Table 10 Mean score of detailed procedure. Procedure 2,3,5,6 in the method of scrubbing and drying hand has maximum score of 4, the other procedure has maximum score of 2

 1. Taking the sufficient amount of liquid soap into sterile brush

 2. Doing scrub procedure evenly by hand to proximal elbow (2 min for each of hands) using scrubbing, done for both side (left and right) and rinsing by rotation

 3. Scrub the nail and palm using brush side and the skin of hand and arm using sponge side, in both hands.

 4. Discarding the brush carefully to the disposal bin

 5. Doing scrub procedure evenly by hand to half of distal lower arm (1 min for each arm) just using soap, done for both side and rinsing by rotation

 6. Doing scrub procedure evenly by hand to half of proximal lower arm (2 min for each of arms) just using soap, done for both side and rinsing by rotation

 7. Turning off the water flow by using elbow or pedal (without using hand)

 8. Then, move to enter the operation room through “butterfly” door by step backward (without touching the door)

 9. During the entire steps of surgical hand disinfection, hands should be keep slightly higher than lower arms, both hands should be on visual fields. The hand and lower arms must not touch the unclean surface. Hold on this position until the gloves are worn.

 10. Taking the sterile towel and dividing it into two parts

 11. Drying the hands one by one, sequentially from distal to proximal area

 12. The hand must be nested in a towel while its drying another hand to protect it from distal to proximal contact of both hands

 13. Discarding the towel directly to the basin

 1. Taking the sterile gown by grasping the inner part of the gown especially to choose the neck part

 2. Unfolding it away from the body. Avoiding contact to the floor

 3. Donning the gown by hands and arms are extending through the long sleeves of the gown, only until the cuffs level (for using closed method of gloving)

 1. Opening the wrapper of the gloves by hands inside the sleeves of the gown

 2. Inside the sleeve, the left hand is opened and facing up

 3. Grasping left glove with right hand (closed by the sleeve) and put the glove over the left hand in opposite direction

 4. Grasping the edge of the glove with both hands and making the broad weep motion simultaneously to insert the left hand inside the glove. While inserting into the glove, the left fingers are in adduction then simultaneously abducted.

 5. The right hand pulls the edge of the glove and the edge of the sleeve, the glove should cover the cuff part of the sleeve

 6. Repeating the same procedure toward the right hand

 7. Adjusting the position of the gloves

 8. During this procedure, hands DO NOT TOUCH the outer parts of the gloves