Identify proper handwashing techniques for medical and surgical situations
Identify proper handwashing techniques for medical and surgical situations
LO 01.06 – Identify 10 parts of a microscope
LO 01.07 – Describe how to use a compound microscope
LO 02.03 – Describe how to apply medical asepsis and surgical asepsis
Career Relevancy
The roles and responsibilities of a medical assistant are absolutely vital, and in your work, you’ll make sure medical practices are performed safely and effectively. In fact, without the work of a medical assistant, the health and well-being of patients and other medical professionals might be compromised. When it comes to providing aseptic environments for everyone, you’ll have to be educated on very specific procedures, including handwashing and using equipment like microscopes. Handwashing, specifically, is one of the most important tasks you’ll do as you prepare for various types of examinations and surgery, so knowing how to do it correctly is essential. As part of your everyday tasks, you’ll be assisting with procedures that require you to use aseptic techniques of all kinds. Practicing these methods of reducing patient and provider infection will prepare you for any healthcare work and setting.
Background
washing hands
Luca is back on the job—this time, with a little more information under his belt. He’s feeling like he’s getting a better grasp of what asepsis is all about and how he can use the principles of asepsis to be the best healthcare professional he can be.
But when he gets to work, Luca is confronted with an unfamiliar situation. Luca’s supervisor, Penny, tells him he’s got two different medical procedures to prepare for today; one requires medical asepsis and one requires surgical asepsis. Despite his new knowledge, he still isn’t sure about one critical practice in creating aseptic environments: handwashing.
Fortunately, Penny shows him the ropes. Penny explains that the skin is a major source of contamination that cannot be sterilized. So, specific handwashing techniques must be used to significantly reduce the number of bacteria on the hands and arms before sterile gloves are put on. This, she explains, is key if you want to create an aseptic field.
For medical asepsis, Luca watches Penny perform two different handwashes. For the first, she uses soap and water. Typically called hand hygiene, this type of handwash is used often in medical settings, and it should always be utilized when dirt or organic material is visibly present on hands. Penny approaches a sink and walks Luca through it.
Penny pushes her gown sleeves above the wrists to expose her hands. She then removes her watch and wedding ring. Removing jewelry and clothing is a necessary first step.
Then, she turns on the water and gets her hands and wrists wet.
Next, she squirts 3 to 5 ml of liquid soap from a soap dispenser onto her wet hands. She rubs the soap all over—on the tops of her hands and the palms, as well as in between her fingers.
She rubs her hands for at least 15 seconds. She lathers each finger and scrubs them individually, and she rubs around her hand and under the fingernails. Doing a thorough, rigorous rub should take a while—this removes more microorganisms.
Penny rinses and dries her hands completely using a paper towel, rubbing from the fingers to the forearm.
She uses the paper towel to turn off the faucet and does not touch the paper towel using the opposite hand.
Penny has finished this first handwash, but there’s one other one that is used in the application of medical asepsis situations. This is an alcohol-based hand rub, and it’s often used when hands are not soiled, but you suspect that microorganisms are present and could lead to contamination. It’s a quick handwash that disinfects the hands. Penny starts off the same way, but then the process changes.
She rolls up her gown sleeves again. She’s already taken off her ring and watch, but removing these accessories is imperative for every handwash.
She applies a hefty amount of antiseptic hand rub to her hands and wrists.
She rubs her hands for 15 to 30 seconds until the solution is dry. Just like the first handwash, she rubs each finger individually, the back of her hand, and under her nails.
Luca steps up, ready to practice each type of handwash. But Penny, now with extra clean hands, stops him. She says there is one more type of handwash he needs to learn, and it’s often called a surgical hand scrub or an antiseptic handwash. This is done before an operation, surgery, or another type of invasive procedure. It’s a method of handwashing that is used for surgical asepsis; it’s an antiseptic wash and scrub that is performed before sterile gloves and attire are put on.
Penny has already removed her jewelry, but she would do this now if this were the first handwash for the procedure. She shows Luca that she has no chipped nail polish, extenders, or artificial nails. She also shows him that she has no sores or abrasions. If she did, she’d need to cover them up or speak with her supervisor.
She pushes her sleeves up to about 2 to 3 inches above the elbows.
She then turns on the water at the sink. Warm water is recommended.
Next, she washes her hands with soap and water, as she did when she performed hand hygiene.
Next, she applies the required amount of antimicrobial soap to hands. She creates a substantial lather.
Then, while keeping her hands lifted above her elbows, she starts scrubbing each side of each finger of one hand. She rubs between the fingers and under each nail with a file, as well as the back and front of her hands. She does this for 4 minutes; most medical facilities require 3- to 5-minute hand scrub procedure.
She scrubs the arm of that hand using an up-and-down movement, always keeping the hands above the elbows. She washes the side of her arm, from wrist to elbow, for a minute.
Then, Penny repeats steps 5, 6, and 7 with the other arm and hand.
She rinses her hands and arms with her hands still raised, letting the water drip down from the fingertips to her elbow.Then, she then dries her arms using a sterile towel and keeping her arms above her waist before donning sterile gloves.
Luca practices doing the handwashes, preparing for each of the medical and surgical asepsis situations he has scheduled for the day. He does a great job, and everyone is pleased with his contribution. But afterward, Penny approaches him. She tells him that at some point soon, he’s going to need to know his way around a microscope.
Luca goes home and begins to research. In school, he learned a bit about microscopes, but he still feels like there’s more to know. First, he takes a look at the Course Online Resource for a labeled diagram of microscope parts, which identifies the main parts and structures of a compound microscope.
Then, he reads the description. A compound microscope is typically used to magnify and view images of small objects on a glass slide. In medicine, compound microscopes are used by laboratory analysts, researchers, pathologists, and other specialists to view cells and tissue samples. This can help them diagnose infections and identify abnormalities.
Luca finds this video (5:09 min) on handwashing just to solidify what he learned earlier in the day.
Resources and References
Anatomical Surgical Hand Scrub. (2018, December 14). Johns Hopkins Medicine. Retrieved from https://youtu.be/WpZqLbWL0c0 (Links to an external site.)
Doyle, G. R., and J. A. McCutcheon. (2012). Sterile Procedures and Sterile Attire. OpenStax. Retrieved from https://opentextbc.ca/clinicalskills/chapter/sterile-gloving/ (Links to an external site.)
Medical and Surgical Asepsis. (n.d.). CNA Free Training. Retrieved from https://cnafreetraining.com/training-materials/health-and-safety/medical-surgical-asepsis/
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