Scrub Nurse Questions
(Q)How do Scrub Nurses get involved in the preparation and performance of surgical
procedures and ensure a safe environment for the patient ?
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(A) All staff will be aware of the principles of asepsis, have received appropriate
training in and have been assessed as competent in this skill, before undertaking any
procedure requiring an aseptic technique to be applied.
Perioperative staff with infected skin lesions of the skin or bacterial infections of the
upper respiratory system should not participate in any aseptic technique.
Staff participating in an aseptic procedure should be scrubbed, gowned and gloved.
Personnel participating within sterile procedures must stay within the sterile
boundaries, and a wide margin of safety should be given between scrubbed and nonscrubbed persons.
All pre-sterilised articles must be checked for damage and expiry date prior to use.
Any packs found to be in an unsatisfactory condition must be discarded.
All items used within the sterile field must be sterile.
An adequate quantity of sterile drapes must be used to establish a sterile field.
To maintain asepsis, it is essential that all staff are aware of the correct method of
opening sterile packages, to avoid contamination of their contents.
Dressings must be removed carefully from pre-existing wounds to prevent scattering
of microorganisms into the air. An assistant wearing gloves rather than a scrubbed
member of the surgical team should carry this out.
Talking, moving, opening and closing of doors, exposure of wounds, disturbance of
clothing or linen and number of personnel in theatre should be kept to a minimum to
reduce the risk of airborne cross infection.
(Q) What is the safest and most hygienic way to insert a urinary catheter into a female
patient who is undergoing a surgical procedure.
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(A) All staff will be familiar with the hospital policy regarding female catheterisation.
Theatre staff will maintain patient dignity and minimise risk of infection to the patient.
All staff will receive the appropriate training and have been assessed as competent
prior to performing this procedure.
Theatre staff will place patient with hip flexed and knees bent, feet should be resting
about 60cm apart.
Theatre personnel must ensure that the patient’s privacy and dignity are maintained
at all times. Excess staff/ visitors must be asked to leave the theatre.
Staff must ensure that the patient remains covered until theatre staff are ready to
perform the procedure.
Good visibility must be ensured by use of theatre lighting.
Staff must wash their hands using bactericidal soap or bactericidal alcohol hand rub.
Staff must don sterile gloves and an apron.
A member of staff is to open the outer catheter pack; the nurse performing the
procedure can then proceed to open supplementary packs maintaining an aseptic
technique.
Place a sterile sheet across the patient’s thighs.
Separate the labia minora so that the urethral meatus is seen. Using swabs provided
on the pack, one hand should be used to maintain labial separation until
catheterisation is complete. This provides better access to the urethral orifice and
helps prevent labial contamination of the catheter.
The urethral orifice will be cleaned using 0.9% NaCl solution; single downward
strokes will be used. This minimises the risk of cross-infection.
The urethral orifice or catheter should be lubricated using sterile aqueous lubricating
jelly, or sodium chloride solution.
The catheter, of appropriate size as assessed by the theatre practitioner or surgeon,
is placed in the receiver between the patient’s legs, this provides a temporary
container as the urine drains.
The tip of the catheter is introduced into the urethral orifice and the catheter
advanced 6 – 8 cm, to prevent the balloon from being trapped in the urethra.
The balloon is inflated with the appropriate quantity of sterile water as dictated by the
manufacturers instructions, having ensured that the catheter is draining adequately
i.e. having visualised urine flowing.
The catheter bag is attached to the catheter, using hourly drainage measuring
devices when appropriate to the surgery.
Ensure that the catheter lumen is not occluded and that the patient is not lying on the
catheter.
Staff must ensure that the patient is dry to prevent secondary infection and skin
irritation.
Used equipment is disposed of into the yellow contaminated waste bag.
(Q) Why should staff in the department be aware of the measures that need to be taken
in the event of the spillage of a hazardous substance ?
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(A) All staff must adhere to COSHH regulations and be conversant with the Trust
COSHH policy for dealing with spillages.
Staff will be conversant with the substances used in the Operating Theatres that are
considered a risk by COSHH
All staff handling hazardous substances must receive training appropriate to their role
and responsibility.
COSHH training is mandatory on appointment to the Trust and it is recommended
that updates are received every two years.
Staff must wear protective clothing, in adherence with the trust policy, when dealing
with disposal of contaminated waste.
Staff will be aware of the measures to be taken in the event of a spillage, regarding
appropriate protective clothing, evacuation requirements etc.
