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Hand Antisepsis


When should we wash our hands in the perioperative setting?

Answer:

Hands should be washed:

  • upon entering the perioperative setting,
  • before and after every patient contact (contact in this situation is interpreted as an exposure to a patient and not each time you touch a patient),
  • before putting on or after removing gloves or other personal protective equipment,
  • any time there has been contact with blood or other potentially infectious materials,
  • before and after eating,
  • before and after using the restroom,
  • before leaving the health care facility, and
  • when hands are visibly soiled

Resources

  • Recommended practices for hand hygiene in the perioperative setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:63-74.

Updated January 28, 2013 

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Can nail polish be worn by personnel in the operating room?

Answer:

Nail polish that is unchipped may be worn by staff in the operating room. Studies have demonstrated that nail polish begins to harbor microorganisms when it is chipped or worn more than four days. In the event of a glove tear or perforation, the health care practitioner's chipped nail polish could potentially go into the surgical wound. Chipped nail polish should be removed to prevent contamination of the environment or the patient.

Resource

  • Recommended practices for hand hygiene in the perioperative setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:63-74.

Updated January 28, 2013 

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Can artificial nails be worn by personnel in the operating room?

Answer:

Artificial nails should not be worn in the perioperative environment. Any nail other than a natural nail is considered artificial. Artificial nails are defined as any fingernail enhancement, resin bonding, extensions, tips, gels, or acrylics. Studies have shown higher microbial counts under artificial nails than under natural nails before and after hand washing.

Resource

  • Recommended practices for hand hygiene in the perioperative setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:63-74.

Updated January 28, 2013 

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Does the first surgical hand scrub of the day have to be soap and water before using surgical hand rub products?

Answer:

A standardized surgical hand scrub with a soap (antimicrobial agent), nonabrasive sponge, and water does not have to be the first surgical hand scrub of the day before an alcohol-based surgical hand rub product is used, unless it is recommended in the manufacturer's instructions for use. The surgical hand scrub reduces the transient and resident flora of the hands, which also may reduce health care-associated infections. A standardized surgical hand scrub using an alcohol-based hand rub product will decrease transient and resident flora on the hands. Hand washing does however need to be performed before the first surgical hand scrub of the day.

Resource

  • Ogg, MJ. First surgical hand scrub of the day. [Clinical Issues]. AORN Journal. 2011;93(3):397-398.

Updated January 28, 2013 

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Can a bar of plain soap purchased at the local market be used for surgical hand antisepsis?

Answer:

Perioperative personnel should not use plain soap for surgical hand antisepsis. Surgical team members should perform a surgical hand scrub with either an antimicrobial surgical scrub agent approved for surgical hand antisepsis or an alcohol-based surgical hand rub with a persistent and cumulative antimicrobial activity according to US Food and Drug Administration regulatory requirements for surgical hand antisepsis before donning a sterile gown and gloves.

Resource

  • Van Wicklin, SA. Surgical hand antisepsis using plain soap. [Clinical Issues]. AORN Journal.2012;95(6):818-819.

Updated January 28, 2013 

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