MEDICAL HANDWASHING / PROPER HANDWASHING

 is the act of cleaning ones hands with or without the use of water or
another liquid, or with the use of soap, for the purpose of removing soil,
dirt, and/or microorganism.
 is the single most important infection control practice.

3 Essentials Elements of Handwashing

1. Soap (liquid soap)

2. Water (medium)
3. Friction (rubbing)

Handwashing should be performed:

1. When you are in doubt
2. Before and after each task
3. Before and after direct client contact
4. After arriving and leaving from work
5. After removing gloves
6. When hands are visibly soiled
7. Before and after eating
8. After excretion of body waste
9. After contact with body fluids
10. Before and after performing invasive procedures
11. After handling contaminated equipment

MEDICAL HANDWASHING TECHNIQUE

Equipment needed:
Liquid soap/Soap Handtowel
Nail brush Orange Wood Stick
Tissue paper Sink
Running Water

Procedure:

1. Assess the environment

2. Check all the equipment needed
Rationale: No interruption during the procedure
3. Remove jewelries. Push sleeves of uniform shirt up above the elbow.
Rationale: Provide access to skin surfaces for cleaning.

4. Asses hands for cuts, breaks, wounds in the skin, and areas that are
heavily soiled.
Rationale: Intact skin acts as a barrier to microorganisms.

5. Turn on the water. Adjust the flow of water check the temperature. Water
temperature should be warm.
Rationale: Running water removes microorganism. Warm water removes
less of the natural skin oils than does hot water.

6. Wet hands starting from the elbow down to the hands and lower forearms
thoroughly by holding under the running water. Keep both hands and
forearms in the down position and with elbow straight. Avoid splashing
water and touching the side of the sink.
Ration` ale: Water should flow from the least contaminated to the most
contaminated areas of the skin. Hands are considered most contaminated
than arms. Splashing of water facilities transfer of microorganism.
Touching any surface during cleaning contaminates the skin.
7. Apply about 5ml (1 teaspoon) of liquid soap. Lather throughly
Rationale: Lather facilities removal of microorganisms.

8. Throughly rub hands together for 20secs. Rub palm to palm. Rub starting
from the elbow down to the hands in a circular motion and apply friction
when rubbing. Right palm over the forearm of the left arm in a circular
motion going down to the hand. Change hand and repeat.
Rationale: Friction mechanically removes microorganisms from the skin
surface. Friction loosens dirt from soiled areas.

9. Lather the soap, right hand over back of the left hand. Change hand and
repeat. Interlace fingers of the right hand over left. Give special attenion on
the interdigital space of the hands. Change hand and repeat. Rotational
rubbing backward and forward for each finger of the righthand of left hand
and palm. Change hand and repeat.
Rationale: Lather soap producesa lot of bubbles for easy removing the dirt.
10. Knuckles to knuckles rub thoroughly. Change hand and repeat. Side of the
hands rub in circular motion to the palmar of the other hand. Change hand
and repeat.
11. Use nailbrush to clean the nails and brush it away from the hand followed
by orange wood stick to remove all the dirt hiding inside the fingernails.
Rationale: fingernails are area known to harbor organisms.

12. Rinse hands in down position starting from the elbows straight. Rinse in
the direction of forearm to wrist to fingers.
Rationale: flow of water rinses dirt and microorganism
 13. Turn off the faucet with clean dry tissue paper.
Rationale: Prevent contamination of the clean hands.

14. Blot hands and forearms to dry throughly. Pot dry in the direction of
fingers to wrist and forearm.
Rationale: Blotting reduces chapping of the skin. Drying from cleanest to
least clean area.

Use of Barriers
Techniques that prevent the transfer of pathogens from one person to another
are referred to as barriers.

Common Barriers
1. Masks
2. Caps and shoe coverings
3. Gloves
4. Private rooms
5. Water proof disposable bags for linen and trash
6. Labeling and bagging of contaminated equipment and specimen
7. Gogles
8. Gowns

SURGICAL CAPS

It should wear it in a manner to cover the hair completely. The wearing of the cap
prevents the possible contamination of the sterile field by falling hair or dandruff.

