Kim, Myoung-Sook;Kim, Kyoung-Ja;Shin, Young-Ran;Park, Kwang-Ok;Mun, Hyang-Mi;Jeong, Jae-Sim;Kim, Mi-Na
Journal of Korean Biological Nursing Science
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v.9
no.2
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pp.118-124
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2007
Purpose: The purpose of this study was to compare three surgical scrub methods-4% chlorhexidine gluconate(CHG) with brush, 4% CHG without brush, and waterless scrub using 1% CHG and 61% ethanol combination(alcohol-based agent)-for antimicrobial efficacy. Method: "Glove-juice technique" was used to evaluate microbial hand counts before surgical scrubs, 1 min and 3 hr after surgical scrubs. Result: Waterless scrub using CHG and ethanol combination resulted in a 4.8-log reduction at 1 min and 4.0-log reduction at 3 hr. CHG without brush resulted in a 4.7-log reduction at 1 min and 3.3-log reduction at 3 hr. The traditional scrub using CHG with brush resulted in a 3.6-log reduction at 1 min and 0.8-log reduction at 3 hr. The waterless scrub and CHG without brush showed significantly higher log reduction(p<.05) than CHG with brush at 1 min and 3 hr after surgical scrub. Waterless scrub showed greater log reductions than CHG without brush, but there was no statistical difference between the two groups. Conclusion: Waterless scrub using alcohol-based agent showed more persistent and immediate antimicrobial efficacy than either CHG with brush or CHG without brush.
Purpose: The purpose of this study was to compare 1% chlorhexidine-gluconate/61% ethanol (CHG/Ethanol) emollient and 7.5% povidone-iodine (PVI) scrub for antimicrobial, residual effect, and skin condition. Method: CHG/Ethanol emollient hand hygiene was performed waterless, and brushless by operating doctors and nurses (N=20). PVI hand washing was performed with water and a brush (N=20) for 5 min. The subjects were asked to press their left hand in hand-shaped agar before a surgical scrub, immediately after a surgical scrub and after the operation. The amount of isolated microorganisms were calculated by counting the number of divided areas($1{\times}1cm$, 160 cell) which were culture positive in the hand culture plate. The skin condition was evaluated. Result: The antimicrobial count of CHG/Ethanol emollient and PVI immediately post surgical scrub was 0.0 vs. 4.1 (p>.05), and after the operation was 0.1 vs. 37.8 (p>.05)respectively. The Residual effect of CHG/Ethanol emollient immediately post surgical scrub and after the operation were 0.0 vs. 0.1 (p>.05), and PVI were 4.1 vs. 37.8 (p>.05)respectively. The skin condition and satisfaction of CHG/Ethanol emollient was higher than PVI (p<.05). Conclusion: The antimicrobial effect between CHG/Ethanol emollient and PVI were the same. Considering skin condition, satisfaction and allergic reaction CHG/Ethanol emollient for surgical scrub is recommended in Korea.
Journal of Korean Academy of Fundamentals of Nursing
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v.13
no.2
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pp.208-216
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2006
Purpose: This study was done to identify the differences in effectiveness of disinfections for surgical hand scrubbing according to the duration of scrubbing and the type of disinfectant. Method: From June 30 to August 14, 2003, the data were collected from 30 surgical nurses and surgeons in one general hospital in P city, Korea. All participants washed their hands with two different disinfectants and four different scrubbing times, they placed both finger tips on a blood agar plate and using sterile cotton tips microbes were collected from their palms, nails and forearms. Results: The first hypothesis of this study(with same disinfectant, there will be no difference in effect of disinfection in surgical hand scrub among four time groups) was supported. The second hypothesis of this study(with same duration of surgical hand scrub, there will be no difference in effect between two disinfectants) was also supported. Conclusion: There are no differences in effectiveness of disinfection for surgical hand scrubbing according to duration of the scrubbing and the type of disinfectant. So it is concluded that the effectiveness of disinfection depends more on the exactly how the scrubbing is done rather than the duration of scrubbing or the type of disinfectant.
The surgical hand scrub (SHS) is the single most important procedure in the prevention of post-operative 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 th atre 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 th atres 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 stat-istics 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 slip-ping 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.
Purpose: The purpose of this study was to examine the effects of foot mats on reducing levels of fatigue, discomfort, lower extremity edema and skin temperature in scrub nurses during surgery. Methods: This study employed one group repeated measures design in which 16 scrub nurses (ages 22-38) stood on steel footstools (SF) during scrub as the conventional test and stood on SF with foot mats as the experimental test. Levels of fatigue, discomfort, lower extremity edema and skin temperature were measured before the first surgical hand scrub and right after the first surgery of the day for 3 consecutive days in both tests. Results: The changes in levels of fatigue and discomfort were significantly different between tests (p<.001~.033). Edema, determined by the differences in circumferences of the ankles and calves before and after the surgery was also significantly different between groups (p=.001~.011). However, the change in skin temperature on the foot tops of both feet was not different between tests (p=.351~.467). Conclusion: The results of this study show that using foot mats on top of the steel footstool is effective in reducing the levels of fatigue, discomfort and lower extremity edema in scrub nurses during surgery.
