Name: Section:

SURGICAL HANDWASHING (Counted Brush-Stroke Method)

DEFINITION
A procedure of washing hands with antimicrobial agents and surgical brush using proper technique to remove as
many microorganisms as possible from the skin of the hands and arms before donning sterile surgical attire. The
counted brush stroke method allots a set number of brush scrub strokes to each designated surface of the hands
and forearms.

PURPOSE
- To decrease the number of resident microorganisms on skin to an irreducible minimum.
- To keep the population of microorganisms minimal during the surgical procedure by suppression of growth.
- To reduce the hazard of microbial contamination of the surgical wound by skin flora.

EQUIPMENT
 Surgical brush
 Running water
 Shoe covers, cap, face mask, and protective eyewear
 Liquid soap
 Orange stick or a file

Considerations before the procedure:

- All jewelry should be removed from the hands and forearms.
- Fingernails should be free of polish and trimmed short. Cuticles should be in good condition.
- Hands and forearms should be free of open lesions and breaks in skin integrity.
- All personnel should be appropriately attired.

Things to follow up after the procedure:

- Do after care.
- Allow the hands and arms to dry before donning gloves.

Things that need to be documented:

Surgical handwashing done.

Things to remember to maintain safety:

- Check the water temperature and regulate the flow of water to prevented contaminating the attire.
- Check hands for open wounds and cuts.

PERFORMANCE INDICATORS:
C –The step was correctly performed
X- The step was not performed
N- The execution of the step needs improvement
R- The step was correctly performed after remediation

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 PROCEDURE RATIONALE CX NR
1. Wear surgical attire: shoe covers, cap, face mask, To protect oneself from infection and to
and protective eyewear. prepare for the operation.

2. Turn on water using knee or foot controls and Water that is too hot can chap the skin.
adjust to comfortable temperature.

3. Wet hands and arms thoroughly under running - The water should flow from the least
lukewarm water and lather with liquid soap up to contaminated (hands) to the most
2 inches above elbows. contaminated area (arms).
- Liquid soap lather emulsifies fats and aids
in cleansing.
4. With hands Hands are held above elbows to allow the
always above water to run from the cleanest area (hands)
the down the elbows (least clean area).
elbows, rinse
hands and
arms
thoroughly
under
running
water,
allowing the water to run
from the hands to the
elbows.

5. Under running water, clean under nails of both Orangewood stick helps remove dirt and
hands with an orange stick or a file. Discard after reduces chance of microorganisms under the
use. nails.
6. Wet brush and apply a sufficient amount of liquid To ensure to remove dirt and
soap. Lather fingertips with sponge-side of brush, microorganisms in spaces under the
then using the bristle side of brush, scrub the fingernails.
spaces under the fingernails of one hand with 30
circular strokes.

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 7. Lather digits and scrub 20 circular strokes on all four To remove dirt and transient
sides of each finger of same hand. microorganisms on all four sides of each
finger.
8. Holding brush perpendicular, lather and scrub the To reduce and remove dirt and
palm, the posterior side of the hand, and the space microorganisms on the palm, at the back of the
between thumb and index finger with 20 circular hand, and the space between thumb and index
strokes each. finger.
9. The arm up to 2 inches above the elbow is mentally This ensures that all area of the arm are
divided into three regions, and each third is covered and that microorganism and dirt are
scrubbed 20 strokes. removed.
10. Repeat steps 6 to 9 for the other arm. To ensure that both hands are washed and
scrubbed.
11. Discard brush without contaminating your To prevent transfer of microorganisms
hand. from the brush to the hands.
12. Rinse hands and arms thoroughly with hands To remove soap thoroughly on hands. Hands
above the elbow. must be held above elbow to allow water to
run from hands to elbow.
13. Turn off water with foot or knee control. To prevent contaminating the hands with
the faucet.
14. Allow the water to drip from your elbows before This prevents the water from dripping into the
entering the operating room with hands elevated scrub suit and the operating room.
in front of and away from the body.
Ability to answer questions

Date of
Completed YES NO Signature
Compilation

Remarks:

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