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Ramon Magsaysay Technological University

Iba, Zambales
College of Nursing

I. HANDWASHING-MEDICAL TECHNIQUE

DEFINITION
• A vigorous short rubbing together of all the surfaces of soap lathered hands followed by rinsing
under stream of running water.

• Considered as single most important and basic preventive technique for interrupting possible
infectious process.

PURPOSE
• To prevent possible transfer of microorganisms.

• To reduce the risk of cross contamination among clients.

EQUIPMENT
• Liquid soap/soap bar with soap dish

• Hand towel

• Tissue paper

• Orange stick

PROCEDURE RATIONALE
1. Inspect hands, observing for visible • Poor personal hygiene and an open area
soiling, breaks or cuts in the skin and of the skin provide areas in which
cuticles. microorganism grow and should
receive extra attention during cleaning.
2. Remove jewelry and watch and push • Microorganism collect in jewelry and
long sleeves above the elbows. Don’t watch bands.
allow the uniform to touch the sink. • Removing jewelry makes it easier to
wash all areas of hands and wrists.
3. Adjust the water to appropriate • Water that is too hot can chap skin. Too
temperature and flow. much force can cause splashing and
spread of microorganisms to other areas
especially your uniform.
4. Wet elbow to hands under the running • Hands are the most contaminated part
water always keeping hands lower than of the arm.
elbow. • Water should flow from the elbow
which is the least contaminated area
over the hands and down the drain.
5. Lather hands with liquid soap or if bar • Soap lather emulsifies fats and aids in
soap is used wash soap and lather hand. cleansing.
If bar soap is accidentally dropped, • Sink is contaminated and dropping bar
repeat the procedure. soap causes contamination.
6. Return bar soap dish on the soap dish • Soap dish contaminated.
without touching the dish.
7. Wash hands thoroughly using firm • Friction helps loosen dirt and
circular motion and friction on back of microorganisms.
the hands, palms and wrists. Wash each • Relathering ensures more thorough
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finger individually paying special cleaning.

attention to areas between fingers and
knuckles by interlacing fingers and
thumbs moving hands back and forth.
Relather if necessary.
8. Rinse elbow down to hands completely, • Water should run from cleaner area
keeping hands lower than elbows. (elbow) over the hands and then down
the drain.
9. Clean fingernails carefully under • Orange stick helps remove dirt and
running water using an orange stick. reduces chance of microorganisms to
remain under nails.
10. Turn off faucets with a towel or tissue • Keeps clean hands from touching
paper. contaminated faucet.
11. Dry hands thoroughly with towel • Prevents chapping of the skin. The
starting from the fingertips, hands and cleanest areas are now the fingers and
then wrists and forearm. hands to drying should progress from
clean to less clean.
12. Use hand lotion if desired. • Keep skin soft and lubricated.
13. Inspect hands and nails for cleanliness. • Ensures cleanliness of hands and nails.
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NAME:_____________________________ DATE:_____________________
COURSE AND SECTION:_____________ RLE GROUP:_______________

A. HANDWASHING

I. CHECKLIST ON HANDWASHING- MEDICAL TECHNIQUE

ABLE TO
PROCEDURE ABLE TO PERFORM UNABLE TO
PERFORM WITH PERFORM
ASSISTANCE
Assessment
1. Assess the hands for visible
soiling, breaks or cuts in the
skin and cuticles.
Planning
2. Assemble the equipment.
Implementation
3. Remove jewelry and watch and
push long sleeves above the
elbow. Uniforms must not touch
the sink.
4. Adjust water to appropriate
temperature and flow.
5. Wet elbow down to hands under
running water always keeping
hands lower than elbow
6. Lather hands with liquid soap or
if bar soap is used, wash soap
and lather hands.
Note: if bar is accidentally
dropped, repeat the procedure
7. Return bar soap on the soap
dish without touching the disk.
8. Wash hands thoroughly using
firm circular motion and friction
on back of hands, palms and
wrists. Wash each finger
individually paying attention to
areas between fingers and
thumb moving hands back and
forth. Relather if necessary.
9. Rinse elbow down to hands,
keeping hands lower than
elbows.
10. Clean fingernails carefully
under running water using an
orange stick.
11. Turn off faucets with hand
towel or tissue paper.
12. Dry hands thoroughly with
towel start by putting at
fingertips, hands and then wrist
and forearm.
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13. Use hand lotion if desired.

Evaluation
14. Inspect hands and nails for
cleanliness.
Documentation
15. Record time when handwashing is
done.

