J Nurs Acad Soc.  1995 Dec;25(4):653-667.

A Study on the Surgical Hand Scrub and Surgical Glove Perforation

• Yoon HS

Abstract

Post-operative wound infections have been a serious problem in nursing care in the operating room and appear to be strongly related to the infection occurring during the performance of operation. The purpose of this study is to identify patterns in duration of surgical hand scrub (SHS), to evaluate the method of SHS and to examine the rate of glove perforation. Subjects for this study include 244 doctors and 169 nurses working in the operative theatre of a hospital in Seoul area. Test samples and related data were collected from this medical facility between April 1, through 15, and July 1, through 5, 1995 by the author and a staff member working in the operating room. For the study, data on the SHS of doctors and nurses were obtained at the time of operation and multiple batches of surgical gloves worn by the operating doctors were collected after each operation. The duration of SHS was measured with a stop watch and the method of SHS was evaluated according to Scoring Hand Scrub Criteria (SHS Criteria) and expressed as SHS scores. For the analysis of the data, t-test was used to compare the differences in the duration and the SHS scores of doctors and nurses, and Pearson's correlation coefficient was used to examine the relationship between the SHS duration and the SHS scores. The results of the study are summarized as follows. 1) The mean time spent in each SHS was 167 seconds in nurses, and 127 seconds in doctors. The data comparing nurses and doctors indicated that there were significant differences in duration of SHS between these two groups (t=5.58, P=.000). 2) The mean time spent in the first SHS was 145 seconds and that in the 2nd SHS, 135 seconds, and there was not a significant difference in the duration of the SHS between doctors and nurses (t=1.44, P=.156). 3) The mean time spent in the SHS by OS (Orthopaedic surgery) doctors was 162 seconds, 150 seconds by NS (Neurologic surgery), 121 seconds by GS(General surgery), 94 seconds by OPH (Opthalmology) and DS (Dental surgery), 82 seconds by URO(Urology), 78 seconds by PS (Plastic surgery) and 40 seconds by ENT (Ear, Nose and Throat). These also showed a significant difference in the duration of the SHS among the medical specialities(t=4.8, P=.0001). 4) The average SHS score of the nurses was 15.2, while that of doctors was 13.1. The statistical analysis showed that t ?value was 3.66, P was . 000. This indicates that the nurses actually clean their hands more thoroughly than the doctors do. 5) The average SHS score of NS doctors was 15.5, 15.3 for doctors for OPH, 14.3 for OS, 12.7 for GS, 12.0 for DS, 11.7 for URO, 10.1 for PS, 7.5 for ENT. Comparison of the average SHS scores from 8 specialties showed that there was a significant differences in the patterns of the SHS (F=5.08, P=.000) among medical specialties. 6) It appears that the operating personnel scrub the palms and dorsum of their hand relatively well, however, less thorough the nails and fingers. 7) The more the operating personnel spend their time in hand scrubbing, the more correctly they clean their hands (r=.6427, P<.001). 8) The overall frequencies of perforation in all post-operative gloves tested was 38 out of 389 gloves (10.3%). The perforation rate for PS was 13%, 12.1% for GS, 8.8% for OS, and 3.3% for NS.

MeSH Terms

Fingers
Gloves, Surgical*
Hand*
Nose
Nursing Care
Operating Rooms
Seoul
Wound Infection