Hand washing

Hand washing procedure for nursing students

1. Hand washing C I Mustafa Abdulla

2. Introduction Hand Hygiene is the easiest and most important way to prevent spread of infection . You use your hands for almost everything. They are easily contaminated.

3. Purpose 1-To clean contaminated hands. 2-To remove dirt 3-minimize number of microorganism 4- To prevent cross and nosocomial infection.

4. Indications Hand hygiene is essential : 1- When hands are visible soiled 2- Before and after caring for a patient 3- After contact with organic material ,such as feces ,wound drainage ,and mucus 4 -In preparation for an invasive procedure ,such as suction catheterization ,or injections

5. 5- Before changing a dressing or having contact with open wounds 6- Befor preparing and administrating medications 7- After removing disposable gloves 8- Before and after using the toilet 9- Before and after eating 10- At the beginning and end of the shift .

6. Hands flora Resident Flora: Deep seated Difficult to remove Part of body’s natural defence mechanism Associated with infection following surgery/invasive procedures. Transient Flora: Superficial Transferred with ease to and from hands Important cause of cross infection Easily removed with good hand hygiene.

7. Hand Hygiene includes : 1- Hand washing Washing hands with plain soap and water 2- Antiseptic hand wash Washing hands with water and soap or other antiseptic agent 3- Alcohol-based hand rub Rubbing hands with an alcohol -containing preparation (used after hand washing)

8. 4- Surgical antisepsis Hand washing with antiseptic soap or alcohol-based handrub before operations by surgical personnel

9. Hand Care Nails Rings Hand creams Cuts & abrasions Skin Problems

10. Rings and Jewelry Studies have demonstrated that skin underneath rings is more heavily colonized than comparable areas of skin on fingers without rings.

11. Keep fingernails SHORT ! Not excesses 1/4 inch Avoid artificial nails Avoid nail polish Fingernails

12. Equipment: - Sink with warm and cold running water . - Tissue paper or small towels . - Trash can- nail cleaner - Soap dispenser or soap and soap dish .

13. Procedure Rational Nursing Actions 1-poor personal hygiene and an open area of the skin provide areas in which microorganisms are able to grow 1-inspect hands ,observing for visible soiling, breaks or cuts in the skin and cuticles 2-determine the type of hand hygiene needed 2-determine amount of contaminate of hands

14. Procedure… cont. Rational Nursing Actions 3-prevent contamination of hands during and after hand hygiene procedure 3-assess areas around the skin that are contaminated 4-microorganisms collect in jewelry and watch bands ;removing jewelry makes it easier to wash all areas of hands and wrists 4- remove jewelry except plain wedding band and push watch and long sleeves above wrist

15. Procedure… cont. Rational Nursing Actions 5-water is too hot or too cold can chap skin ,and too much force can cause splashing and spread microorganisms to other areas ,especially your clothing 5-adjust the water to appropriate temperature and force 6-hands are the most contaminated part of the upper extremities ;water should follow from the wrists (least contaminated areas) over the hands ,and then down the drain 6-wet hands and wrist under the running water ,always keeping hands lower than elbow s

16. Procedure… cont. Rational Nursing Actions 7- soap lather emulsifies fat and aids in cleaning 7-lather hands with liquid soap 8- helps to loosen soil and microorganisms , both resident (normally present )and transient (acquired from contamination) 8-wash hands thoroughly using a firm , circular motion and friction: a. Rub palms together

17. Procedure… cont. Rational Nursing Actions b. Rub the back of both hands c . Interlace and rub hands together

18. Procedure… cont. Rational Nursing Actions d. Interlock fingers and rub the back of fingers of both e. Rotational rubbing of left thumb clasped in right palm and vice versa ;

19. Procedure… cont. Rational Nursing Actions f. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa; g. Rub both wrists in a rotating manner ;

20. Procedure… cont. Rational Nursing Actions 9-Rinsing removes the loosened microorganisms ,and re-lathering ensures more thoroughly cleaning . the greater the contamination , the more needed for longer washing 9-wash for 15 to 30 s econds ,rinse thoroughly , relather ,and wash another minutes ,using continuous friction 10-The water should run from cleaner areas (the wrists) over the hands , and then down the drain , rinsing microorganisms away 10- rinse wrists and hands completely --- keep hands lower than elbows

21. Procedure… cont. Rational Nursing Actions 12-prevent chapping .drying should progress from clean to less clean , and the cleanest areas are now your fingers and hands 12-dry hands thoroughly with paper towels . -start by patting at fingertips , then hands ,then wrists and forearms

22. Procedure… cont. Rational Nursing Actions 13- keeps cleans hands from touching contaminated hands 13- turn of faucets using a dry paper towels 14- keeps skin soft and lubricated so it will not crack easily 14-use hospital-approved hand lotion if desired

23. Procedure… cont. Rational Nursing Actions 15- ensures cleanliness of hands and nails 15- inspect hands and nails for cleanliness 16-helps the patient understand that hand hygiene slows down the spread of infection 16- provide patient teaching .explain to the patient the importance of hand hygiene

24. Hand Hygiene: Frequently Missed Areas Courtesy of SDS Kerr

25. Remember : Bacteria and viruses can cause illness and even death. Hey, wait a minute! We’re not all bad!

26. And remember… No Matter Where You Are… No Matter What You Do… WASH YOUR HANDS!