HAND GLOVING

 All health care providers must apply clean or sterile gloves according to the risk of exposure to potentially
infective materials.

Gloves are a type of personal protective equipment (PPE).

 TYPES OF PPE
 - gown
 - masks
 - shoes
 - head covers
 - face shields

Antimicrobial soap – help to prevent microorganisms

Antibacterial soap – help to prevent bacterias

Types of endogenous microorganisms

 - staphylococcus epidermidis
 - staphylococcus aureus

Gloves create a barrier between microorganism and yourhands. Wearing gloves in the hospital prevents
the spread of microorganism.
 
 THE GLOVES ARE WORN FOR THREE REASONS:
 1. They protect the hand when the nurse is likely to handle any body substances (bodily fluids and  
           tissues, mucous membrane or broken skin.)
 2. Reduce the likelihood of nurses transmitting their own endogenous microorganisms to individuals
           receiving area.
 3. Reduce the chance that the nurse‘s hands will transmit microorganisms from one client to another

THE HANDS ARE WASHED EACH TIME THE GLOVES ARE REMOVED FOR TWO PRIMARY
REASONS:

A. The gloves may have imperfections or be damaged during wearing that allows entry of
microorganism.
B. The hands may become contaminated during glove removal
Equipment:
 1. Sterile pair of rubber gloves (right size)
 2. powder
 3. Transfer forceps

Action Rationale

1. See to it that the nurse‘s nails are 1. To prevent tears in the gloves.
adequately trimmed.
2. Prepare the equipments .  
3. Do medical handwashing.
3. This washes off microorganisms that might
4. Lay the glove pocket with cuff of the gloves
be sources of nosocomial infections.
facing the worker.
5. Open the glove pocket and pick the 4. For easier pick up of the cuff without
powdered paper containing the gloves with contaminating the unexposed area.
the transfer forceps.
6. Powder the palm and interdigital spaces by 5. Observing aseptic technique to prevent
Interlacing the digits; rub the back of the contamination
hands with the powdered palms
7. Pick the folded cuff with the forefinger and 6. Powder makes it easy to slide the hand and
thumb of one hand. Keep other fingers of insert it to the gloves.
this hand clinched.
8. Bring the thumb of the hand to be gloved 7. To prevent accidental contamination with
towards the small fingers across the palm. sterile part of the gloves.
9. Hold the remaining fingers close to each
other.  
10. Insert this hand into the cuff of the glove,
thrusting it forward while the other hand
holding the glove pulls it backward. Never
release the glove until the thumb is in the
right place.

11. Spread the rest of the fingers to find its

digits in the glove.

12. Gently release the folded cuff.

13. Insert two or three fingers (forefinger and

middle finger) of the gloved hand under the
folded cuff of the remaining glove.

14. Thrust this well forward until the middle

finger and the thumb is in each proper digit of
the glove.

15. The fingers in the fold of the cuff should

manage to push the cuff downward, well into
the wrist 

16. Insert two fingers into the fold of the first

glove and push it well into the wrist of the
first hand, taking care not to allow any of
each part to touch the ungloved skin at the
wrists.
R - To avoid accidental contamination with the
17. Keep gloved hands clinched until the
environment.
procedure starts.

Removal of the gloves:

Action Rationale
1. Remove one glove by grasping the cuff of 1. Allows to dispose both gloves at once by
the glove and pulling downwards so that the enclosing one glove within the other
glove turns inside out. Hold the glove you
remove in the remaining gloved hand 2. The inside of the gloves are considered
cleaner than the outside
2. Slip fingers of the ungloved hand inside the
cuff of the other glove. Pull the glove off, inside  
out.

3. Hold contaminated gloves away from the

body. Dispose of the in the proper designated
waste receptacle.
HAND WASHING

What is Handwashing?

- It is an act of cleaning ones hand with the use of any liquid or bar soap for the purpose of
removing dirt or microorganism. It is the most effective measure in reducing the risk of
transmitting infectious diseases. In a hospital setting, it is also the most important
procedure in preventing nosocomial or hospital acquired infections

Examples of hospital acquired infections

  - UTI
  - Central line associated
  - Surgical site infection
  - Ventilator associated pneumonia

Definition of terms

• Hand hygiene - general term referring to any actions of hand cleansing, this includes handwashing ,
antiseptic handwash , and surgical hand antisepsis.

