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TRINITY VALLEY COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING
RNSG 1216
PROCEDURE GUIDE AND CHECK-OFF SHEET
HANDWASHING
Performing hand washing is the first line of defense to prevent spread of infection between patients and between
the nurse and the patient. This may seem to be a very simple skill but it is one of the most important and most
over looked skills that the health care provider must perform. Hand washing is required before and after each
patient contact and as needed to prevent transmission of microorganisms. The number one cause of nosocomial
infection (health care facility acquired) is lack of proper hand-washing.
Delegation: Every health care worker is required to wash their hands. This procedure cannot
be delegated.
Procedure
Scientific Rationale
1.The following equipment is needed for this skill:
a. Liquid soap is used as opposed to bar soap because bar
a. liquid soap in a dispenser
soap can transfer microorganisms onto the hands.
b. sink with running water
b. Running water is used to flush the microorganisms off
c. disposable paper towels
the hands.
d. cleansing sponge with a cuticle stick if needed.
c. Disposable towels are used because re-use of cloth
towels spreads microorganisms.
d. Cuticle stick can be used to clean to assist in cleaning
under the finger nails.
2. If using a paper towel dispenser that requires
This is done to provide hands a barrier to advance enough
manual advancing be sure to advance sufficient paper to completely dry hands to prevent recontamination
amount of paper approximately 4 to 6 inches.
of hands. Do not allow paper towel to touch sink or
counter. These are considered dirty.
3. Turn on faucet so that warm water is flowing..
4. Adjust water to a medium flow to minimize
splashing.
5.
Wet the hands and lower arms under running
water while holding the hands lower than the
elbows. Avoid touching the sink.
6.
Apply sufficient amount of liquid soap to hands
working into lather and thoroughly rubbing all
surfaces for at least 20-30 seconds.
7.
Special attention should be paid to areas of
concentrated microorganisms:
a. Cuticle sticks can be used to clean under
the finger nails
b. If cuticle stick is not available use other
fingernails of opposite hand to clean under
all finger nails
c. Must wash thoroughly between fingers and
creases of the skin.
8.
Rinse hands allowing the water to run off the
finger tips.
Hot water depletes protective oils of the skin that leads to
chafing; cold water can irritate to the skin.
The sink and surrounding area are considered dirty areas.
Anything that is touched with splashed water is considered
dirty.
Holding hands lower than elbows allow microorganisms to
run off the fingers. Washing should be done from area of
least contaminated to area of most contamination. The
sink is considered a dirty area.
Enough soap is needed to remove contaminants and the
thorough rubbing employs the use of friction to remove
microorganisms.
a. Manually removes microorganism from under the
nail.
b. Removes microorganisms from under the nail.
c. Between fingers and creases of skin are areas for
increased concentration of microorganisms.
Allows the microorganisms to flow from the arms, down
the hands, off the fingertips into the dirty sink.
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Procedure
9. Use the 4-6 inches of paper towel to manually
advance enough paper towel to dry hands. If
using a motion-free dispenser, do not allow
paper towel to touch counter top.
10. Use paper towels and pat dry hands starting at
the moving from wrists to fingertips. Throw
paper towel in trash receptacle taking care to
not touch trash container.
11. Obtain a new, dry paper towel and use to turn
off the water taking care to protect hands from
the side of the towel which came in contact
with the faucet. Do not turn off the faucet with
the bare hands.
Additional information:
Alcohol based hand rubs may be used in certain
facilities to complete hand hygiene between
patients if hands are not visibly soiled.
Scientific Rationale
Ensures that the clean hands will not come into contact
with any surface that has microorganisms.
Patting prevents the movement of any remaining
microorganisms. Vigorous rubbing chaffs the skin and will
remove protective oils.
Towel acts as a barrier to prevent clean hands from coming
into contact with contaminated faucet.
Using a moist paper towel is contraindicated as it allows
microorganisms to “wick” through the towel and recontaminate hands.
The Center for Disease Control (CDC) states that this hand
hygiene technique can be utilized safely and prevents the
transmission of microorganisms.
N:ADN/ADN Syllabus/CBC Curriculum/Level I/1216/Performance Checklist for Basic Skills - Handwashing
Reviewed 04/16
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