REMARKS:_________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________
Grade:____________________

Rating Scale:
Excellent: 96-100%
Very Satisfactory: 90-95%
Very Good: 85-89%
Good: 80-84%
Fair: 75-79%
Poor: 74 and below

CONTESSA MORA GABRIEL,RM,RN,MAN _____________________

Clinical Instructor Student’s Signature
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II. HANDWASHING – SURGICAL TECHNIQUE

SURGICAL HANDWASHING OR SCRUB
DEFINITION
• Type of handwashing used in the operating room.

PURPOSE
• To remove soil and most transient microorganism from the skin

EQUIPMENT
• Brush

• Sink with faucet and running water

• Liquid soap

• Sterile towel

• Nail cleaner

PROCEDURE RATIONALE
1. Inspect hands for cuts in the skin and • Breaks in skin facilitate development of
cuticles. Do not scrub if there are open infection
lesions or breaks in the skin.
2. Remove rings, chipped nail polish, and • To decrease resident and transient
watch and push long sleeves above the microorganisms.
elbow.
3. Put on cap or hood, shoes cover and a • To prevent introduction of
mask. contaminants into environment.
4. Use a deep sink with side foot pedal. • To prevent hands and forearm from
touching a soiled surface.
5. Turn on water using foot or knee • Warm water removes less of the
control and adjust temperature to be protective oil of the skin than hot water.
comfortably warm.
6. Wet hands starting from the tips of • Water will drain off your elbows,
fingers to forearms keeping hands flowing from cleanest area to less clean
higher than elbows. area.
7. Apply soap to a scrub brush or open a • To remove resident bacteria from the
pre-package scrub brush if available. skin surfaces.
8. With brush on your dominant hand, • The circular motion mechanically
using a circular motion, scrub nails and removes microorganisms, scrubbing the
all skin areas of non-dominant hand non-dominant hands first sets a routine
and arm (ten strokes to each of the you can remember to prevent
areas). contamination.
9. Take second scrub brush and repeat • Same as above.
action in no.8 on your dominant hand
and arm.
10. Keep the hands and arms above elbow • Allows flow of water from the area of
level, place the fingertips under running least (hand) contamination to the area
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water and thoroughly rinse the fingers, of most contamination (elbow)

hands and the arms.
11. Keep arms flexed and proceed to • Prevents water from flowing from least
operating or procedure room. clean area (elbows) to most (hands)
clean area.
12. Secure a sterile towel by grasping it on • Maintain sterility of the towel.
one edge, opening it at full length
making sure it does not touch your
uniform.
13. Dry each hand and arm separately, • Prevents contamination by drying from
extend one side of the towel around cleanest to least clean area.
fingers and hands and dry in a rotating
motion up to the elbow.
14. Reverse towel and repeat same action • To prevent contamination of gown.
on the other hand and arm, thoroughly
drying the skin. Discard towel into
linen hamper.

NAME:_____________________________ DATE:_____________________
COURSE AND SECTION:_____________ RLE GROUP:_______________
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2. HANDWASHING – SURGICAL TECHNIQUE

ABLE TO
PROCEDURE ABLE TO PERFORM UNABLE TO
PERFORM WITH PERFORM
ASSISTANCE
Assessment
1. Assess hand for visible soiling,
breaks or cuts in the skin and
cuticles.
Planning
2. Assemble the equipment.
Implementation
3. Remove rings, chipped nail
polish and watch and push long
sleeves above the elbow.
4. Put on cap or hood, shoes cover
and mask.
5. Use deep sink with side foot
pedal.
6. Turn on water using foot or
knee control.
7. Wet hands starting from the tips
of fingers to forearms keeping
hands higher than elbows.
8. Apply soap to a soap brush or
open a pre packaged scrub.
9. With brush on dominant hand,
scrub nails and all skin areas of
non-dominant hand and arm
using circular motion (ten
strokes to each areas)
10. Repeat action in no.9 on
dominant hand.
11. Place the fingertips under
running water and thoroughly
rinse the fingers, hands, and the
arms and keeping hands and
arms above elbow level.
12. Keep arms flexed and proceed
to operating room.
13. Secure a towel by grasping it on
one edge, and open it at full
length.
14. Extend one side of the towel
around fingers and hands and
dry in rotating motion up to the
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elbow.
15. Reverse towel and repeat
procedure on the other hand.
16. Discard towel into linen
hamper.
Evaluation
17. Inspect hands and nails for
cleanliness.
Documentation
15. Record time when handwashing
was done.

REMARKS:_________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________
Grade:____________________
Rating Scale:
Excellent: 96-100%
Very Satisfactory: 90-95%
Very Good: 85-89%
Good: 80-84%
Fair: 75-79%
Poor: 74 and below

CONTESSA MORA GABRIEL,RM,RN,MAN _____________________

Clinical Instructor Student’s Signature

Prepared by:

CONTESSA M. GABRIEL,RM,RN,MAN
Professor