• Hand washing - defined as the washing of hands either with plain (non antimicrobial) soap or antimicrobial
soap and water for the purpose of removing soil and transient microorganism.

• Antiseptic handwash - term that applies to handwashing with an antimicrobial soap and water for the   
                          purpose of destroying transient microorganism and reduce resident flora.

• Surgical hand antisepsis - commonly called as surgical hand scrub . This is to remove as many
                         microorganism from the hands as possible before the sterile procedure. Recommended
                        duration is 2-6 minutes.

Concepts

• use running water in a sink that drains out water instead of using a basin
• must rub the hands against each other for at least 10-30 seconds to facilitate proper removal of  
   microorganism
• long nails and jewelry traps microorganism. It is best to keep fingernails short and trimmed and remove 
    jewelries
• it is better to use disposable paper towels than use dry cloth when drying hands to ensure it can only be  
   used once.
• the faucet is always considered dirty and it is recommended to turn off using a paper towel or dry cloth in
   the absence of the ideal sensor or foot pedal.
• dispensers of soap should be used until completely empty. Once emptied, it should be washed before
    refilled.

Indicators of Hand Hygiene

According to WHO, there are five (5) moments for hand hygiene:

1. Before patient contact

2. Before clean/antiseptic procedure
3. After body fluid exposure risk
4. After patient contact.
5. After contact with patients surroundings

Supplies needed for hand washing:

 - liquid or bar soap
 - lotion (optional)
 - dry towels/paper towel
 ACTION
1. Stand in front of the sink. Do not allow your
uniform to touch the sink during the washing
procedure
2. Remove your jewelry ( a plain wedding band
does not have to be removed)
3. Turn on water and adjust force
4. Wet the hands and wrist area. Keep hands
than elbows to allow water to flow toward
fingertips.
5. Use about 1 tsp. or 3 to 5 mL liquid soap
from dispenser or lather
6. With firm rubbing and circular motions, wash
the palms and back of the hands with
interlaced fingers, back of fingers to opposing
thumb with fingers inlerlock , each finger, the
knuckles, wrists and forearms. Wash up the
forearms at least as high as contamination is
likely to be present
7. Continue this friction motion for 10 to 30
seconds  degree of contamination and required for
8. Use brush or fingernails or the other hands
to clean under fingernails of the other hand
9. Rinse hands thoroughly . Keep hands below
wrist and forearm
10. Dry hands and wrists with towel
11. Turn off the faucet with a dry paper towel
(desirable) or cloth.
12. Use lotion on hands, if desired
RATIONALE
1.The sink is considered contaminated.
Uniforms may carry organisms from place to
place.
2.Removal of jewelry facilitates proper
cleansing. Microorganisms may accumulate in
settings of jewelry.
3.Water splashed from contaminated sink will
contaminate your uniform
4.Water should flow from the cleaner area
toward the more contaminated area. Hands are
more contaminated that forearms
5. Rinsing the soap removes the lather that
may contain microorganisms
6. Friction caused by firm rubbing and circular
motions helps to loosen dirt and organisms that
can lodge between fingers , in skin crevices of
knuckles, on palms and back of the hands, as
well as the wrists and forearms
7. Length of hand washing is determined by
mechanical removal of microorganism and to
give antimicrobial soap adequate contact with
the skin surfaces to be effective.
8. Organisms can lodge and remain under the
nails where they can grow and be spread to
others
9. Visually inspect for remaining dirt or soap.
Running water washes organisms, dirt and
residual soap into the sink. Prevents from
flowing down the arms or wetting the uniform
10. Drying the skin will prevent chapping
11. prevents contamination of the hands from
faucet
12. Lotion helps keep the skin soft and
prevents chapping
Variation: Using Alcohol based handrubs
1. Use alcohol based handrubs when hands
are not soiled.
2. Apply sufficient quantity of antiseptic solution
to cover the hands and wrist
3. Rub antiseptic solution on all surfaces of the
fingers and hands until they are dry
1. Antiseptic solutions are not effective when
organic material or dirt from hands are present
2. All surfaces must be covered to remove
microorganism
3. ensures the effectiveness of the solution;
usually takes 10 to 15 seconds