Medical Hand washing

- Is a vigorous, brief rubbing together of all surfaces of lathered hands, followed by rinsing under a
stream of warm water, it removes microorganisms mechanically from hands
PURPOSE
- To remove transient micro organisms, acquired through everyday tasks in the clinical setting from
the surface of the hands.
- To protect both the patients and staff.
- To prevent infection.
- To avoid transmitting pathogenic microorganisms.
MATERIALS
- Antibacterial liquid soap
- Orange stick or toothpick
- Sterile towel
PRINCIPLES
1. Clean and wash hands should be from the least contaminated(elbow) to the most contaminated
(palms).
2. Effective handwashing Is an essential part in everyday clinical practice
3. Use running water in a sink that drains out instead of using a basin.
4. Use an antibacterial liquid soap instead of bar soap.
5. You must rub your hands against each other for at least 30 seconds to facilitate removal of
microorganisms.
6. Long nails and jewelry trap germs keep fingernails short
7. It is always better to use disposable paper towels than to use cloth towel when drying hands to
ensure that you can only use those once .
8. The faucet is always considered dirty and it us recommended to turn it off using a paper towel in
the absence of the ideal sensor or foot pedal.

The WHO guidelines on “hand Hygiene in healthcare” describe five key situations where hand
washing is required
5 MOMENTS FOR HAND HYGIENE
- Before touching the patient
- Before a clean or aseptic procedures
- after body fluid exposure risk
- after touching a patient
- after touching patient surroundings

STEPS
1. inspect surface of your hands for breaks or cuts in skin or cuticles. Cover any skin lesions with a
dressing before providing care .
2. inspect condition of nails natural tips need to be less than ¼ inch long and free of artificial nails,
extenders or polish
3. push long uniform sleeve above the wrists. Avoid wearing jewelry.
4. Stand in front of sink, keeping hands and uniform away from sink surface.
5. Turn on water faucet. Avoid splashing water against uniform.
6. Wet hands and wrist thoroughly under running water keep hands and forearms lower than
elbows during washing.
7. Apply 3-5ml of antiseptic soap and rub hands palm to palm, lather thoroughly.
8. Wash hands using plenty of lather and friction for at least 15-20 seconds. Interlace fingers and
rub palms and back of hands with circular motion at least 5 times each.
9. Palm to palm with fingers interlaced. Then back of fingers to opposing palms with fingers
interlaced
10. Perform rotational rubbing of left thumb clasped in right palm and vice versa. Then rotational
rubbing, backward and forwards with clasped fingers of right hand in left palm ang vice versa.
11. Areas under fingernails are often soiled. Clean them with fingernails of other hand and
additional soap with a stick.
12. Rinse hands and wrist thoroughly, keeping hand down and elbows up.
13. Dry hands thoroughly from fingers to wrist and forearms with a towel.
14. To turn off faucet use clean towel, avoid touching handles with hands.

SURGICAL HAND WASHING

- Is an antiseptic handwash or hand -rub technique that surgical personnel perform before
surgery to eliminate transient microorganisms and reduce resident hand flora.

PURPOSE
- Remove debris and transient microorganisms from the nails, hands and forearms.
- Reduce the resident microbial count to a minimum, and
- Inhibit rapid rebound growth of microorganisms.

MATERIALS
- Antibacterial liquid soap
- Surgical scrub brush
- Orange stick or toothpick
- Surgical mask
- Surgical cap
- Sterile towel

STEPS
- Wet clean surgical Brush and apply antimicrobial agent. Visualize each finger hand and
arms as having four sides, wash all four sides effectively. Scrub the nails of one hand with
15 strokes. Scrub the palm, each side of the thumb and finger and posterior side of hand
with 10 strokes each.
- Do the same with the other hand.
- Divide arm mentally into thirds. Scrub the sides of each third 10 times. Rinse brush and
repeat sequences for the other arm.
- Discard brush, flex arm and rinse from fingertips to elbows in one continuous motion,
allowing water to run off at elbow
 - Turn off water with foot or knee control, with hands elevated in front of and away from
body.
- Approach sterile set up, grasp sterile towel and dry oe hand , moving from fingers to
elbow in a rotating motion.
- Repeat drying method for other hand by carefully reversing towel or using a new sterile
towel
- Drop towel into linen hamper.

OPEN GLOVING TECHNIQUE- is the technique of placing sterile gloves on the hands.

PURPOSE -to protect both caregiver and patient from transmissible diseases.

MATERIAL. – 1 PAIR STERILE GLOVES

STEPS
1. Perform thorough medical hand washing
2. Remove outer glove package wrapper by carefully separating and peeling apart sides.
3. Grasp inner package and lay it on clean, flat surface just above waist level. Open package,
keeping gloves on wrappers inside surface.
4. Identify right and left glove. Each glove has cuff approximately 2 inches wide. Glove dominant
hand first .
5. With thumb and first two fingers of nondominant hand , grasp edge of cuff of glove for
dominant hand. Touch only inside surface of glove.
6. Carefully pull glove over dominant hand leaving cuff and being sure that it does not roll up wrist.
Be sure that thumb and fingers are in proper spaces.
7. With gloved dominant hand slip fingers underneath cuff or second glove.
8. Carefully pull second glove over nondominant hand. Do not allow fingers and thumb of gloved
dominant hand to touch any part exposed nondominant hand. Keep thumb of dominant hand
abducted back.
9. After second glove is on, interlock fingers, gloved hands and hold away from body above waist
level until beginning procedure.

REMOVING GLOVES
10. Grasp outside of one cuff with other gloved hand avoid touching wrist, pull halfway down palm
of hand. Take thumb of half- ungloved hand and place under cuff of other glove.
11. Pull glove off, turning it inside out. Discard receptacle.
12. Take fingers of bare hand and tuck inside remaining glove cuff. Peel glove off inside out. Discard
in receptacles.