Quality of surgical scrub in a heart hospital: Do not take it for granted

Abstract

Introduction: The role of scrub in the prevention of post-surgery infections is well-known. This study aimed to investigate the inputs and process of surgical scrub in operating rooms of the largest heart hospital of northwest Iran. Methods: This study took place with a before-after design as a clinical audit in 2014. A check list developed based on national and international standards of surgical hand scrub was used as the study instrument. Checklists were completed by observation of surgical team scrubbing in real situation. Descriptive statistics and graphs were used to describe the results. Results: A compliance degree with the standards for prerequisites, equipment, general items, process and time of scrub was observed as 58%, 55%, 33%, 68% and 22%, respectively. The compliance degree after the intervention was 72%, 66%, 66%, 85% and 61%, respectively. Improvement was observed in all studied aspects of scrub. The total score of compliance with the standards changed from 47% to 70%. The main issues were incorrect order of scrubbing the areas of the hands, incorrect way of scrubbing the arms, insufficient scrubbing the arms (not above elbow), and lack of awareness about hospital’s policy on scrub time. Conclusion: The results showed defects in the surgical scrub of the studied hospital and that the compliance with the standards can be improved by simple interventions. Periodical audit and observation of the scrub and then feedback is recommended.

Compliance of surgical hand scrub in operation theatre of teaching hospital, Chitwan

“…Several studies of similar type have shown that significance dissimilarities of level of surgical hand scrub compliance. 4,6,10,[12][13][14] This study found that only 13% of respondents had compliance the surgical hand scrub according to the standard checklist criteria of (more than 90% score without missing critical steps).…”

“…minimum 3 minutes. 9 The most commonly use products for surgical hand antisepsis is chlorhexidine or povidine-iodine containing soaps.1 Abdollahi et al 10 found that compliance with scrub prerequisites 58%, scrub process 68%, 2 minutes scrub time 22% and scrub equipments 55% in pre-test. Dhakal, Angadi & Lopchan 11 claimed that nurses (4.29%) on operation theatre did not scrub hands well to two inch above the elbow and completed the procedure less than 3 to 5 minutes.…”

Can Medical Students Lead Effective Quality Improvement Initiatives? A Systematic Review

“…Checklists and posters appear to be a sustainable and a low-resource intervention; these were very commonly used and appeared to generate some very positive results. 13,18,19,28 However, the low variation and low use of technology in interventions leaves significant room for improvement. We are moving into an era in which “big data” has the ability to drive improvement and technological intervention and, with nearly every patient in Organisation for Economic Co-operation and Development countries owning a smartphone, this appears to be an underutilized way to collect data, perform interventions, and quickly validate them.…”

Effectiveness of Surgical hand Washing with Chlorhexidine, Providone iodine and Alcohol on Reducing the Microorganisms on the Hands: A Systematic Review

“…This is one of the causes of mortality in patients after surgery. The most common cause is the hands of the surgical team (Abdollahi, Tabrizi, Jodati, Safaie, & Moradi-joo, 2017). Perioperative hand hygiene is one of the most critical factors affecting the risk of surgical site infection (SSI) as well as the safety of the medical staff (Tsai, Lin, Huang, Loh, & Wen, 2016).…”

“…Surgical hand wash preparation is recommended by both the Center for Disease Control and Prevention (CDC) and the WHO for preventing SSI in all kinds of surgical procedures. According to the CDC, proper hand washing can reduce the occurrence of nosocomial infections (HCAI) to 30% (Abdollahi et al, 2017). The application of surgical hand washing is recommended by the CDC and WHO to prevent SSI in all types of surgical procedure (Gaspar et al, 2018).…”