Friday, January 25, 2013


In order to control the transmission of microorganisms or any infectious disease, our hands is the main site that needs serious attention to.

Handwashing is always the primary thing to do in all types of isolation precautions. The germs are spreading everywhere and it is through giving much attention to wash our hands that the transmission of diseases or microorganisms will impede from scattering the body from the diseases.

Handwashing is the rubbing together of all surfaces and crevices of the hands using a soap or chemical  and water. It is a must to do handwashing before and after every direct contact of the patient, after arriving from work, between contacts of the patient, after removing the gloves, when hands are soiled, before and after eating, after contact with secretions and fluids of the body, after urination and defecation and whenever it is possible.

*To prevent the spread of microorganisms
*To kill the germs
*To ensure medical asepsis or clean technique

*Equipments should be accessible and easy to reach
*Water should be available and overflowing
*Wash by rubbing, circular motion and through rinsing
*Drying from cleanest (hand) to least clean area (forearm)

Procedure with Rationale: 
1. Remove jewelry. Wristwatch may be pushed up above the wrist (mid-forearm). Push sleeves of uniform or shirt up above the wrist at mid-forearm level.
Rationale: Provides access to skin surfaces for cleansing. Facitlitates cleaning of fingers, hands, and forearms.

2. Access hands for hangnails, cuts or breaks in the skin, and areas that are heavily soiled.
Rationale: Intact skin acts as a brarrier to microorganisms. Breaks in skin intergrity facilitate developemnt of infection and should receive extra attention during cleaning.

3. Turn on the water. Adjust the flow and temperature. Termperature of the water should be warm.
Rationale: Running water removes microorganisms. Warm water remoeves less of the natural skin oils thatn does hot water.

4. Wet hands and lower forearms thoroughly by holding under running water. Keep hands and forearms in the dowm position with elbows straight. Avoid splashing water and touching the sides of the sink.
Rationale: Water should flow from the least contaminated to the most contaminated areas of the skin. Hands are considered more contaminated than arms. Splashing of water facilitates transfer of microorganisms. Touching of any surface during cleaning contaminates the skin.

5. Apply about 5 ml or 1 teaspoon of liquid soap. Lather thorougly.
Rationale: Lather facilitates removal of microorganisms. Liquid soap harbors fewer bacteria than does bar soap.

6. Thoroughly rub hands together for about 20 seconds. Interlace fingers and thumbs and move back and forth to wash between digits. Rub palms and back of hands with circular motion. Special attention should be provided to areas such as the knuckles and fingernails, which are known to harbor organisms.
Rationale: Friction mechanically removes microorganisms form the skin surface. Friction loosens dirt from soiled areas.

7. Rinse with hands in the down position, elbows straight. Rinse in the direction of forearm to wrist to fingers.
Rationale: Flow of water rinses away dirt and microorganisms.

8. Blot hands and forearms to dry thoroughly. Dry in the direction of fingers to wrist and forearms. Discard the paper towels in the proper receptacle.
Rationale: Blotting reduces chapping of skin. Drying from cleanest (hand) to least clean area (forearm) prevents transfer of microorganisms to cleanest area.

9. Turn off the water faucet with a clean, dry paper towel.
Rationale: Prevents contamination of clean hands by a less clean faucet.

Source: Fundamentals of Nursing by Rick Daniels, Frederick Wilkins and Ruth Grendell

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