Performing Medical Handhygiene
Performing Medical Handhygiene
Performing Medical Handhygiene
Definition:
Handwriting is a vigorous,brief rubbing together of all surface of hands lathered in soap followed by
rinsing under a stream of water
Indications:
1) Before contact with patients who are susceptible to infection (eg: newborn infants or
immunosuppressed patients).
Purposes:
1) To remove diet and trasient organisms from the hands and to reduce total microbial counts.
Articles:
Proceedure:
3. Inspect nails for length Nails should be short because most microbes on
hands come from beneath the fingernails.
4. Assess patients risk for infection Use of antimicrobial soap is encouraged when
caring for patients who are at risk for infection.
5. Remove wrist watch and push long uniform Provides complete access to fingers, hands and
sleeves abovee wrist watch. Remove all jewellery wrist. Wearing of rings an increases the number
from handssuch as ring, watch and bracelet etc. of microorganisms on hands
6. Stand in front of the sink, keeping hands and Inside of sink is a contaminated area. Reaching
uniform away from sink surfaces. over sink increases risk of touching edge, which is
contaminated
7. Turn on water. Avoid splashing water against Microorganisms travel and grow in moisture
uniform.
8. Regulate flow of water and make sure that the Warm water removes less of the protective oils
water is warm. than cold water.
9. Wet hands and wrists thoroughly under Hands are the most contaminated parts to be
running water. Keep hands and forearms lower washed. Water flows from least to most
than elbows during washing. conatminated are, rinsing micro-organisms from
the sink.
10. Apply a small amount of soap or Use of antiseptic exclusively can be drying to
antiseptic,lathering thoroughly. hands and can cause skin irritation
11. Wash hands using plenty of lather and Soap cleanses by emulsifying fat and oil thus
friction for at least 10-15 seconds. Interface lowering surface tension. Friction and rubbing
fingers and rub palms and back of hands with mechanically loosen and remove dirt. Interlacing
circular motion for at least 5 times each. Special fingers and thumbs ensures that all surfaces are
attention should be provided to areas such as cleansed. Knuckles and fingernails harbour
knuckles and fingernails. microorganisms.
12. Area underlying fingernails are often soiled. Are under nails can be highly contaminated
Clean them with fingernails of other hand and which will increase the risk of infection for the
use additional soap if required. nurse or the patient
13. Rinse hands and wrists thoroughly keeeping Rinsing from cleanest to least clean area avoids
hands down and elbows up. contamination
15. Dry hands thoroughly from finger to wrst and Drying from cleanest to least clean area avoids
to forearm with paper towel. contamination
16. Discard used towel Prevents transfer of microorganisms
Definition
Surgical handwriting is a procedure by which dirt and microorganisms are destroyed and removed
from hands and fingers bby chemical action and mechanical friction.
Purposes:
Articles:
1. Soap/antiseptic lotion
4. Towels (sterile)
1. Ensure that the nails are short. Remove Short nails are less likely to harbour
artificial nail, if any. organisms,scratch the patient or puncture gloves.
3. Inspect hands for abrasions,cuts or open These conditions increase likelihood of more
lesions microorganisms residing on skin surfaces
7. Wet hhands and arms under running Water flows from fingertips to elbows. Fingertips
lukewarm water and lather with soap/detergent are considered to be cleansed than the elbows.
to scum above the elows (hands need to be
raised , held above tthe elbows at all time ). use
firm circular movements to wash palms, back of
hands,wrists,forearms and interdigital spaces for
20-25 seconds
8. Rinse, hands and arises thoroughly under Rinsing removes transient bacteria forn hands
running water
9. Clean under nail of both hands with nail Removes dirt and microorganisms
pick/nail brush
11. Holding the brush perpendicular scrub palm, Scrubbing loosens resident bacteria that adhere
each side of thumb and fingers and posterior side to skin surfaces
of handwith 10 strokes each.