All identified hazardous substances will be handled with care and compliance to
manufacturers instructions adhered to.
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Handling of identified hazardous substances will be kept a minimum.
Any untoward occurrences involving hazardous substances must be reported, with
referral to the Occupational Health Department as necessary.
(Q)How do you make sure that alll instruments used during surgical procedures will be
returned to DSDU for reprocessing in a manner that minimises risk to all staff handling
the contaminated items ?
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(A) All instrumentation used will be accounted for and returned to its original tray at
the end of each operative procedure.
All disposable items will be removed and safely disposed of.
It is the scrub person’s responsibility to ensure that all sharps are removed and
discarded.
Instruments which may potentially cause injury will be closed if possible e.g.
ratcheted items, or placed within a receptacle e.g. diathermy point should be placed
inside the quiver.
All linen will be removed and sent for reprocessing as detailed in the Infection Control
Linen Policy.
Used trays will be removed from theatre via the sluice area, and placed into the
DSDU “buggy”, with the heaviest trays at the bottom and more delicate items on top,
along with the completed DSDU check sheets.
The “dirty corridor” orderly will remove the buggy when full and deliver it to DSDU for
reprocessing.
If items are required to be reprocessed quickly, the theatre team will telephone DSDU
as soon as the item is available to request urgent turn around. The dirty corridor
orderly is then contacted to collect the item from theatre, for rapid delivery to DSDU.
(Q) All staff members are responsible for the identification and documentation of
accidents and incidents within the department (WHY)
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All staff must ensure they have received training on the responsibilities of the
employer and the employee in relation to health and safety, and be familiar with the
following policies;
o Health and Safety and Environmental Policy
(Introduction & Responsibilities for Health & Safety)
o Policy for Risk & Incident Management
o Serious Adverse Incident Policy & Procedure
Staff must take an active part or be aware of the need and necessity of updating
policies.
All accidents to, or all incidents involving staff/and or equipment/ adverse incidents/
breaches of protocol or any issues pertaining to patient care and the running of the
theatre lists must be reported to the co-ordinator and the relevant paperwork
completed i.e. Incident report forms.
All staff, if necessary, should seek medical assessment of any injury sustained.
The person responsible for co-ordinating the department should sign the incident
report form. One copy remains in the department and the other is sent to Risk
Management for assessment whereby the level of risk can be ascertained.
(Q) Why is it important to ensure that any implant or prosthesis is minimally handled?
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(A) The implant/ prostheses must not be opened until the scrub person and the
surgeon have checked the item and requested its delivery to the sterile trolley.
The item should be opened carefully according to the manufacturer’s guidelines and
should be taken directly by the scrub person. The item must not be dropped on to the
sterile surface to prevent both damage to the item, accidental contamination, and
wastage if the item should fall.
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The scrub person having taken the item should identify a sterile receiver, if
appropriate, or a safe area of the sterile trolley, that is away from the working area,
for storage of the item, until it is actually required.
Where the item is provide sealed within another layer of packaging, the scrub person
should leave this packaging intact as long as possible, to reduce possible cross
contamination.
When the surgeon requests the item, the packaging may be opened on a clutter free
sterile area of the trolley ensuring adequate drop space around the item. The item
should be kept as close to the surface of the trolley as possible, in case the item is
accidentally dropped.
Transfer of the item wherever possible should be either, within the opened sterile
packaging provided, or in an identified safe receptacle, such as a receiver.
Where the item has its own specific delivery instrument or impaction device, the item,
where possible should be mounted by the surgeon who is undertaking the procedure.
Once mounted the whole should be placed very carefully on a flat sterile surface, of
sufficient area, free from any other swabs or instruments. The surgeons themselves
should then pick up the item as required.
Where there is no other option but to hand the item from scrub person to surgeon,
this must be done directly and never through a third party, such as assisting surgeon,
or trainee scrub person to reduce the risk of wastage and cross contamination.
Any traceability stickers or prostheses/implant details must be recorded in the
patients’ notes and on the Stores sheet for reordering.
In the event of a prosthesis or implant being dropped or contaminated, the item must
be discarded and a fresh sterile item sourced. It is not acceptable to decontaminate
any implants or prostheses using Little Sister Autoclave or Chemical e.g. Perasafe
forms of decontamination. If in doubt contact a senior member of the theatre team for
advice.
(Q) All member of staff working within the theatre environment should present a
professional appearance and conduct themselves in a professional manner at all times
How do you ensure this?