Ju, Houng Ley;Jeong, Jae Sim;Kim, Mi Na;Park, Kwang Ok
Journal of Korean Clinical Nursing Research
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v.15
no.1
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pp.55-65
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2009
Purpose: The purpose of this study was to compare the 1% chlorhexidine gluconate/61% ethanol (CHG/ethanol), 45% ethanol/18% 1-propanol (ethanol/propanol) and 7.5% povidone-iodine (PVI) scrub with brush to evaluate their antimicrobial effect. Method: Utilizing repeated measures design, 9 nurses participated in the study. Glove juice sampling procedure was used to evaluate microbial hand counts before the surgical hand antisepsis, one minute after hand wash, and after the surgery. Results: Waterless rub using CHG and ethanol combination resulted in a 3.94 log reduction at 1 min and 2.78 log reduction at 3 hrs. Ethanol/propanol resulted in a 2.42 at 1 min and 2.22 at 3 hrs. The traditional scrub using PVI with brush resulted in a 0.94 at 1 min and 0.95 at 3 hrs (p=.003) and 3 hrs (p=.026) after the surgical hand antisepsis. Repeated measures ANOVA results showed that there was a statistically significant difference among group (p=.002). Duncan post hoc test result showed that the PVI was less effective (p<.05) in sterilizing microbials on hands than CHG/ethanol or ethanol/propanol. Conclusion: Both of the two alcohol-based antiseptic rubs are acceptable alternatives to the PVI with brush for surgical hand antisepsis.
Purpose: The purpose of this study was to explore the effect of glove changing during surgery for colon cancer on reducing the degree of contamination of surgical gloves. Methods: The randomized posttest control group design was used. Total 72 surgeries of colon cancer in the K University Hospital in Seoul performed by the team of A-Surgeon and B-Scrub nurse were randomly assigned to one of the three groups. Glove changing with single-gloved state was implemented in the Experimental Group I and outer glove changing with double-gloved state was executed in the Experimental Group II. Single-gloved state was carried in the Control Group. Following the surgical procedure, specimens for bacterial culture were collected the from scrub nurse's gloves to compare the degree of contamination among the three groups. Data were analyzed with One-way ANOVA and the Scheff$\acute{e}$'s multiple comparison test. Results: The degrees of contamination of the Experimental Group I and II were significantly lower than that of the Control Group. There was no significant difference between Experimental Group I and II. Conclusion: Glove changing during surgery with either single or double-gloved state is effective in reducing the degree of contamination of surgical gloves, therefore these methods should be utilized in clinical practice.
Journal of the Korea Fashion and Costume Design Association
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v.16
no.4
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pp.99-116
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2014
The purpose of this study was to examine the state of scrub wearing among scrub uniforms medical staff. The results of the research is the following. First, As for the state of scrub uniforms, they wore scrubs only while they gave medical treatment and took care of routine work. Regarding the design of their current scrubs, type 1 was dominant, and the most common color was dark sky blue. Second, Concerning considerations for scrub design, they answered that scrubs should be designed to give no inconvenience during job performance. As for the image, they placed the most importance in a clean image due to hygiene. In relation to preference for color, pattern and materials, they had the most preference for dark blue, no pattern and materials that would not easily be contaminated. Third, As to preference for the length of the top, they were most fond of hip length, and short sleeves were their favorite length of sleeve. Concerning the design of the front and the back of the top, they had a liking for a box style with no straight cutting line. As for the design of the neckline, hem and pocket of the top, they had the most preference for round neckline, square bottom and round patch pocket respectively. Fourth, when the design preference of the respondents was analyzed, there were a difference between the men and the women in preference for neckline design. The women had a liking for round neck, whereas the men were fond of V neck. And the women showed a higher preference for rubber waistband than the men for the waist design of the pants. No gender differences were found in preference for color, pattern and the length of the top.
Purpose: This study was conducted to evaluate the incidence and risk factors for surgical glove perforation during operation. Methods: During the month of december 2008, a total of 1,400 pairs of surgical gloves used in major operations was collected in a tertiary hospital. All gloves were examined immediately after operation using the standardized water-leak method to detect any perforation. Incidence of the glove perforation was counted according to the type of operation, operation time, the number of involved personnel, perforation sites, and the manufacturing companies. Results: Out of 2,800 gloves examined, 312 perforations were detected comprising 11.1% of samples. In terms of the type of operation, the perforation incidence varied from 5% to 20%, and the perforation rates in CS (20%) and NS (18%) (p<.001) were significantly higher than those in other departments. The 1st assistant or scrub nurse got glove perforation more frequently than the 2nd assistant or operator (p<.001). Longer operation time was associated with higher incidence of perforation evidently (p<.001). In terms of the sites, the thumb and index finger were more frequently perforated than other sites (4.1% and 3.4% respectively) without any differences between left and right side. Conclusion: Risk factors for glove perforation including the department of operation, operation time, participating personnel, and location of perforation should be taken into account to improve surgical safety.
Purpose: The purpose of this study was to examine the puncture incidence of surgical gloves in an operational setting. Methods: The 277 surgical gloves were used collecting at one general hospital located in Seoul from February 1, 2011 to April 3. The data were analyzed by $x^2$ test, Fisher's exact test, and multiple logistic regression. Results: In the dental and orthopedic department, the puncture incidence were significantly higher than others. The time of wearing gloves demonstrated significant difference: The group 181-240 minutes had a significantly higher than those with under 90, 91-180, or over 240 minutes. The influencing factors were as follows. Compared to that of the 2nd assistants, the puncture incidence rates of the surgeons were 9.91 times, scrub nurses were 8.39 times higher respectively. The participants in work experience under 1 year showed a 4.58 times higher than those with over 7 years. In addition, compared to the puncture incidence rate of neurosurgery department, the 17.41 times in cardio-thoracic surgery, 13.89 times in dental surgery, 4.93 times in gynecology, and 4.97 times in orthopedics higher respectively. Conclusion: There is a need for training operational room personnels to occasionally exchange the gloves even during the procedure and to use double surgical gloves.
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