12. Scrub from wrist to 5cm above each elbow Scrubbing is performed from cleaner area to less
that is lower arm, upper arm and ante cubital clean are (upper arms)
fossa to marrginal area above elbos
13. Entire scrub should last for 5-10 minutes Scrubbing time can be lengthened according to
agency policy / according to the degree of
contamination of hands
16. Use a sterile towel to dry one hand moving Drying prevents chapping and facilitates donning
from fingers to elbow . Dry from cleanest to least of gloves
clean area
Definition:
This procedure is the wearing of mask and a specially stitched gown in the operation theatre to
maintain asepsis and to protect the nurse from contaminating herself and others around her.
Purposes:
Articles Required:
1. Articles for the surgical and washing.
Procedure:
Masking
Gowning :
1. Grasp the sterile gown at the crease near the Prevents gown from becoming unsterile
neck,hold it away from yourself and permit it to
unfold freely without touching anything including
the unform
2. Hold the gown at the shoulder level from Protects the outer portion of gown from
inside and put each hand directly into the arm contamination
hole
4. The circulating nurse pulls back the gown from Prevents conatmination from the outer portion
inside. So that the upper limbs go into the of gown
sleeves. The circulating nurse ties the gown frm
the bag
5. The waist ties are loosened by the scrub nurse The waist flapcover the back,preventing
and flap brought around the waist by the use of
cheattle forceps held by the circulating nurse and contamination of the area when turning around
it is tied
Gown:
1. Untie strings at the back of the gown. Remove Prevents contact with contentment portion of
gown, folding inside out cover outside of gown gown.
Mask:
1. Wash hands. Untie lower strings first, then the Avoids contact of the contaminated portion of
top strings and pull mask away from face mask to our body
DEFINITION
Gloving is defined as the donning of a pair of sterile gloves to protect one’s own hands from
pathogenic microorganisms and to avoid contamination of a sterile area by hand
Purposes:
Articles Required:
Soap/ antiseptic detergent, running warm wate,nail brush in antiseptic lotion,towels(sterile) mask and
cap. A pair of sterile surgical gloves.
1. Perform through surgical handwashing and dry Handwashing deters the spread of
hands using sterile towel microorganisms. Gloves are easier to don when
hands are dry.
2. The circulating nurses remove the outer glove Prevents inner glove package from accidentally
package by carefully seperating and peeling apart opening and touching contaminated objects.
the sides. Scrubbed nurse pulls out the inner
glove pack taking care not to touch the outer one
3. Grasp inner package and lay it on clean,flat Sterile object held below waist is contaminated.
surface just above waist level. Open Inner surface of glove packae is sterile.
package,keeping gloves on wrapper’s inside
surface.
5. Identify right and left glove. Each glove has a Proper identification of gloves prevents
cuff of approximately 5cm(2 inches)wide. Glove contamination by improper fit. Gloving of
dominant hand first. dominant hand first improves ddexterity.
6. With thumb and first two fingers of non - Inner edge of cuff will lie against skin and thus it
dominant hand. Towel only the inside surface of is not sterile
gloves.
7. Carefully pull glove over dominant hand Prevents tearing the glove material,guiding the
making sure the thumb and fingers fit into the fingers into proper places facilitates gloving
proper spaces of the glove.
8. With the gloved dominant hand, slip in fingers If gloves outer surface touches hand /wrist,then
under the cuff of the outer glove. Keep thumb of it is contaminated. Cuff protects gloved fingers
glove dominant hand abducted back to avoid maintaining sterility
touching of exposed non gloved hand
Removal of gloves:
1. Remove the first glove by grasping it on its This keeps the soiled parts of the used gloves
palms surface taking care to avoid touching from touching the skin of the wrist/hand
wrists.
4. Pull the second glove off to the fingers by The soiled part of gloves and folded to the inside
turning it inside out this pulls the first glove to reduce the chance of transferring any
inside the second glove microorganisms by direct contact
6. Wash hands
Bibliography:
1. Jacob Annamma, Rekha R.Clinical Nursing Procedures The Art of Nursing Practice . 2 nd Edition.