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Surgical Handwashing Performance Checklist: Procedure 4 3 2 1

The document is a surgical handwashing performance checklist used to evaluate nursing students at Iloilo Doctors' College College of Nursing. It contains 25 steps for proper surgical handwashing technique and rates student performance on a scale of 1 to 4 for each step. Students are evaluated on removing jewelry, ensuring short, polish-free nails, using an antimicrobial soap and deep sink, scrubbing different areas of the hands and arms for a specified number of strokes, rinsing thoroughly, and drying hands without contaminating the sterile towel. Student and instructor signatures verify completion and review of the evaluation.

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Charisse Lutero
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299 views1 page

Surgical Handwashing Performance Checklist: Procedure 4 3 2 1

The document is a surgical handwashing performance checklist used to evaluate nursing students at Iloilo Doctors' College College of Nursing. It contains 25 steps for proper surgical handwashing technique and rates student performance on a scale of 1 to 4 for each step. Students are evaluated on removing jewelry, ensuring short, polish-free nails, using an antimicrobial soap and deep sink, scrubbing different areas of the hands and arms for a specified number of strokes, rinsing thoroughly, and drying hands without contaminating the sterile towel. Student and instructor signatures verify completion and review of the evaluation.

Uploaded by

Charisse Lutero
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ILOILO DOCTORS’ COLLEGE

COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

SURGICAL HANDWASHING
PERFORMANCE CHECKLIST

Student’s Name: ______________________________Score/ Equivalent: ________________


Year & Sec: __________________________________Date Performed: _________________

PERFORMANCE RATING
4 – Consistently demonstrates high level performance
3 – Satisfactorily achieves performance based on standard
2 – Performs task with difficulty
1 – Unable to perform tasks as required

PROCEDURE 4 3 2 1
1. Removed jewelry.
2. Ensured that fingernails are short and free of polish and that cuticles are in good
condition.
3. Used deep sink with foot pedals or knee controls of dispensing soap and
controlling water flow.
4. Used appropriate antimicrobial agent such as Betadine soap.
5. Have disposal hand brush and disposal nail file available
6. Wet hand and forearms liberally, kept arm and hands above elbow level during
entire procedure. Scrub dress or uniform must be kept dry.
7. Dispensed liberal amounts of soap (2.5 ml)into hands and lathered hands and
arms to 5cm (2in) above elbows.
8. Cleaned nails with file under running water. Discard file.
9. Wet brush and applied antimicrobial soap. Scrubbed fingernails, hand and arm in
the following manner.
10. Scrubbed nails of hand 15 strokes
11. Using circular motion, scrubbed palm of hand and anterior surface of finger 10
strokes.
12. Scrubbed side of thumb 10 strokes and posterior aspect of thumb 10 strokes.
13. Scrubbed sides and back of each fingers 10 stroke each area
14. Scrubbed back of hand 10 strokes
15. Rinsed brush thoroughly. Reapplied soap
16. Mentally divided arms into thirds. Scrubbed each surface of lower forearm with
circular motion for 10 strokes; scrubbed middle and upper forearm in same
manner. Discarded brush.( distal 1/3, middle 1/3, proximal 1/3)
17. With arm flexed, rinse thoroughly from fingertips to elbows in one motion, allowing
water to run off at elbow.
18. Repeated step 8 through 11 for second arm
19. Kept arm flexed, discarded brush. Turned off water with foot pedal
20. Picked up sterile towel found on pack. Be sure no one is within arms’ reach
21. Opened rowel full length holding one side away from scrub attire
22. Bent slightly forward to avoid towel touching the attire
23. Dried each hand separately. To dry one arm, held towel in opposite hand; using
patting motion, drawn towel from fingertips up to elbow.
24. Carefully reversed towel and dried other hand and arm
25. Discarded towel, which prevents accidental contamination
TOTAL

Student’s Signature : _________________


Instructor’s Signature: __________________

Verified by:

CYGNETTE S. LUMBO, R.N., Ph. D. MA. ANA V. CRUZ, R.N., M.A.N.


Academic Coordinator, IDC-CON Clinical, Coordinator, IDC-CON

Approved:

MA. JOSEPHINE B. PROVIDO, R.N., PH. D.


Dean, IDC- CON

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