Hand hygiene:
(1) Remove all hand jewelry.
(2) Do not wear artificial nails.
(3) Wash both hands and forearms thoroughly. An alcohol wash is preferred.
(4) Wear powder-free sterile gloves.
Other:
(1) Wear a hat and an effective facial mask.
(2) Wear a clean gown.
Site preparation
(1) Clean the patient's skin twice over a wide area, using an alcoholic chlorhexidine spray or pain.
(2) Securely drape the site.
Prolonged catheter:
(1) Avoid if possible, especially if immuncomprised or if multiple insertion attempts made.
(2) Use a local anesthetic with antibacterial activity.
Do not contaminate
(1) the outside of sterile gloves.
(2) sterile equipment
(3) the skin once cleaned
These steps are repeated for each patient. This includes changing mask and gloves, as well as repeating hand hygiene.
Many surgical cases utilizing neuraxial block will administer a prophylactic antibiotic dose.
