration Verbalization

Surgical asepsis: Hand scrub using water, a scrub sponge, and

antimicrobial soap
Objective: To perform a surgical hand scrub using water, a scrub sponge, and
antimicrobial soap according to the standard of care.

Checklist Step Comments

Y- Meets; N- Does not meet; I- Not Applicable

__ Perform hand hygiene before and after each

patient contact, when you make contact with a
contaminated source, and after removing gloves.

__ Examine your fingernails to ensure that they're

clean, healthy, and short.

__ Inspect your hands for cuts, abrasions, dermatitis,

and hangnails.

__ Remove jewelry from your hands and forearms.

__ Put on a surgical mask.

__ Turn on the water and bring it to a comfortable

temperature.

__ Wet your hands and forearms.

__ Use a hands-free pump to dispense antimicrobial

soap into your hands. Add enough water to make
a lather.

__ Wash your hands and forearms with antimicrobial

soap and running water for at least 15 seconds.

__ Rub your hands together vigorously, covering all

surfaces of the hands and fingers.

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© 2024 Skills Checklist - Surgical asepsis: Hand scrub using water, a sc... https://legacy-procedures.lww.com/lnp/form/printPage.jsp

__ Clean under your nails using a disposable nail

cleaner under running water.

__ Rinse well before beginning the surgical scrub.

__ Open the packaged scrub sponge and run it under

water.

__ Dispense antimicrobial soap and rub it into your

hands and forearms with the sponge.

__ Scrub each side of your fingers, hands, and arms

while keeping the hands elevated.

__ Start with your fingernails and work your way up

the fingers, paying particular attention to the
webbed area between each finger.

__ Scrub the hand and then the wrist and forearm,

finishing 2″ (5 cm) above the elbow.

__ Keep your hands above your elbows.

__ Repeat the sequence with your other hand and

arm.

__ Complete a timed scrub.

__ Avoid splashing your surgical attire.

__ Drop the sponge into an appropriate container.

__ Rinse both hands and arms, keeping your hands

above your elbows.

__ Holding your hands and arms up in front of your

body with your elbows slightly flexed to keep
hands above your elbows, enter the operating
suite.

__ Dry your hands and forearms with a sterile towel:

Grasp the folded towel near the corner and
extend your arms to open the towel, blot dry one
hand using half the towel and dry the forearm up
to the elbow, dry the other hand and arm using
the other half of the towel, and discard the towel
in an appropriate receptacle.

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