Handwashing

When are we suppose to wash our hands?

People should wash their hands before eating, after using the restroom, or when their hands are visibly dirty/soiled
(especially if contact with blood or bodily fluids has been made). If the preceding do not apply, handwashing can be
substituted by using an alcohol-based hand rub or gel.

Importance of Proper Handwashing

Everyone knows washing hands regularly is important to a healthy lifestyle and healthcare workers are no
exception. Although healthcare professional receive training, not all clinicians practice correct hand washing
techniques. For some workers it is a behavioral issue while for others it is because washing frequently becomes
painful due to skin problems. Did you know total hand washing time should be at least 15 seconds? It is easy to see
how proper technique can be avoided when people are busy or in a rush. I have to admit that I did not adhere to
proper handwashing technique until an infection control nurse taught me the correct way. There are still many who
do not know the correct method and for this reason education is one of the most important aspects of improving
hand hygiene. The hands are the main transmitters of microorganisms. Regular handwashing is the effective way to
prevent the spread of infectious diseases including respiratory illnesses. Even regular washing with non-medicated
soap will help prevent healthcare-associated infections as it helps in the removal of microorganisms. Using soap
containing Triclosan or Chlorhexidine will be more effective as it can reduce the number of certain pathogens on the
hands due to their antimicrobial properties. It is important to note that excessive handwashing and utilizing
antimicrobial soap contributes to dehydrating and breaking down the skin. For this reason, it is recommended to
combine handwashing while utilizing alcohol-based antiseptic for removing microorganisms on the hands. Localizing
harmful pathogens is the best method of reducing healthcare-associated infections for hospitals.

PROPER TECHNIQUES FOR HAND WASHING

Repeat steps 1-6 until hands are clean. Wash hands for at least 15 seconds.

Step 1. Wet hands and wrists with Step 2. Place one palm over the other Step 3. Rub your hands palm to palm, fingers
lukewarm water. Apply soap. working the soap into a lather. interlaced.
Step 4. Rub back fingers to opposing Step 5. Rotate the right thumb in a Step 6. Rub backwards and forwards while
fingers interlocked. Be sure to get rotational manner clasped in left palm rotating wiith tops of fingers and thumb of right
underneath the fingernails. and vice versa. hand in left and vice versa.

OXYGEN ADMINISTRATION
Via nasal cannula

1. Explain procedure to patient and review safety precautions necessary when oxygen is
in use. Place No Smoking sign in appropriate areas.
2. Perform hand hygiene.
3. Connect nasal cannula to oxygen setup with humidification, if one is in use. Adjust flow
rate as ordered by physician. Check the oxygen is flowing out of prongs.
4. Place the prongs in patient’s nostrils. Adjust according to type of equipment:
a. Over and behind each ear with adjuster comfortably under chin or
b. Around patient’s head.
5. Use gauze pads at ear beneath tubing as necessary.
6. Encourage patient to breathe through nose with mouth closed.
7. Perform hand hygiene.
8. Assess and chart patient’s response to therapy.
9. Remove and clean cannula and assess nares at least every 8 hours or according to
agency recommendations. Check nares for evidence of irrigation or bleeding.

Via face mask

1. Explain procedure to patient and review safety precautions necessary when oxygen is in use. Place No Smoking
signs in appropriate areas.
2. Perform hand hygiene.
3. Attach face mask to oxygen setup with humidification. Start flow of oxygen to fill bag before placing mask over
patient’s nose and mouth.
4. Position face mask over patient’s nose and mouth. Adjust it with the elastic strap so mask fits snugly but
comfortable on face.
5. Use gauze pads to reduce irrigation on patient’s ears and scalp.
6. Perform hand hygiene.
7. Remove mask and dry skin every 2 to 3 hours if oxygen is running continuously. Do not powder around mask.
8. Assess and chart patient’s response to therapy