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(A) All personnel must be familiar with and adhere to the R.U.H. Trust Code of
Expectations, the Trust Uniform policy, the Theatre Departmental Expectations, and
the Theatre Policy; Preparation of Personnel within the Operating Theatre
Environment.
All staff must receive yearly mandatory training in infection control, including good
hand washing techniques and the need for good personal hygiene.
Finger nails should be kept short, clean and free from nail polish and artificial nails.
All cuts and abrasions should be kept covered with a clean waterproof dressing.
Jewellery must be kept to a minimum i.e. a plain wedding ring may be worn along
with one pair of plain stud earrings and a plain neck chain only.
All personnel who enter the restricted areas of the theatre environment must be
appropriately attired in clean freshly laundered theatre wear in good repair. Theatre
wear must be changed when it becomes soiled or wet.
Footwear is provided to all staff working within the restricted areas. All footwear must
be kept clean and in good repair, exchanging for new when appropriate.
Clean headwear must be worn within the restricted areas and all head hair should be
kept within the confines of the headwear provided. Several styles of headwear are
available within the changing areas to allow for differing hairstyles to be
accommodated.
Disposable facemasks must be worn by all staff entering Orthopaedic areas.
Personal discretion and preference may be used in other specialities, but it is
recommended that staff working in
close proximity to bodily fluids should wear masks for their own protection.
Masks must be changed when they become soiled, and every two hours where
possible. Masks should be removed entirely when leaving the restricted areas. Visor
and laser masks are provided for additional protection as required.
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Disposable gloves are provided throughout the department and must be worn when
dealing with any contaminated items. Latex free gloves are provided for staff with
latex allergy, these must be stored separately from those gloves containing latex.
Disposable gloves are single use items and must be disposed of into an appropriate
clinical waste receptacle after use. Wearing of gloves does not negate the
requirement for good hand washing before and after use.
If it is necessary for a member of staff wearing theatre blues to leave the department,
a clean buttoned up white coat must be worn over theatre wear. All hats and masks
must be removed, and theatre footwear exchanged for staff members own outdoor
shoes.
(Q) Why is it important for staff to ensure that they are familiar with and utilize the
appropriate types of personal portective equipment available for use within the
operating department ?
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(A) All staff must ensure that they are familiar with the different types of personal
protective equipment available, relevant to the operative procedure they are
undertaking, before commencing any procedure that may expose themselves or
others to contamination with either body fluids, cleaning fluids or other material
controlled by C.O.S.H.H. i.e. Control of Substances Hazardous to Health.
All staff will receive mandatory training in Infection Control issues and in C.O.S.H.H.
This training is undertaken at Trust Induction and should then be updated yearly. If
this training has not been completed or kept up to date all staff have a duty to inform
their manager.
All staff should be familiar with the RUH Trust Infection Control Policies: Protection
against Infection, Hand Decontamination and Protection against Infection with Blood
Borne Viruses. Also COSHH recommendations.
Disposable aprons and gloves are available in each clinical area, together with a
variety of surgical masks for all types of surgery.
Specialist laser masks must be worn together with appropriate eye protection
whenever the Laser is being used. External door signs must be clearly displayed on
all entrances to minimise the risk of accidental exposure to laser beams. Only Laser
trained personnel are permitted to operate the Laser and the Laser key holder must
be present during use.
Alternative forms of eye protection are available in each clinical area. An appropriate
type must be selected on an individual basis depending on the risk encountered. It is
strongly recommended that all staff members who are in close proximity to the
operative field wear some form of eye protection to prevent accidental eye splashes
or contamination with diathermy plume.
Types of eye protection available:
1. Surgical masks
2. Visor masks
3. Laser masks
4. Single use visors with holders
5. Eye goggles
6. Laser goggles
Disposable gloves must be worn when dealing with any contaminated items to
minimise the risk of cross infection. Appropriate sized gloves should be donned onto
freshly washed and dried hands. Gloves should be changed when contaminated,
between each patient intervention and prior to leaving the operating theatre.
Hands must be washed on removing gloves and a moisturiser used as appropriate, to
prevent cracking or chapping of dry skin thereby reducing the risk of cross infection.
Various types of disposable and surgical gloves are provided within the department,
including latex free forms of both types.
Freezer gauntlets are provided for dealing with the freezer unit containing the
Orthopaedic Bone Bank
All members of the theatre team should wear disposable aprons where there is a high
risk of contamination with either body fluids or cleaning materials.
