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The following recommended practices were developed by the AORN Recommended Practices Committee and have been approved by the AORN Board of Directors. They were presented as proposed recommended practices for comments by members and others. They are effective Jan 1, 1999.
These recommended practices are intended as achievable recommendations representing what is believed to be an optimal level of practice. Policies and procedures will reflect variations in practice settings and/or clinical situations that determine the degree to which the recommended practices can be implemented.
AORN recognizes the numerous types of settings in which perioperative nurses practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive procedures may be performed.
Purpose: Skin is a major potential source of microbial contamination in the surgical environment. Although scrubbed members of the surgical team wear sterile gloves, the skin of their hands and forearms should be cleaned preoperatively to reduce the number of microorganisms in the event of glove tears.
The purpose of the surgical hand scrub is to
remove debris and transient microorganisms from the nails, hands, and forearms;
reduce the resident microbial count to a minimum; and
inhibit rapid rebound growth of microorganisms.
RECOMMENDED PRACTICE I
All personnel should be in surgical attire before beginning the surgical hand scrub. Interpretive statement 1:
Before entering the restricted areas of the surgical environment, all personnel should wear scrub clothes, hair coverings, and masks. Protective eyewear and other protective barriers should be worn as needed.
Rationale:
Surgical attire reduces shedding and promotes environmental control.1
Interpretive statement 2:
Rings, watches, and bracelets should be removed before beginning the surgical hand scrub.
Rationale:
During hand washing, rings, watches, and bracelets may harbor or protect microorganisms from removal. Allergic skin reactions may occur as a result of scrub agent or glove powder accumulating under jewelry.2
Interpretive statement 3:
Fingernails must be kept short, clean, and healthy. Rationale:
The subungual region harbors the majority of microorganisms found on the hand. Removing debris from fingernails requires the use of a nail cleaner under running water. Additional effort is necessary for longer nails. The risk of...