A Survey on the Performance of Surgical Hand Scrubs

Yoon, Hae Sang

Abstract

The surgical hand scrub(SHS) is the single most important procedure in the prevention of postoperative wound infections and yet it remains the most violated of all infection control procedures. The purpose of this study was to gain an overview of SHS habits in operative theatre personnel and to determine knowledge and attitudes to identify whether there is a need for improvement. The subjects for this study included 79 doctors and 94 nurses working in the operative theatres of four hospitals in Incheon City and Kyungki Province. Related data were collected from July 25 to August 10, 1995 by the author. The data were analyzed using descriptive statistics and Chi-squre test. The results of the study are summarized as follows: 1. Nurses felt that they conducted SHS for a longer period of time than doctors did(X=20.1, P= .005). 2. Nurses and doctors had some knowledge of slipping rings off fingers and the length of nails, but they lacked knowledge on the duration of SHS, handwashing after an operation and on manicure. 3. There were many reasons given for insufficient SHS included: 1) because they were so busy (38%). 2) brushes were too harsh(19.7%). 3) operations were very simple(18.7%). 4) surgical latex gloves provide functional barrier(11.6%). 5) SHSs were troublesome(7.4%) 6) there were no clocks near the sinks(2.5%) and 7) the operative patients were administered antibiotics after operartion(2.1%). 4. Most of nurses and doctors considered SHS to be important in prevention against post operative infections. 5. Nurses were found to do a thorough SHS, but residents were found to neglect SHS. 6. Considering prevention against postoperative infections, most nurses and doctors considered aseptic techniques, environment-sanitary management and SHS more important than the use of antibiotics, the resistance of patients or the method of operation. 7. Half of the nurses and doctors(54.3%) considered surgical latex gloves to function well as a barrier. 8. Half of the nurses(56.4%) and doctors(51.9%) learned SHS as part of the curriculum in their school education and the rest (nurses: 95.7%, doctors: 74.7%) learned SHS as part of their In Service Education. In conclusion, these findings suggest a need to develop an educational program on surgical hand scrub and hospital infection control for surgical personnels, to install clocks near the hand scrub sinks, to consider a violation report for negligent surgical hand scrubs, and to develop a soft brush for hand scrubs in order to increase performance of the surgical hand scrub.