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Disposable aprons must be removed before leaving the operating theatre and a fresh
one applied between each patient intervention. Aprons should be removed with
gloved hands and disposed of into an appropriate clinical waste receptacle, prior to
the removal of gloves ensuring hands are kept protected for as long as possible.
Lead gowns and thyroid protectors are provided for all staff involved in operative
procedures where there may be exposure to radiation. See Radiation Protection
Standard no.17a
Freshly laundered supplies of theatre scrub suits are available in each staff changing
area. Scrub suits must be changed daily or as soon as visibly contaminated. Scrub
suits should not be stored in lockers prior to use.
All staff who work in the operating theatre environment are supplied with appropriate
footwear. It is the individual’s responsibility to keep these clean and appropriately
stored when not in use. If footwear becomes damaged, a new pair should be
sourced.
Footwear should be enclosed at the front to prevent accidental injury to toes, and if of
the clog variety, have a back strap applied to prevent injury when forced to walk
backwards e.g. when escorting patients on beds or trolleys.
(Q) Do all staff members have a responsibility to protect the patient, themselves and
others and why?
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Only authorised personnel who are trained and assessed may use the X-Ray
equipment.
Patients undergoing procedures where X-Ray is deemed necessary should be
protected wherever possible. Radiation doses and exposure should be kept to a
minimum.
Only essential staff should remain in the theatre whilst X-Ray is in use. All staff
remaining in the immediate vicinity must be protected with appropriate lead garments.
Protective lead garments must be safeguarded from damage, cleaned after use and
examined frequently. They must be stored hanging freely on the provided racking
system.
Any member of staff known to be pregnant should not be present in theatres when XRay is being deployed.
When X-Ray is in use it is essential that access to the area is restricted in order to
prevent accidental exposure, with notices being displayed wherever possible.
Details of any radio-opaque contrast used must be recorded in the perioperative
documentation. Radio-opaque contrast must be used with extreme caution in any
patient with known iodine allergy.
(Q ) Why should all staff that take part in operative procedures will be able to scrub,
gown and glove effectively to ensure asepsis is maintained in order to reduce the risk
of cross infection to the patient.
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(A) All staff that need to take part in operative procedures will be trained and
assessed as competent in these skills before undertaking them unsupported.
All staff will be in appropriate theatre attire before commencing, wearing a freshly
donned mask, correctly positioned over the nose and mouth, with all hair covered by
a surgical hat.
Fingernails must be clean, short and free from polish or artificial nails.
All jewellery must be removed, except a plain wedding ring, which may be worn if
extra care is taken to clean under and around it when scrubbing.
Protective eyewear is advised for all invasive procedures. Any spectacles or
microscopic lenses should be securely positioned prior to scrubbing.
Skin on hands and arms should be intact.
Protective clothing such as lead gowns or aprons should be donned and comfortable.
In order to minimise contamination during scrubbing staff should ensure the following;
o
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Taps are operated using the elbows only once the scrub sequence has
begun
o The water is of a comfortable temperature and steady flow.
o The hands are above the level of the elbows
o Care should be taken not to splash theatre clothing
o Rinsing is performed from fingertips to elbows using the water flow not the
hands.
o Approximately 5ml of scrub solution is dispensed onto the hands at each
application using an elbow operated device.
Scrub solution is worked into all areas of the hands paying particular attention to the
nails and between the fingers, and then worked down the arms to the elbows.
o A nailbrush should be used for the first scrub of the operating session.
o Only the nails should be brushed, brushing of other areas of the fingers and
hands has been shown to be detrimental to the skin, causing abrasions and
bringing organisms to the surface.
o The first scrub of the day should last for 5 minutes, subsequent scrubs need
only be of 3 minutes duration, alcohol hand rub may be used between short
cases e.g. oral surgery, E.N.T. etc. if no visible contamination is present.
o Care should be taken to keep the hands up and allow cleansing solution to
run off the elbows.
o A separate disposable paper towel should be used to dry each hand, with
drying commencing at the fingertips and finishing at the elbows.
o A dabbing motion should be used for drying; vigorous rubbing must be
discouraged as it disturbs skin cells.
All gowns used should be presented in a good state of repair; any gown found not to
be processed to a high standard must be discarded.
o The practitioner touches only the inside of the folded gown, and inserts both
arms into the sleeves of the gown at the same time.
o The circulating person will assist the scrubbed person by securing the back
ties.
o The gown should be of the wrap around variety and this should be secured
with the assistance of another scrubbed person.
o Disposable gowns are provide for use within the orthopaedic operating
theatres, to prevent contamination with lint from linen drapes
Closed gloving is the method of choice, i.e. donning of gloves with hands tucked
inside the cuffs of the gown so that no outer part of the glove is touched with bare
hands.
