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Ramon Magsaysay Technological University Iba, Zambales College of Nursing

I.

HANDWASHING-MEDICAL TECHNIQUE

DEFINITION A vigorous short rubbing together of all the surfaces of soap lathered hands followed by rinsing under stream of running water. Considered as single most important and basic preventive technique for interrupting possible infectious process.

PURPOSE To prevent possible transfer of microorganisms. To reduce the risk of cross contamination among clients.

EQUIPMENT Liquid soap/soap bar with soap dish Hand towel Tissue paper Orange stick

PROCEDURE 1. Inspect hands, observing for visible soiling, breaks or cuts in the skin and cuticles. 2. Remove jewelry and watch and push long sleeves above the elbows. Dont allow the uniform to touch the sink. 3. Adjust the water to appropriate temperature and flow.

4. Wet elbow to hands under the running water always keeping hands lower than elbow.

5. Lather hands with liquid soap or if bar soap is used wash soap and lather hand. If bar soap is accidentally dropped, repeat the procedure. 6. Return bar soap dish on the soap dish without touching the dish. 7. Wash hands thoroughly using firm circular motion and friction on back of the hands, palms and wrists. Wash each

RATIONALE Poor personal hygiene and an open area of the skin provide areas in which microorganism grow and should receive extra attention during cleaning. Microorganism collect in jewelry and watch bands. Removing jewelry makes it easier to wash all areas of hands and wrists. Water that is too hot can chap skin. Too much force can cause splashing and spread of microorganisms to other areas especially your uniform. Hands are the most contaminated part of the arm. Water should flow from the elbow which is the least contaminated area over the hands and down the drain. Soap lather emulsifies fats and aids in cleansing. Sink is contaminated and dropping bar soap causes contamination. Soap dish contaminated. Friction helps loosen dirt and microorganisms. Relathering ensures more thorough

2 finger individually paying special attention to areas between fingers and knuckles by interlacing fingers and thumbs moving hands back and forth. Relather if necessary. 8. Rinse elbow down to hands completely, keeping hands lower than elbows. 9. Clean fingernails carefully under running water using an orange stick. 10. Turn off faucets with a towel or tissue paper. 11. Dry hands thoroughly with towel starting from the fingertips, hands and then wrists and forearm. 12. Use hand lotion if desired. 13. Inspect hands and nails for cleanliness. cleaning.

Water should run from cleaner area (elbow) over the hands and then down the drain. Orange stick helps remove dirt and reduces chance of microorganisms to remain under nails. Keeps clean hands from touching contaminated faucet. Prevents chapping of the skin. The cleanest areas are now the fingers and hands to drying should progress from clean to less clean. Keep skin soft and lubricated. Ensures cleanliness of hands and nails.

NAME:_____________________________ COURSE AND SECTION:_____________

DATE:_____________________ RLE GROUP:_______________

A. HANDWASHING I. CHECKLIST ON HANDWASHING- MEDICAL TECHNIQUE ABLE TO PERFORM WITH ASSISTANCE

PROCEDURE Assessment 1. Assess the hands for visible soiling, breaks or cuts in the skin and cuticles. Planning 2. Assemble the equipment. Implementation 3. Remove jewelry and watch and push long sleeves above the elbow. Uniforms must not touch the sink. 4. Adjust water to appropriate temperature and flow. 5. Wet elbow down to hands under running water always keeping hands lower than elbow 6. Lather hands with liquid soap or if bar soap is used, wash soap and lather hands. Note: if bar is accidentally dropped, repeat the procedure 7. Return bar soap on the soap dish without touching the disk. 8. Wash hands thoroughly using firm circular motion and friction on back of hands, palms and wrists. Wash each finger individually paying attention to areas between fingers and thumb moving hands back and forth. Relather if necessary. 9. Rinse elbow down to hands, keeping hands lower than elbows. 10. Clean fingernails carefully under running water using an orange stick. 11. Turn off faucets with hand towel or tissue paper. 12. Dry hands thoroughly with towel start by putting at fingertips, hands and then wrist and forearm.

ABLE TO PERFORM

UNABLE TO PERFORM

4 13. Use hand lotion if desired. Evaluation 14. Inspect hands and nails for cleanliness. Documentation 15. Record time when handwashing is done. REMARKS:_________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________ Grade:____________________ Rating Scale: Excellent: Very Satisfactory: Very Good: Good: Fair: Poor: 96-100% 90-95% 85-89% 80-84% 75-79% 74 and below

CONTESSA MORA GABRIEL,RM,RN,MAN Clinical Instructor

_____________________ Students Signature

II. HANDWASHING SURGICAL TECHNIQUE SURGICAL HANDWASHING OR SCRUB DEFINITION Type of handwashing used in the operating room.

