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National Infection Prevention and Control Manual

National Infection Prevention and Control Manual

Appendix 4 - Best Practice - Surgical Rubbing

Step by step images for surgical hand preparation technique using alcohol based hand rub (ABHR)

The hand rubbing technique for surgical hand preparation must be performed on clean, dry hands.

On arrival in the operating theatre and after having donned theatre clothing (cap/hat/bonnet and mask), hands must be washed with soap and water.

After the operation when removing gloves, hands must be rubbed with an alcohol-based formulation or washed with soap and water if any residual talc or biological fluids are present (e.g. the glove is punctured).

Surgical procedures may be carried out one after the other without the need for hand washing. provided that the hand rubbing technique or surgical hand preparation is followed (images 1-15).

 Put approximately 5ml (3 doses) of alcohol-based hand rub in the palm of your left hand, using the elbow of your other arm to operate the dispenser.Dip the fingertips of your right hand in the hand rub to decontaminate under the nails (5 seconds).Steps 3-4. Smear the hand rub on the right forearm up to the elbow.Steps 3-4. Smear the hand rub on the right forearm up to the elbow.Steps 5-7. Ensure that the whole skin area is covered by using circular movements around the forearm until the hand rub has fully evaporated (10-15 seconds).Steps 5-7. Ensure that the whole skin area is covered by using circular movements around the forearm until the hand rub has fully evaporated (10-15 seconds).Steps 5-7. Ensure that the whole skin area is covered by using circular movements around the forearm until the hand rub has fully evaporated (10-15 seconds).Repeat steps 1 to 7 for the left hand nails and arm.Put approximately 5ml (3 doses) of alcohol- based handrub in the palm of your left hand, using the elbow of your other arm to operate the distributor. Rub both hands in the same time up to the wrists, and ensure that all the steps presented in steps 9-14 are followed.Cover the whole surface of the hands up to the wrist with alcohol-based hand rub, rubbing palm against palm with a rotating movement.Rub the back of the hands up to the wrist with alcohol-based handrub, rubbing palm against palm with a rotating movement.Rub the back of the left hand, including the wrist, moving the right palm back and forth and vice-versa.Rub palm against palm back and forth with fingers interlinked.Rub the thumb of the left hand by rotating it in the clasped palm of the right hand and vice versa.When the hands are dry, sterile surgical clothing and gloves can be donned.

National Infection Prevention and Contol Manual

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