Different varieties of gloves are available for different purposes; also latex free
varieties are available for those with latex sensitivity.
Double gloving is recommended for all cases to minimise the risk of contamination in
the event of an accidental sharps injury. It is advised that a pair one size larger is
placed underneath the usual sized outer glove to optimise wearer comfort.
Double gloving is essential for all Orthopaedic cases, as the incidence of puncture of
the outer glove is high. Whilst double gloving does not prevent sharps injury it has
been shown to effect up to a six-fold decrease in inner glove puncture. In the event of
percutaneous injury, the volume of blood transmitted may also be reduced due to the
enhanced wiping effect of two layers of glove
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Double gloving is also essential in any known or suspected patients with blood borne
viruses such as Hepatitis B & C and HIV, also patients who are thought to be in other
high risk groups as defined by the RUH Trust Policy for Protection against Infection
with Blood Borne Viruses.
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If it is necessary to change gloves during a procedure, the closed method remains the
method of choice if possible.
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It is essential that the practitioner understands that their area of sterility is from
fingertips to elbows, and from below nipple line to waist.
The hands must be kept at or above waist level at all times.
When not involved in a sterile procedure the scrubbed person should stand with their
hands together in front of their lower chest.
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At the end of the procedure the practitioner should remove firstly the gown over
gloved hands and then the gloves, to minimise skin contamination, then disposing of
them into the appropriate receptacle i.e. yellow clinical waste bin or bag. Hands
should then be rewashed and dried.
It is recommended that a hand moisturiser is used at frequent intervals to prevent
chapping or cracking of skin, to minimise the risk of infection.
( Q ) How are all the sharp items used during procedures handled and disposed of
safely to protect self, colleagues and patients?
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(A) All staff will receive mandatory yearly training and updates on infection control.
All staff will receive training on the correct handling and disposal of sharps.
All staff will be familiar with the various types of sharps containers within the
department and be aware of their appropriate use.
All staff will be familiar with the policy regarding the reporting of and dealing with
needle stick injuries.
During surgery all sharps must be kept contained within an appropriate receptacle,
e.g. handle and blade in a receiver, sutures in their packets until required, then
secured on an adhesive sharps pad.
The scrub person is responsible for their sharps at the end of any procedure and
must not allow anyone else to dispose of them.
All sharps will be disposed of into an appropriate sharps container, either secured to
an adhesive pad or disposed of directly into the sharps bin.
The container must not be overfilled, and replaced as required.
Personnel disposing of the full item must ensure that the lid of the container is fully
secure, and that the outside is labeled with the location and date.
(Q) Why are all staff are responsible for ensuring that the operating theatres are
adequately stocked at all times and ensuring correct stock rotation ?
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All staff must ensure that the theatres are left stocked ready for use at the end of
each operating session. All areas should be checked including cupboards and
shelves in preparation rooms and fluid warming cabinets as well as the trolleys in
theatres. If this is not achievable because of pressure of work, the coordinator for the
shift must be informed, so other staff can be directed to fulfill this requirement during
any other quieter periods.
Staff must ensure that when placing new stock into theatres, older stock is brought
forward to ensure it is used in date order.
All expiry dates must be checked prior to the stock being placed into theatres and
again before use.
Each theatre has required stock levels for each item they hold, and these should not
be exceeded.
Staff should ensure that stock items are stored neatly to reduce damage to items.
If a final item is removed from a box, staff must ensure the box is disposed of and that
there is a new box of the item available for use.
Any items noted to be in short supply, must be notified to the Stores person on duty
Bleep7215 or extension 5756. Also noted on the white board outside the main
storeroom.
The stores team monitors the stores levels on a daily basis, but welcome any
information regarding reduced levels, any increased usage in a particular item that
will be sustained, should be notified to the Stores person so that stock levels can be
increased accordingly.
Items that are unwanted or unused must be returned to their appropriate storage
area.
Items should not be removed from the main storage area as this is a receiving and
distribution area only and items may not have been processed completely.
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Staff should only use other theatres stock as a last resort, if the particular item
required is out of stock.
Any labels on stock items must be attached to the patient notes for traceability
purposes. Any prostheses or implants used should also have labels attached to the
reorder sheets in each theatre and patient’s operation note.
