COURSE MODULE Palawan Polytechnic College Inc.

MODULE WEEK NO.1

Manalo Extension, Puerto Princesa City

048-434-23-93

Department of Nursing
COURSE CODE: NCM 104 Community Health Nursing – RLE (Skills)
Semester of A.Y. 2020-2021

Introduction

Microorganisms that can cause infectious diseases are all around us, especially in the current situation. They
can even be found on things and places we think are the cleanest. If our immune system drops, these
pathogens may enter our system and may cause serious illnesses. However, transmission of these harmful
microbes can be prevented through handwashing.

Rationale

Hands are the main pathways of germ transmission during health care. Hand hygiene is therefore the most
important measure to avoid the transmission of harmful germs and prevent health care-associated infections.

Intended Learning Outcomes

A. Discuss the terms, concepts, purpose types, indicator, supplies needed and procedures of hand
hygiene.
B. Demonstrate understanding of the skill through return demonstration.

Pre-test
1. What 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?

A. Aseptic Technique B. Handwashing

C. Medical Asepsis D. Surgical Asepsis

2. What is known as clean technique which includes procedures used to reduce the number of
organisms on hands?

A. Aseptic Technique B. Handwashing

C. Medical Asepsis D. Surgical Asepsis

3. What is known as sterile technique, prevents contamination of an open wound, serves to isolate
the operative area from the unsterile environment, and maintains a sterile field for surgery?

A. Aseptic Technique B. Handwashing

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C. Medical Asepsis D. Surgical Asepsis

4. What are we trying to reduce or eliminate when we are doing handwashing?

A. Viruses B. Bacteria C. Fungi D. All the above

5. The clinical instructor asks her students the rationale for handwashing. The students are correct if
they answered that handwashing is expected to remove:

A. transient flora from the skin. B. resident flora from the skin.
C. all microorganisms from the skin. D. media for bacterial growth.

Discussion
Hand Hygiene and Handwashing

I. Description
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.

II. Terms
To understand this study guide better, familiarize yourself with the terms used:

 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.

III. Concepts

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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.
 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.

IV. Purposes
The purposes of hand hygiene are:

 Hand washing can prevent infection

 Avoid pathogenic microorganisms and to avoid transmitting them

V. Types of Hand Hygiene

The following are the types of hand hygiene:

 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 15-30
minutes, and is usually done before doing a surgical procedure.

VI. Indicators of Hand Hygiene

According to the World Health Organization (WHO), there are Five Moments for Hand Hygiene:

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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.

VII. Supplies Needed in Doing Hand

The following materials or equipment are needed to perform hand washing:

 Soap or detergent
 Warm running water
 Paper towels
 Alcohol
 Optional: Antiseptic cleaner, fingernail brush, plastic cuticle stick

VIII. Procedures
a. Antiseptic Handrub
The use of alcohol-based handrub.

1. Ensure jewelry has been removed

2. Apply quantity of alcohol-based hand hygiene product as per manufacturer’s

recommendations into cupped hand.

3. Rub hands palm to palm

4. Right palm over left dorsum with interlaced fingers and vice versa.

5. Palm to palm with fingers interlaced

6. Backs of fingers to opposing palms with fingers interlaced

7. Rotational rubbing of left thumb clasped in right palm and vice versa

8. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left

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palm and vice versa

9. Rubbing hands together until hands are dry before continuing with patient care, do not
rub off excess product

b. Antiseptic Handwash
Also known as clean technique, includes procedures used to reduce the number of
organisms on hands.

1. Gather the necessary supplies. Stand in front of the sink.

2. Wet the hands and wrist area. Keep hands lower than elbows to allow water to flow
towards the fingertips.

3. Cover all areas of hands with soap.

4. With firm rubbing and circular motions, wash the palms and backs of the hands, each
finger, the knuckles, wrists, and forearms. Continue this friction motion for 30 seconds.

5. Rinse thoroughly with water flowing towards the fingertips.

6. Pat hands dry, beginning with the fingers and moving upward towards forearms, with a
paper towel and discard immediately.

7. In the absence of sensors or foot pedal, use another clean paper towel to turn off the
faucet.

c. Surgical Antisepsis
Also known as sterile technique, prevents contamination of an open wound, serves to
isolate the operative area from the unsterile environment, and maintains a sterile field
for surgery.

1. Remove all pieces of jewelry.

2. Wet hands using sterile water with water closest to your body temperature.

3. Wash hands using antimicrobial soap and/or povidone-iodine.

4. Clean subungual areas with a nail file.

5. Scrub each side of each finger, between the fingers, and the backs and fronts of the

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hands for at least 4 minutes.

6. Proceed to scrub the hands, keeping the hand higher than the arm always to prevent
bacteria-laden soap and water from contaminating the hands.

7. Rinse hands and arms by passing them through the flowing water in one direction
only, from fingertips to elbow.

8. Proceed to the operating room holding hands above elbows.

9. Dry hands and arms using sterile towel observing aseptic technique.

Exercise

Do a return demonstration of the procedure of all types of hand hygiene. Present it to me through a video
recording and send it to my email.

Post-test
1. What 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?

A. Aseptic Technique B. Handwashing

C. Medical Asepsis D. Surgical Asepsis

2. What is known as clean technique which includes procedures used to reduce the number of
organisms on hands?

A. Aseptic Technique B. Handwashing

C. Medical Asepsis D. Surgical Asepsis

3. What is known as sterile technique, prevents contamination of an open wound, serves to isolate
the operative area from the unsterile environment, and maintains a sterile field for surgery?

A. Aseptic Technique B. Handwashing

C. Medical Asepsis D. Surgical Asepsis

4. What are we trying to reduce or eliminate when we are doing handwashing?

A. Viruses B. Bacteria C. Fungi D. All of the above

5. The clinical instructor asks her students the rationale for handwashing. The students are correct if

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they answered that handwashing is expected to remove:

A. transient flora from the skin. B. resident flora from the skin.
C. all microorganisms from the skin. D. media for bacterial growth.

Reflection

Handwashing, even before the pandemic has been part of our daily life, describe to me your reflection on the
importance of hand hygiene, especially on our current situation. Please submit to me a 300-word reflection
about this.

Resources and Additional Resources

 https://nurseslabs.com/hand-hygiene-handwashing/

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