HANDWASHING

Definition: The most effective infection control measure.

Purpose:
1. To reduce the number of microorganism on the hand.
2. To reduce the risk of transmission of microorganisms to clients
3. To reduce the risk of cross-contamination among clients
4. To reduce the risk of transmission of infectious organisms to oneself.

Equipment:
- Soap
- Warm running water
- Disposable or sanitized towels

Implementation/Rationale:
Assess Hands:
1. Nails should be kept short
- Short natural nails are less likely to harbor microorganisms, scratch a client or puncture gloves.

2. Remove all jewelry
- Microorganisms can lodge in the settings of jewelry & under rings.

3. Check hands for break in the skin
- A nurse who has open sores may require a work assignment w/ decreased risk for transmission of infectious organisms.

4. Explain to the client what are you going to do and why it is necessary.

5. Turn on the water and adjust the flow - Warm water removes less of the protective oil of the skin than hot water.

6. Wet your hands & wrist w/ warm water & apply soapfrom a dispenser. Don’t use bar soap, it allows cross-contamination.

7. Wet hands thoroughly holding the hands lower than the elbow under running water so that the water flows from the arms to the fingertips & to prevent water from running up your arms & back down, thus contaminating clean areas, then apply soap.
- The water should flow from the least contaminated to the most contaminated area; the hands are considered more contaminated than the lower arms.

8. Use firm rubbing & circular movements.
- The circular action helps remove the microorganisms mechanically.
Work up a generous lather for at least 10 seconds. Soap & warm water loosen surface microorganisms, which wash away in lather.
Palm to palm
Palm to dorsal
Dorsal to dorsal
Interlace fingers
Sides of the fingers
Inside of the nails
Knuckles
- Interlacing the fingers & thumbs cleans the inter-digital spaces. The nails & finger tips are commonly missed during handwashing.

9. Avoid splashing water on yourself or on the floor, microorganisms spread more easily on wet surfaces & slippery floors are dangerous.

10. Avoid splashing water on yourself or the floor, microorganisms spread more easily on wet surfaces & slippery floors are dangerous.

11. Don’t touch the sink or faucets; they are considered contaminated.
12. Rinse hands & wrists well, so running water flushes suds, soil & microorganisms away.

13. Pat hands & wrists dry with paper towels. Avoid rubbing, which can cause abrasion & chopping.
- Moist skin becomes chapped readily, chapping produces lesions.

14. Use a new paper towels to grasp a hand operated control.
- This prevents the nurse from picking upmicroorganisms from the faucet handles.

15. Use a new towel to dry the other hand & arm.
- A Clean towel prevents the transfer of microorganisms from one elbow to the other hand.

16. After Care- wash, clean & dry all the re-usable equipments. Discard all the disposables. Return the re-usable equipments on their designated places.