1. ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology Dress code & Scrubbing, Gowning, Gloving Procedures Scrubbing, Gowning, Gloving Procedures Sr. Panchavarnam Sr. Panchavarnam Supervisor - OT Supervisor - OT

2. Dress Code Should have a separate dress code Should have a separate dress code Wear only sterile clothes inside the operating room Wear only sterile clothes inside the operating room Should not move around various zones while wearing sterile clothes Should not move around various zones while wearing sterile clothes Should not leave the OT with theatre linen Should not leave the OT with theatre linen

3. Why Dress code? To minimize the risk of cross infection. To minimize the risk of cross infection.

4. Dress code in OT Footwear to be left outside in allocated area; Footwear to be left outside in allocated area; separate OT footwear separate OT footwear Cap and mask should cover completely Cap and mask should cover completely  No loose hair  Nose should be fully covered Theatre dress Theatre dress  Loose and comfortable  No buttons/ zips  Clean and neat, regularly washed  Green/ blue/ white preferable

5. Dress Code

6. What is Scrubbing? Process of removing micro-organisms from hands and arms by hand wash technique

7. Why Scrubbing? To Minimize infection To Minimize infection To Provide sterile field To Provide sterile field

8. Materials needed Anti microbial agents like soap, Anti microbial agents like soap, chlorhexidine 4% and povidone iodine 10% Sterile water in a sterile container Sterile water in a sterile container Timer Timer

9. Key points to Remember Inspect hands for cuts and wound Inspect hands for cuts and wound Remove jewelry - ring, watch Remove jewelry - ring, watch Clip nails short and remove nail polish Clip nails short and remove nail polish

10. Scrubbing Procedure Wet the hands with sterile water Wet the hands with sterile water Apply soap and scrub on both sides of the hands for 2 minutes Apply soap and scrub on both sides of the hands for 2 minutes Wash hands from finger to elbow Wash hands from finger to elbow Repeat the procedure Repeat the procedure

11. Scrubbing Procedure Take 5ml of chlorhexidine 4% and Take 5ml of chlorhexidine 4% and scrub the same way as before scrub the same way as before for 2minutes for each arm for 2minutes for each arm Wash hands from finger to elbow Wash hands from finger to elbow Repeat the procedure Repeat the procedure

12. Scrubbing

13. Gowning Procedure Pick up sterile gown at the neckline, lift straight and hold away from the body. Pick up sterile gown at the neckline, lift straight and hold away from the body. Allow gown to unfold completely. Allow gown to unfold completely.

14. Gowning.  Put both hands into arm holes by raising and spreading arms

15. Gowning Keep hands inside gown, ask assistant to tie gown before gloving

16. Gowning Procedure

17. Gloving Procedure Pick up sterile glove by its inside cuff with one hand. Pick up sterile glove by its inside cuff with one hand. Slide glove onto the opposite hand. Slide glove onto the opposite hand.

18. Gloving Procedure Using partially gloved hand, slide fingers into the outer side of the opposite glove cuff. Using partially gloved hand, slide fingers into the outer side of the opposite glove cuff. Slide the hand into the glove and unroll the cuff. Slide the hand into the glove and unroll the cuff.

19. Gloving Procedure With the gloved hand, slide the fingers under the outside edge of the opposite cuff and unroll it using the same technique. With the gloved hand, slide the fingers under the outside edge of the opposite cuff and unroll it using the same technique.

20. Gloving procedure

21. Key points to remember wearing of sterile gown and glove NEVER drop hands below the level of the sterile area at which he is working.

22. Key points to remember wearing of sterile gown and glove NEVER touch surgical gown above the level of the axilla or below the level of the sterile area

23. Key points to remember wearing of sterile gown and glove NEVER put hands behind back; must keep them within full view at all times.

24. Key points to remember wearing of sterile gown and glove NEVER reach across an unsterile area for an item.

25. Key points to remember wearing of sterile gown and glove NEVER touch an unsterile object with gloved hands

26. Conclusion Right Practices of Dress code, Scrubbing, Right Practices of Dress code, Scrubbing, Gowning and Gloving will minimize cross infection. Right Attitude of Theatre Personnel in Right Attitude of Theatre Personnel in adapting the right practices is indispensable. If this go hand in hand we could offer Quality If this go hand in hand we could offer Quality Eye Care to all.