In the operation theatre, OT in-charge is instructing about scrubbing to the staff nurse. Which is the correct order of preference-1 Gloves 2. Gown 3. Scrub 4. Check Instrument 5. Gauze count?

1. A

   1,2,3,4,5

2. B

   3,2,1,5,4

3. C

   3,2,1,4,5

4. D

   4,3,2,1,5

Appeared in: SGPGI Nursing Officer-2023

Explanation

• The correct sequence follows the strict principles of surgical asepsis, moving from personal cleaning to donning sterile attire, and then preparing the sterile field.
• Scrubbing (3) is always the first step to reduce microorganisms on the hands and arms.
• Gowning (2) and then gloving (1) are performed sequentially to create a complete sterile barrier for the healthcare provider.
• Once sterile, the nurse prepares the instrument trolley (4), which involves arranging and checking the instruments.
• The final step before the procedure begins is the initial gauze and instrument count (5), a critical safety check to prevent retained surgical items.

Why Other Options Were Wrong

• Option A: This sequence starts with gloving (1), which is incorrect. Sterile gloves cannot be donned before performing a surgical scrub (3) and putting on a sterile gown (2).
• Option B: This sequence incorrectly places the gauze count (5) before the instrument check (4). The formal count is performed after the sterile trolley is fully set up and instruments are arranged.
• Option D: This sequence incorrectly starts with checking instruments (4). A nurse cannot handle sterile instruments before performing the surgical scrub (3) and donning a sterile gown (2) and gloves (1).

Related Visual

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Surgical Asepsis and Operating Room Protocol in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• Adhering to the correct sequence is paramount for preventing Surgical Site Infections (SSIs), a major cause of postoperative morbidity.
• The instrument and gauze count is a critical safety protocol mandated by organizations like the Association of periOperative Registered Nurses (AORN) to prevent Retained Surgical Items (RSIs), which can have devastating consequences for patients.
• What if? In an extreme emergency (e.g., a crash caesarean section), while the sequence remains the same, the steps are performed with maximum speed. The team may use an abbreviated scrub and have multiple people working simultaneously to expedite the setup, but the core principles of scrub -> gown -> glove are never violated.

How to Approach the Question

• First, identify the question type. This is a process-based question that requires knowledge of a standard operating procedure.
• Recall the fundamental principle of surgical asepsis: move from a state of 'clean' to 'sterile'. The first step must be the one that initiates this process for the individual.
• Logically sequence the actions. Scrubbing must precede touching any sterile items. Therefore, 'Scrub' (3) is first. This eliminates options A and D.
• Next, consider the sterile attire. A gown (2) is put on before gloves (1) to maintain sterility (using the closed-gloving technique). The sequence is 3, 2, 1.
• Finally, differentiate between the last two steps. The instrument trolley must be set up and checked (4) before a formal count (5) can be accurately performed. Therefore, the correct sequence is 3, 2, 1, 4, 5.

Concept Tested & Keywords

• Concept Tested: Surgical Asepsis and Operating Room Protocol
• Stem keywords: operation theatre, OT in-charge, scrubbing, staff nurse, correct order
• Lead-in keywords: correct order of preference

Question ID

Q_SO99wMjqA-T0Xvjlo0az

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 94-96

E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 245-247