Procedure :

Female : Wear the cap starting from the back area going to the front and see to it
that all hair covers the cap, no excess hair outside the cap or falling hair on the
face.
Male : Wear the cap starting from the front going to back area and see to it that
the entire hair covers the cap.

MASK

How to put Surgical Mask

1. Make sure your hands are clean. Wash them in a quality-grade soap and rub them
together to help loosen any dirt or bacteria. You may even be asked to put on a pair
of sterile gloves before putting on the surgical mask.
2. Gently pull the mask open.
3. You can do this easily by pulling on the top and bottom of the mask from the
middle.
4. Gently place the mask over your face. Now rub over the area of the mask that will
lie above your nose. This will allow the mask to fit your nose better, giving you
greater comfort and better breathing.
5. Grasp the top ties in your hands and pull behind your head, near that area of your
crown. Gently but firmly tie the top ties behind your head. Make sure the ties are
tight enough to hold the mask in place. You may even want to tie them in a bow.
6. Pull the bottom ties behind your back. Tie them firmly together. Make sure the
mask feels secure.
7. Rub over the area that covers your nose. Make sure it fits securely and snugly,
especially if your mask has a built in nose piece.
8. Take a deep breath and let it out slowly. Does you feel like you can breathe smoothly
and normally? Does you mask feel as it will stay in place? Adjust if needed.

How to remove Surgical Mask

1. Clean your hand with soap and water or hand sanitizer before touching the
mask.

2. Avoid touching the front of the mask. The front of the mask is
contaminated. Only touch the ear loops/ties/band.

3. Follow the instructions below for the type of mask you are using.
 Face Mask with Ear loops: Hold both of the ear loops and gently lift
and remove the mask.
 Face Mask with Ties: Untie the bottom bow first then untie the top
bow and pull the mask away from you as the ties are loosened.
 Face Mask with Bands: Lift the bottom strap over your head first
then pull the top strap over your head.

4. Throw the mask in the trash.

5. Clean hands with soap and water or hand sanitizer.

STERILE GLOVES
- sterile or clean fitted coverings for the hands, usually with a separate
sheath for each finger and thumb. Clean gloves are worn to protect
health care personnel from urine, stool, blood, saliva, and drainage from
wounds and lesions of patients and to protect patients from health care
personnel who may have cuts. Sterile gloves are worn when there is
contact with sterile instruments or a patient's sterile part.

APPLYING STERILE GLOVES

1. Asses the glove package

2. Asses the surface area

3. Wash hands
4. Remove the alter wrapper from the package place, the inner wrapper
onto a clean, dry, flat surface. Surface should be at or above waist
height level.

5. Open inner wrapper to expose gloves using the dominant hand and
start picking the farthest edge corner of the wrapper.
6. Indentify R & L hand
7. Glove dominant hand first

8. Grasp the 2 inches (5cm) wide cuff & the thumb and two first fingers
in the on-dominant hand touching only the cuff.

9. Gently pull the glove over the dominant hand, hold hand above waist
while applying gloves, keep hands risible and above waist to prevent
accidental contaminations.

10. With the gloved dominant hand slip with fingers the cuff of the
other glove.
11. Gently slip the glove onto non-dominant hand be carefulto
drag glove/touch gloved dominat hand & in gloved non-dominant
hand.
 12. With gloved into each fingers.

REMOVING SOILED GLOVES

1. Slip glove fingers of the dominant hand under the cuff of the
opposite hand, grasp the outer part of the gloves at the wrist part.
2. Pull the glove down to the fingers exposing the thumb.
3. Slip the uncovered thumb into the opposite glove at the wrist.
4. Pull the glove down over the dominant hand most to the fingertip
and slip the glove to the other hand.
5. Pull the glove over the dominant hand so that only the inside
expose and it will become one unit.
6. Dispose in the proper receptacle and then hand wash.