Handwashing Procedure PDF

ASEPSIS AND INFECTION CONTROL  HAND HYGIENE Hands should be cleansed at the following times to prevent the spread of microorganisms: before eating, after using the bedpan or toilet,and after the hands have come in contact with any body substances, (e.g., sputum or drainage...

ASEPSIS AND INFECTION CONTROL  HAND HYGIENE Hands should be cleansed at the following times to prevent the spread of microorganisms: before eating, after using the bedpan or toilet,and after the hands have come in contact with any body substances, (e.g., sputum or drainage from a wound. HAND HYGIENE For routine client care, vigorous hand washing under a stream of water for 15 to 20 seconds using granular soap, soap- filled sheets, or liquid soap at the beginning of the nurse’s shift, when hands are visibly soiled, and after using the toilet is recommended (WHO, 2009). PERFORMING HAND HYGIENE PURPOSE: To reduce the number of microorganisms on the hands. To reduce the risk of transmission of microorganisms to clients. To reduce the risk of cross contamination among clients. To reduce the risk of transmission of infectious organisms to oneself. PERFORMING HAND HYGIENE ASSESSMENT: Determine the client’s: Presence of factors increasing susceptibility to infection and possibility of undiagnosed infection (e.g., HIV) Use of immunosuppressive medications Recent diagnostic procedures or treatments that penetrated the skin or a body cavity Current nutritional status PERFORMING HAND HYGIENE ASSESSMENT: Determine the client’s: Signs and symptoms indicating the presence of an infection: Localized signs: swelling, redness, pain or tenderness with palpation or movement, palpable heat at site, loss of function of affected body part, presence of exudate. Systemic indications: fever, increased pulse and respiratory rates, lack of energy, anorexia, enlarged lymph nodes. PERFORMING HAND HYGIENE PLANNING: Determine the location of running water and soap or soap substitutes. DELEGATION: The skill of hand hygiene is identical for all health care providers, including unlicensed assistive personnel (UAP). Health care team members are accountable for themselves and others to implement appropriate hand washing procedures. PERFORMING HAND HYGIENE INTERPROFESSIONAL PRACTICE: Hand washing is an essential skill for all health care providers. EQUIPMENTS: Soap Warm Running Water Paper Towels  HANDWASHING STEPS: 1.Silently recite the prayer for the success of the procedure. 2.Inspect surface of your hands for breaks or cuts in skin or cuticles. 3.Inspect hands for visible soiling.  HANDWASHING RATIONALE: Short, natural nails are less likely to harbor microorganisms, scratch a client, or puncture gloves. A nurse who has open sores may require a work assignment with decreased risk for transmission of infectious organisms due to the chance of acquiring or passing on an infection.  HANDWASHING STEPS: 4. Remove wristwatch, rings and fold the sleeves above the wrists. RATIONALE: Although the research is controversial, microorganisms can lodge in the settings of jewelry and under rings. Removal facilitates proper cleaning of the hands and arms.  HANDWASHING STEPS: 5. Stand in front of the sink, keeping hands and uniform away from the sink surface. 6. Turn on water with a foot pedal (if no foot pedal, use dry paper towel). Regulate flow of water.  HANDWASHING STEPS: 7. Wet hands and wrists thoroughly under running water. Keep hands and forearms lower than elbows during washing. RATIONALE: The water should flow from the least contaminated to the most contaminated area; the hands are generally considered more contaminated than the lower arms.  HANDWASHING STEPS: 8. Apply 3-5 ml of antiseptic soap and rub hands together lathering thoroughly. Note: If the soap is liquid, apply 4 to 5 mL (1 tsp). If it is bar soap, granules, or sheets, rub them firmly between the hands.  HANDWASHING STEPS: 9. Wash hands for at least 1 minute as follows: 9.1 Rub hands palm to palm. 9.2 Rub hands palm to palm, with fingers interlaced with palm of other hand. 9.3 Rub hands palm to palm with fingers interlaced.  HANDWASHING STEPS: 9. Wash hands for at least 1 minute as follows: 9.4 Rub back of fingers to opposing palms with fingers interlocked. 9.5 Sweep hand from fingers to thumb 9.6 Rub tips of fingers in opposite palms- circular motion  HANDWASHING STEPS: RATIONALE: The circular action creates friction that helps remove microorganisms mechanically. Interlacing the fingers and thumbs cleans the interdigital spaces. 9.7 Rub each wrist with opposite hand  HANDWASHING STEPS: 10. Areas under fingernails are often soiled, clean with fingernails of other hand and additional soap with an orange stick (optional). RATIONALE: The nails and fingertips are commonly missed during hand hygiene. 11. Hold arms down elbow straight and rinse.  HANDWASHING STEPS: 12. Dry thoroughly from the fingers to wrist to forearm with a paper towel or face towel. 13. Discard paper towel or face towel. 14. Turn off faucet with foot pedal. (If there is no foot pedal, use paper towel to turn off faucet.)  HANDWASHING STEPS: RATIONALE: This prevents the nurse from picking up microorganisms from the faucet handles. 15. Evaluate the need for frequency of hand washing during client care. HANDWASHING