Purposes
Rationale: the circular action creates friction that
1. Reduce the number of microorganisms on the hands.
2. Reduce the risk of transmission of microorganisms to
clients.
3. Reduce the risk of cross contamination among
clients.
4. Reduce the risk of transmission of infectious
organisms to oneself.
Implementation: PREPARATION
Assess hands:
1. Nails should be cut short.
Rationale: short, natural nails are less likely to harbor
microorganisms, scratch a client or puncture gloves.
2. Removal of all jewelry is recommended.
Rationale: microorganisms can watch in the settings
of jewelry and under rings. Removal facilitate proper
cleaning of the hands and arms.
3. Check hands for breaks in the skin, such as hang nails or
cuts.
Rationale: chance of acquiring or passing on an
infection.
Implementation: PERFORMANCE
1. If you are washing your hands where the client can
observe you, introduce yourself and explain to the client
what you're going to do and why it is necessary.
2. Turn on the water. Adjust the flow so that the water is
warm.
Rationale: warm water removes less of the
protective oil of the skin than hot water.
3. Wet hands for only by holding them under their wanting
water and apply soap to the hands.
> Hold hands over the and elbows so that the water
flows from arms to fingertips.
Rationale: the water should flow from the least
contaminated to the most contaminated area, the hands are
generally considered more contaminated than the lower
arms.
> If the soap is liquid, apply 4-5 ml (1 tsp). If bar
soap, granules, rub them firmly between the hands.
4. Thoroughly wash and rinse the hands.
> Use firm, rubbing and circular movements to wash the
home, back, and wrist of each hand. Be sure to include the
heel of the hand. Interlace fingers and palms, and move the
hands back and forth. Continue this motion for at least 20
seconds.
helps remove microorganisms mechanically.
> Rub to fingertips against the palm of the opposite
hand.
> Rinse the hands.
5. Thoroughly dry the hands and arms.
> Dry hands and arms thoroughly with a paper towel
without scrubbing - Pat dry.
Rationale: waste skin becomes chapped readily as
does dry skin that is rubbed vigorously; chapping produces
lesions.
>Discard the paper towel in the appropriate container.
6. Turn off the water.
> Is a new paper towel to grasp a hand operated
control.
Rationale: this prevents the nurse from picking up
microorganisms from the faucet handles.
Implementation: PERFORMANCE
VARIATION: HANDWASHING BEFORE PERFORMING STERILE
SKILLS
1. Apply the soap and was as described in step 4, but hold
the hands higher than the elbows doing this hand wash. Wet
the hands and forearms under the running water, letting it
run from the fingertips to the elbows so that the hands
become cleaner than the elbows.
Rationale: the water runs from the area that now
has the fewest microorganisms to areas with a relatively
greater number of pathogens.
2. After washing and rinsing, use a towel to dry one hand
thoroughly in a rotating motion from the fingers to the
elbow. Use a new towel to dry the other hand and arm.
DIFFERENCE BETWEEN MEDICAL AND SURGICAL
HANDWASHING
MEDICAL (arms higher than hand)
vs.
SURGICAL (hands higher than elbows)
Nursing skill 101: Applying and removing sterile gloves
GLOVING: OPEN METHOD
1. Dominant hand first
2. Nondominant hand inserted with thumb close to gloved
palm.
 PURPOSES

1. Enable the nurse to handle or touch sterile objects

freely without contaminating them.
2. Prevent transmission of potentially infective
organisms from the nurse's hands to clients at high
risk for infection.
Equipment: sterile gloves

Implementation: PERFORMANCE
1. Introduce yourself, verify client's identity and explain
to the client with you are going to do and why it is
necessary.
2. Perform hand hygiene.
3. Provide for client privacy.
4. Open package of sterile gloves.
> Plays the package of gloves on a clean, dry surface
rationale: any moisture on the surface could contaminate
the gloves.
>Open outer package without contaminating the
gloves of the inner package.
> Remove inner package from data package.
> Open the inner package.
Rationale: the inner surfaces, which are next to the sterile
gloves, will remain sterile.

5. Put the first love on the dominant hand.

> If the gloves are packaged so that they lie side-by-side,
grasp the love for the dominant hand by its folded cuff edge
(on the Palmar side) with the thumb and first finger of the
nondominant hand. Touch only the side of the cuff.
Rationale: the hands are not sterile. By touchingly decided
the glove, the nurse avoids contaminating the outside
> insert the dominant hand into the glove and pull
the glove on. Keep the dawn of the inserted hand against
the palm of the hand during insertion.
Rationale: if the phone is kept against the phone, it is less
likely to contaminate the outside of the glove.
> Leave the cuff in place once the unsterile hand
releases the glove.
Rationale: attempting to further unfold the cough is
likely to contaminate the glove.

6. Put the second glove on the dominant hand.

> Touch the other glove with the sterile gloved hand,
inserting the gloved fingers under the cuff and holding the
gloved thumb close to the gloved palm.
Rationale: this helps prevent accidental contamination of the
glove by the bare hand.
> Pull on the second glove carefully. Hold the thumb
of the gloved firsthand as far as possible from the palm.
Rationale: in this position, the thumb is less likely to touch
the arm and become contaminated.
> Adjust each glove so that it fits smoothly and
carefully, pull the cops up by sliding the fingers under the
cuffs.