HAND WASHING Procedure 29-1: Handwashing

Performed Preparation Yes No Mastered Comments 1. Determine: Presence in client of factors increasing susceptibility to infection Whether client uses immunosuppressives Clients medications Recent diagnostic procedures or treatments that penetrated the clients skin or a body cavity Clients current nutritional status Signs and symptoms indicating the presence of an infection: Localized signsswelling, redness, pain or tenderness with palpation or movement, palpable heat at site, loss of function of affected body part, presence of exudate Systemic indicationsfever, increased pulse and respiratory rates, lack of energy, anorexia, enlarged lymph nodes 2. Determine: The location of running water and soap or soap substitutes 3. Assemble equipment: Soap Warm, running water Disposable or sanitized towels 4. Assess the hands: Nails should be kept short. Remove all jewelry. Check hands for breaks in the skin, such as hangnails or cuts. Procedure 1. If you are washing your hands where the client can observe you, explain to the client what you are going to do and why it is necessary. 2. Turn on the water, and adjust the flow: For knee levers, move with the knee to regulate flow and temperature. For foot pedals, press with the foot to regulate flow and

temperature. For elbow controls, move with the elbows instead of the hands. For infrared control, motion in front of the sensor causes water to start and stop flowing automatically. Be sure to adjust flow so that water is warm. 3. Wet the hands thoroughly by holding them under the running water, and apply soap to the hands. Hold the hands lower than the elbows, so that the water flows from the arms to the fingertips. If the soap is liquid, apply 24 ml (1 tsp). If it is bar soap, granules, or sheets, rub them firmly between the hands. 4. Thoroughly wash and rinse the hands. Use firm, rubbing, and circular movements to wash the palm, back, and wrist of each hand. Interlace the fingers and thumbs, and move the hands back and forth. Continue this motion for 10 seconds. Rub the fingertips against the palm of the opposite hand. Rinse the hands 5. Thoroughly dry the hands and arms. Dry hands and arms thoroughly with a paper towel. Discard the paper towel in the appropriate container. 6. Turn off the water. Use a new paper towel to grasp a hand-operated control

Variation: Handwashing Before Sterile Technique

Procedure Apply the soap and wash as described in step 4, but hold the hands higher than the elbows during this hand wash. Wet the hands and forearms under the running water, letting it run from the fingertips to the elbows so that the hands become cleaner than the elbows. Apply the soap and wash as described earlier in step 6, maintaining the hands uppermost. After washing and rinsing, use a towel to dry one hand thoroughly in a rotating motion, from the fingers to the elbow. Use a new towel to dry the

other hand and arm.