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Medical Handwashing Purpose: 1. 2. 3. 4. To To To To reduce reduce reduce reduce the the the the number of microorganisms on the hand.

risk of transmission of microorganisms to client. risk of cross contamination. risk of transmission of infectious organisms of oneself.

Equiptment: 1. Easy to reach sink and warm running water. 2. Antimicrobial or regular soap. 3. Paper towels or air dryer or towels. Procedure: 1. Inspect surface of hands for breaks or cuts in skin or cuticles. Open cuts of wounds can harbor high concentrations of microorganisms. 1. Inspect hands for heavy soiling/dirt. Requires longer handwashing. 1. Inspect nails for length. Nails should be short and filed because mostes microbes on hands come from beneath the fingernails. 1. Remove jewelries and push long uniform sleeves above wrists. Microorganism can lodge in the settings of jewelry and under ring. Removal of it failitates proper cleaning of hands and arms. 1. Stand in fron of sink, keeping hands and uniform away from the sink surface. Inside of sink is a contaminated area. Reaching over sink increases risk of touching edge, which is contaminated. 1. Turn on, water. Turn faucet on or push knee pedals laterally or press foot pedals to regulate water flow and temperature. 2. Avoid splashing of water against uniform. Microorganism travel and grow in moisture. 1. Regulate flow of water so that temperature is warm. Warm water removes less of the protective oils than hot water. 1. Wet hands and wrists thoroghly under running water. Keep hands and forearms lower than elbows during washing. Hands are the most contaminated parts to be washed. Water flows from least to most contaminated area, rinsing microorganisms into the sink. 1. Apply small amount of soap or antiseptic lathering thoroughly. Use antiseptic exclusively can be drying to hands and can cause skin irritation. The decision whether to use antiseptic should depend on the procedure to be performed and the clients immune status. 1. Apply The 8 Strokes of handwashing. a. Right palm over left palm.

b. c. d. e. f. g.

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1. 1.

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Left palm over right palm. Palm to palm with fingers inserted. Back fingers to opposing fingers interlocked. Rotational rubing of right thumbs in the left palm. Rotational rubing of left thumbs in the right palm. Rotational rubing backwards and forwards with tops of fingers and thumbs of right hand in left palm. h. Rotational rubing backwards and forwards with tops of fingers and thumbs of left hand in right palm. Rinse hands and wrists thoroughly, keeping hands down and elbows up. Rinsing mechanically washes away dirt and microorganism. Dry hands thoroughly from fingers to wrist and forearms with paper towel/clean cloth towel, single used cloth, or warm air dryer. Drying from cleanest to least clean area avoids contamination. Drying hands prevent chapping and rouhened skin. Discard paper towel/clean cloth towel, if used, in proper receptacle. Prevents transfer of microorganisms. Turn off water with foot or knee pedals. To turn off hand faucet, use clean dry paper towel/ clean cloth towel. Avoid touching handless with hand. Wet towel and hands allow transfer of pathogens by capillary actions. If hands are dry or chopped, a small amount of lotion or barrier cream can be applied. Use small, individual-use container of lotion because large, refillable containers have been associated with nosocomial infections. Insect surfaces of hands for obvious signs of soil or other contaminants. Determine if hand washing is adequate. Inspect hands for dermatitis or cracked skin. Indicates complications from excessive handwashing.

Gloving (Open Method) Equiptment: Sterile gloves

Procedure: 1. Perform thorough hand washing. 2. Remove outer glove package wrapper by carefully separating and peeling apart sides. 3. Lay inner package on clean, flat surface just above waist level. 4. Open package, keeping gloves on inside surface of wrapper. 5. If gloves are not prepowdered, apply sterile powder lightly to hands over sink or wastebasket. 6. Identify sides of right and left gloves. 7. Start by applying glove to dominant hand with thumb and first two fingers on nondominant hand, grasp edge of cuff of glove of dominant hand, touching only inside surface. 8. Carefully pull glove over dominant hand, ensuring cuff does not toll up to the wrist. 9. With gloved dominant hand, slip fingers underneath second gloves cuff to pick it up. 10.Carefully pull second glove over nondominant hand, and do not allow gloved hand to touch any part of exposed nondominant hand. Keep thumb of dominant hand abducted back. 11.When both gloves are on, interlock fingers of both hands to secure gloves in position. Being careful to touch only sterile sides. 12.Dispose of Gloves: a. Without touching wrist, grasp outer side of one cuff with other gloved hand. b. Pull glove off, turning inside out. Discard in receptacle. c. Tuck fingers of bare hand inside remaining glove cuff. Peel glove off, inside out. Discard in receptalce. d. Wash hands with soap and water.

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