PURPOSE To remove soil and most transient microorganism from the skin

EQUIPMENT Brush Sink with faucet and running water Liquid soap Sterile towel Nail cleaner RATIONALE Breaks in skin facilitate development of infection To decrease resident and transient microorganisms. To prevent introduction of contaminants into environment. To prevent hands and forearm from touching a soiled surface. Warm water removes less of the protective oil of the skin than hot water. Water will drain off your elbows, flowing from cleanest area to less clean area. To remove resident bacteria from the skin surfaces. The circular motion mechanically removes microorganisms, scrubbing the non-dominant hands first sets a routine you can remember to prevent contamination. Same as above. Allows flow of water from the area of least (hand) contamination to the area

PROCEDURE 1. Inspect hands for cuts in the skin and cuticles. Do not scrub if there are open lesions or breaks in the skin. 2. Remove rings, chipped nail polish, and watch and push long sleeves above the elbow. 3. Put on cap or hood, shoes cover and a mask. 4. Use a deep sink with side foot pedal. 5. Turn on water using foot or knee control and adjust temperature to be comfortably warm. 6. Wet hands starting from the tips of fingers to forearms keeping hands higher than elbows. 7. Apply soap to a scrub brush or open a pre-package scrub brush if available. 8. With brush on your dominant hand, using a circular motion, scrub nails and all skin areas of non-dominant hand and arm (ten strokes to each of the areas). 9. Take second scrub brush and repeat action in no.8 on your dominant hand and arm. 10. Keep the hands and arms above elbow level, place the fingertips under running

6 water and thoroughly rinse the fingers, hands and the arms. 11. Keep arms flexed and proceed to operating or procedure room. 12. Secure a sterile towel by grasping it on one edge, opening it at full length making sure it does not touch your uniform. 13. Dry each hand and arm separately, extend one side of the towel around fingers and hands and dry in a rotating motion up to the elbow. 14. Reverse towel and repeat same action on the other hand and arm, thoroughly drying the skin. Discard towel into linen hamper. of most contamination (elbow) Prevents water from flowing from least clean area (elbows) to most (hands) clean area. Maintain sterility of the towel.

Prevents contamination by drying from cleanest to least clean area. To prevent contamination of gown.

NAME:_____________________________ COURSE AND SECTION:_____________

DATE:_____________________ RLE GROUP:_______________

2. HANDWASHING SURGICAL TECHNIQUE PROCEDURE Assessment 1. Assess hand for visible soiling, breaks or cuts in the skin and cuticles. Planning 2. Assemble the equipment. Implementation 3. Remove rings, chipped nail polish and watch and push long sleeves above the elbow. 4. Put on cap or hood, shoes cover and mask. 5. Use deep sink with side foot pedal. 6. Turn on water using foot or knee control. 7. Wet hands starting from the tips of fingers to forearms keeping hands higher than elbows. 8. Apply soap to a soap brush or open a pre packaged scrub. 9. With brush on dominant hand, scrub nails and all skin areas of non-dominant hand and arm using circular motion (ten strokes to each areas) 10. Repeat action in no.9 on dominant hand. 11. Place the fingertips under running water and thoroughly rinse the fingers, hands, and the arms and keeping hands and arms above elbow level. 12. Keep arms flexed and proceed to operating room. 13. Secure a towel by grasping it on one edge, and open it at full length. 14. Extend one side of the towel around fingers and hands and dry in rotating motion up to the ABLE TO PERFORM ABLE TO PERFORM WITH ASSISTANCE UNABLE TO PERFORM

8 elbow. 15. Reverse towel and repeat procedure on the other hand. 16. Discard towel into linen hamper. Evaluation 17. Inspect hands and nails for cleanliness. Documentation 15. Record time when handwashing was done. REMARKS:_________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________ Grade:____________________ Rating Scale: Excellent: 96-100% Very Satisfactory: 90-95% Very Good: 85-89% Good: 80-84% Fair: 75-79% Poor: 74 and below

CONTESSA MORA GABRIEL,RM,RN,MAN Clinical Instructor

_____________________ Students Signature

Prepared by: CONTESSA M. GABRIEL,RM,RN,MAN Professor