Copyright 2019 CW Nursing Solutions. All rights reserved.

Handwashing Hand washing, also known as hand hygiene, is the act of cleaning hands to remove soil, dirt, and microorganisms. Hand washing before administering medicine or medical care can prevent or minimize the spread of disease. The main purpose of washing hands is to cleanse the hands of pathogens like bacteria or viruses and chemicals which can cause harm or disease.

Learning objectives: Upon completion of this course participants should be able to:

• Explain the importance of handwashing

• Summarize 5 Steps to hand washing

• Recognize when to wash hands

• Gloves help break the chain of infection

• Detail the Do’s and Don’ts of hand washing

Handwashing is the single most important means of preventing the spread of infection!

Hand washing is for everyone!

Did you know only one out of

three people wash their hands

after sneezing or coughing?

The easiest way germs are spread is by coughing

and sneezing into your hands, and then rubbing

yourself or touching objects. Many people don’t

realize they are at-risk.

Pathogens thrive on doorknobs, railings, bed

tables, toilets, sinks, your clothes and hands, and

other common objects. Infections spread within a

care facility are called nosocomial infections or

Healthcare/Hospital Acquired Infections (HAIs).

used objects. Think about

all of the objects you touch

before visiting a client.

Nosocomial infections are the most common

cause of death in nursing home clients. Over

88,000 patients die every year. The CDC also

states that more than 160,000 people in the U.S.

die from an infectious disease annually. Infectious

diseases are the leading cause of death in the

world! At least 50% of these infections could be

avoided with proper handwashing techniques.

Diarrhea and pneumonia kill 3.5 million children

around the world each year. According to

UNICEF, hand washing before eating and after

using the toilet can save more lives than any

single vaccine or medical intervention.

Hey Nurse Char, how many other germs can my hands transport?

As many as the hairs on you head…oh,

sorry. Shigella sonnei, dysenteriae, and

boydii, hepatitis E, candida albicans,

Microsporum canis, streptococci

pneumoniae and viridians, Klebsiella

pneumoniae, corona virus, giardia bacteria,

salmonella typhi, ascaris lumbriocoides,

mycoplasma pnuemoniae, ECHO virus,

Rota virus, coxsackie virus, escherichia

coli, cryptosporidium, adeno virus,

pseudomonas aeruginosa, orthomyxo

virus, proteus mirabilis, chlamydia

trachomatis, haemophilus influenza,

campylocater species and more!

1. Begin by wetting each hand. Hot water that is comfortable for washing hands is not hot enough to kill bacteria.

2. Apply soap. Antibacterial and plain soaps are effective. Bar soaps should be placed on a clean rack when finished so water will drain off the soap keeping it free from germs. Rub and scrub all surfaces of the hands and wrists thoroughly including between each finger. Scrub each hand for 15-20 seconds. Do not rub so hard that the skin becomes irritated as this can lead to certain skin conditions.

3. Rinse both hands well in warm, but not scalding, water. Very warm water can harm your skin, and even add to infection!

4. Dry hands thoroughly. Paper towels are preferred over cloth. The best way to dry hands is using a motion activated dryer.

5. Faucet handles are the breeding ground of germs in restrooms. Turn the handles with a towel and/or avoid touching them.

y to be.

A comprehensive analysis from the University of

Oregon School of Public Health indicated that plain

soaps are as effective as consumer-grade anti-

bacterial soaps containing triclosan in preventing

illness and removing bacteria from the hands.

Hey Wayne.

Which soap

should I

use?

Antibacterial soaps (99.9%) and

antiseptic hand rubs (60%) kill

microorganisms. Plain soaps

remove germs and dirt – use liquid

over bar soap preferably.

(Antiseptic hand rubs are acceptable but not effective

for some viruses especially the Norovirus. Wash

hands with water and soap after multiple rub uses.)

The World Health Organization has "Five Moments" caregivers should

wash their hands:

• Before patient contact/care • Before an aseptic task • After exposure to blood/body fluids • After patient contact/care • After contact with patient surroundings

Times it is “absolutely necessary” everyone should wash their hands:

• Before handling and/or eating food • Before and after caring for ill patients. • Before and after treating a cut or wound • After using the toilet • After changing diapers or cleaning up a

child who has used the toilet • After blowing your nose, coughing, or

sneezing • After touching an animal, animal feed, or

animal waste • After touching garbage • Before and after putting on gloves

Food-borne illnesses

Food-borne pathogens cause 80 million illnesses, 300,000 hospitalizations, and 5,000 deaths in the US annually. Salmonella and Norovirus are the most common food-borne pathogens. Key contributors to outbreaks are food not fully cooked, storage time and temperature, and improper handling. Over 80% of diseases are spread by poor hand washing.

Gloves and hand washing break the chain of infection

Gloves are called personal protective equipment (PPE). Other types of PPE are gowns, masks, shoes and caps or nets. Gloves create a barrier between pathogens, dirt, chemicals and your hands. Wearing gloves in the hospital helps prevent the spread of disease.

Gloves should be worn every time you touch blood, bodily fluids, bodily tissues, mucous membranes, or broken skin. They are appropriate for:

• Direct contact with blood

• Direct contact with body fluids – secretions, excretions, and items soiled by body fluids

• Procedures that involve a risk with direct contact with blood or fluid

• Contact with mucous membranes or non-intact skin

• IV insertion and removal

• Drawing blood

• Examinations of any open orifices

• Contact with infectious material

• Most types of cleaning

Wearing gloves helps protect the patients and caregivers from infection. Gloves and sanitizers should never take the place of hand washing. Hands should be washed before and after glove placement.

