HAND HYGIENE Notes for ANM,GNM, B.Sc.Nursing, P.B.B.Sc.Nursing

1. HAND HYGIENE AND
HAND WASHING
Prepared By: Mrs. Leena Sameep Sakpal.
Nursing Tutor

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

3. • Handwashing is the act of cleaning one’s hands with the use of any liquid with or without
soap for the purpose of removing dirt or microorganisms. It is the most effective measure in
reducing the risk of transmitting infectious diseases.
• It cannot be said too often that hand washing is the most important and most basic technique
in preventing and controlling infections. It is the single most effective infection
control measure.
• Handwashing is under the umbrella of hand hygiene. Hand hygiene is defined by the World
Health Organization as a general term that applies to handwashing, antiseptic handwash,
antiseptic hand rub or surgical hand antisepsis.

5. PURPOSE
• To clean contaminated hands.
• To remove dirt .
• Minimize number of microorganism.
• To prevent cross and nosocomial infection.
• Avoid pathogenic microorganisms and to avoid
transmitting them.

6. INDICATIONS
According to the World Health Organization (WHO), there are Five Moments
for Hand Hygiene:
1.Before Patient Contact.
2.Before and Antiseptic Task.
3.After Body Fluid Exposure Risk.
4.After Patient Contact.
5.After Contact with Patient Surroundings.

8. • When hands are visible soiled.
• Before and after caring for a patient.
• After contact with organic material ,such as feces ,wound drainage ,and mucus.
• In preparation for an invasive procedure ,such as suction catheterization ,or injections
• Before changing a dressing or having contact with open wounds.
• Before preparing and administrating medications.
• After removing disposable gloves.
• Before and after using the toilet.
• Before and after eating.
• At the beginning and end of the shift.

9. HAND HYGIENE
Hand Hygiene include :
• Hand Hygiene - It is a general term that applies to handwashing, antiseptic handwash,
antiseptic hand rub, or surgical hand antisepsis
• Hand Washing - It is defined as the washing of hands with plain (i.e., non-antimicrobial)
soap and water.
• Antiseptic Handwash - A term that applies to handwashing with an antimicrobial soap and
water.
• Surgical Hand Antisepsis - Commonly called as a surgical hand scrub. This is to remove as
many microorganisms from the hands as possible before the sterile procedure.

10. TYPES OF HAND WASHING
• Routine handwash. Use of water and non-antimicrobial soap for the purpose of removing
soil and transient microorganisms.
• Antiseptic handwash. Use of water and antimicrobial soap (e.g., chlorhexidine, iodine and
iodophors, chloroxylenol [PCMX], triclosan) for the purpose of removing or destroying
transient microorganisms and reduce resident flora.
• Antiseptic handrub. Use of alcohol-based handrub.
• Surgical antisepsis. Use of water and antimicrobial soap (e.g., chlorhexidine, iodine and
iodophors, chloroxylenol [PCMX], triclosan) for the purpose of removing or destroying
transient microorganisms and reduce resident flora. Recommended duration is 2-6 minutes.

11. PRINCIPLES
Principles and concepts surrounding hand hygiene:
• You must use running water in a sink that drains out instead of using a basin.
• You may use soap – antibacterial soap if necessary.
• You must rub your hands against each other for at least 30 seconds to facilitate removal of
microorganisms.
• Long nails and jewelry trap germs. It is best to keep fingernails short. If you wear a ring, it is
better not to remove the ring before hand washing so that it can be washed too.
• 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.

12. • The faucet is always considered dirty and it is recommended to turn it off using a paper
towel 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.

13. EQUIPMENTS
• Sink with warm and cold running water.
• Tissue paper or small towels.
• Trash can- nail cleaner.
• Soap dispenser or soap and soap dish.

14. PROCEDURE

15. STEPS RATIONALE
1. Inspect hands ,observing for visible soiling, breaks or cuts
in the skin and cuticles.
1. Poor personal hygiene and an open area of the skin provide
areas in which microorganisms are able to grow.
2. Determine amount of contaminate of hands. 2. Determine the type of hand hygiene needed.
3. Assess areas around the skin that are contaminated. 3. Prevent contamination of hands during and after hand hygiene
procedure.
4. Remove jewellery present on hands. 4. Microorganisms collect in jewelry and watch bands; removing
jewelry makes it easier to wash all areas of hands and wrists.
5. Adjust the water to appropriate temperature and force 5. Water bis too hot or too cold can chap skin ,and too much
force can cause splashing and spread microorganisms to other
areas ,especially your clothing.
6. Wet hands and wrist under the running water ,always
keeping hands lower than elbows.
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.

16. STEPS RATIONALE
7. Lather hands with liquid soap. 7. Soap lather emulsifies fat and aids in cleaning.
8. Wash hands thoroughly using a firm , circular motion and
friction: a. Rub palms together
8. Helps to loosen soil and microorganisms , both resident
(normally present )and transient (acquired from
contamination)
a. Rub palms together.
b. Rub the back of both hand.

17. STEPS RATIONALE
c. Interlace and rub hands together.
d. Interlock fingers and rub the back of fingers of both.
e. Rotational rubbing of left thumb clasped in right palm and
vice versa.

18. STEPS RATIONALE
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.
9. Wash for 15 to 30 seconds ,rinse thoroughly ,re-lather ,and
wash another minutes ,using continuous friction
9. Rinsing removes the loosened microorganisms ,and re-
lathering ensures more thoroughly cleaning . the greater the
contamination , the more needed for longer washing.

19. STEPS RATIONALE
10-The water should run from cleaner areas (the wrists) over
the hands , and then down the drain , rinsing microorganisms
away.
10-The water should run from cleaner areas (the wrists) over
the hands , and then down the drain , rinsing microorganisms
away.
12-Dry hands thoroughly with paper towels .
-start by patting at fingertips, then hands ,then wrists and
forearms
12-Prevent chapping .drying should progress from clean to
less clean , and the cleanest areas are now your fingers and
hands