Ordering of non stock items can only be authorised by the senior team leaders in
each speciality.
(Q)The preparation of sterile instrument trolleys for surgical intervention is a skilled and
precise procedure that requires adherence to a strict aseptic technique throughout. WHY IS
THIS ?
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 All staff involved in the preparation of trolleys for surgical intervention will have
received training appropriate to their level of participation and have been assessed as
competent.
 Staff will ensure that sufficient trolleys, mayo stands and bowl stands are available for
the planned surgical procedure and that they are in a good state of repair and have
been cleaned thoroughly prior to use.
 Staff will collect together all items expected to be required for each procedure in
advance of surgery. Any items not available must be detailed to the surgeon in
charge of the case prior to start of anaesthesia, to allow the surgeon to make an
informed decision regarding whether to continue.
 All items to be used must be inspected for sterility and damage.
 Trolleys must be prepared immediately prior to each individual surgical intervention in
accordance with the planned operative procedure and individual patient needs.
 Trolleys must only be laid up in an area that affords sufficient space to open packs
and maintain a sterile field. There should be minimal movement of personnel within
this area during preparation of the trolley.
 For Orthopaedic surgery, trays and packs must not be opened until the patient’s
position on the operating table is finalised, including catheterisation, and the ward bed
has been removed from the operating theatre.
All trolleys must remain within the boundaries of the Laminar Flow.
 All doors within the operating theatre must remain closed wherever possible to
maintain correct airflow changes.
 A minimum of two personnel are required to prepare sterile trolleys. It is essential that
one member is scrubbed, gowned and gloved, and strictly follows the principles of the
aseptic technique.
 All trolleys should be covered with a minimum of two layers of sterile drapes. The
drapes should be large enough to cover the horizontal plane of the trolley, and long
enough vertically to avoid contamination.
 Sterile equipment must be presented to the scrub person from the edge of the sterile
field and received in such a way as to prevent glove contamination on the unsterile
wraps.
 It is recommended that wherever possible items are handed directly to the scrub
person. Where this is not possible, items may be delivered directly to the sterile field,
but it is recommended that a separate area is identified for this purpose, away from
the work area to minimise the risk of contamination.
 Items must only be delivered to the sterile field at the request of the scrub person.
Although anticipation of needs by the circulating person is appreciated, they must not
open additional items prior to a request being made, to ensure best possible use of
resources.
 Once prepared the trolley must be attended at all times.
 Standard basic layout of trolleys should be followed in order to facilitate continuity of
patient care and safety in the event of a sudden change of scrub personnel during the
operative procedure.
 Trolleys must be placed correctly around and above the patient depending on the
planned operative procedure.
Care must be taken to ensure there is no undue pressure on any part of the patient’s
body or limbs.
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All instruments must be returned to the trolley or mayo stand in order to prevent
accidental injury to the patient or members of the surgical team.
Any breach of aseptic technique must be acknowledged and acted on immediately.
Contaminated equipment must be removed from the sterile field. Re-gloving, gowning
and draping should be carried out as required.
The disposal of equipment drapes and sharps must be carried out in accordance with
Hospital Policies and Theatre Standards.
(Q) How do all staff ensure that universal precautions are adhered to, in order to
protect themselves from the spread of blood borne viruses, such as HIV/ Hepatitis B &
C and other harmful microorganisms that may be present in blood, saliva and other
body fluids.
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(A) All staff must be educated in the principles of Universal Precautions, and receive
mandatory yearly updates in Infection Control.
All blood/saliva and body fluids must be treated as infected.
Principles of good hand hygiene must be adhered to, hands must be washed before
and after all patient contact and after removing gloves.
Any blood or body fluid splashes are removed immediately with soap and water.
Any broken skin areas must be covered with a clean waterproof dressing. Any staff
members with chronic skin lesions to the hands or forearms should avoid invasive
procedures and seek the advice of the Occupational Health Department.
Gloves must be worn when making contact with any patients. Gloves should be
discarded after each episode of care/procedure.
If gloves become punctured they must be removed, hands washed and fresh gloves
donned.
Protective clothing must be worn when dealing with body fluids. Where there is a low
risk of splashing, gloves and a gown or apron should be worn. Where there is a high
risk of splashing, eye protection and masks should also be applied.
Principles of safe practice must be adhered to when using and disposing of sharps.
Ensure that body fluid spillages are dealt with correctly.
Staff must be aware of and adhere to RUH Trust policies for Disposal of Waste and
Linen.