⬧ Never wear the same gloves with different patients. ⬧ Make sure gloves fit right. ⬧ Gloves too large are clumsy and allow germs to enter. ⬧ Gloves too small tear easily. ⬧ Do not use oil-based hand creams or lotions under gloves. ⬧ Use non-latex gloves for allergic patients and caregivers. ⬧ It is not always necessary to wear gloves for taking vital signs, feeding, mobilizing, dressing or transferring patients or for injections. ⬧ Use sterile gloves PRN. ⬧ Wear gloves when handling food but not for serving. ⬧ Dispose of gloves properly. ⬧ Do not reuse gloves. ⬧ Over and improper use of gloves can cause skin damage.

Is there anything else I should

know about using gloves?

DO make sure to wash the entire surface area of

your hands and wrists. Most of the germs on the

hands are hiding under and around the fingernails.

DO remove all jewelry and/or watches before

washing your hands. If you don’t, microorganisms can hide under your jewelry and then be free to contaminate your clients!

DO wipe down any soiled counters while cooking

or serving food. Diseases can thrive on uncooked

food, and can transfer from food to counters, then

to your hands. Make sure to use a strong

disinfectant spray, and not just a wet paper towel.

DO encourage your client to wash their hands on a

regular basis, if they are able. If your client keeps

up with their own hygiene, it is less likely that they

will become sick.

DO check your facility guidelines for artificial and long fingernails. They are hard to clean. According to Nurseweek.com, long artificial or natural nails have been blamed for numerous outbreaks of infectious diseases around the country.

DON’T wear the same pair of gloves when treating a different client, even if they are washed or rinsed. Gloves can easily carry illnesses from client to client.

DON’T skip drying your hands after you wash them. Much of the bacteria is removed by the heat of a dryer, or they are simply wiped off with a dry towel. The way hands are washed is just as important as how often.

DON’T directly touch the sink at any time while washing your hands. Use a dry towel to turn the faucet on and off.

DON’T touch your eyes, nose or mouth or examine a client without washing your hands. Hands should be washed immediately before you come into contact with a client and again immediately after.

DON’T wear excessive jewelry on fingers and wrists which can serve as a nest for pathogens. Think about leaving rings at home and sliding watches onto the upper arm or use alternative time devices.

Scientists have known for over 100 years that handwashing helps prevent infection. Yet, infections continue to proliferate from poor hand washing.

Handwashing is the single most important means of preventing the spread of infection!

DO’s DON’Ts

PRESENTERS

Wayne Russell MA, ASN, 91C Medic

Wayne is an Army-trained ICU nurse and long-term care specialist with 35 years of clinical, administrative and staff development experience. He is CEO of CW Scrubs and Mercy League.

• Combat Medic/ICU trained 91C LPN

United States Army

• Associate of Science in Nursing –

Sanford Brown College

• Bachelor of Arts in Education –

Brigham Young University

• Master of Arts in Health

Management – Webster University

• 2019 Who’s Who in health care

•

Charlotte Russell

MS, RN, FNE, CLL

With over 20 years of clinical expertise as an OB/GYN, Med/Surg, SANE, Forensic Nurse and Chronic Lymphocytic Leukemia Specialist, Char is dedicated to supporting and helping nurses succeed.

• Associate of Science in Nursing

New York University

• Bachelor of Science in Nursing

Grand Canyon University

• Master of Science in Nursing –

University of Phoenix

• Sexual Assault Nurse Examiner

• 2019 Who’s Who in health care

•

•

References

Larson EL (August 1995). “APIC guideline for handwashing and hand antisepsis in health care settings.” Am J Infection Control 23 (4): 251-259.

Zhong CB, Liljenquist K (2006). “Washing away your sins: threatened morality and physical cleansing.” Science 313 (5792): 1451-1452.

PPPHW (2014). “Global Handwashing Day Planner’s Guide.” 3rd edition.

Vujcic, J., Ram, P.K. (2013). “UNICEF Handwashing Promotion - Montoring and Evaluation Module.” UNICEF, New York, USA

Curtis, V., Scott, B., Cardosi, J. (2000). “The Handwashing Handbook - A guide for developing a hygiene promotion program to increase handwashing with soap.” The International Bank for Reconstruction and Development/World Bank.

Gould, Dinah J.; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H.; Taljaard, Monica (2017). “Interventions to improve hand hygiene compliance in patient care.” The Cochrane Database of Systematic Reviews.

Girou, E; Loyeau, S; Legrand, P; Oppein, F; Brun-Buisson, C. (2002) “Efficacy of handrubbing wih alcohol based versus standard handwashing with antiseptic soap: clinical trial.” BMJ, (Clinical Research Ed).

Fischler, GE; Fuls, JL; Dail, EW; Duran, MH; Rodgers, ND; Waggoner, AL (2007). “Effects of hand wash agents on controlling the transmission of pathogenic bacteria from hands to food.” Journal of Food Production 70 (12): 2873-2877.

Whitby, M; Pessoa-Silva, CL; McLaws, ML; Allegranzi, B; Sax, H; Larson, E; Seto, WH; Pittet, D; Donaldson, L (2007) “Behavioral considerations for hand hygiene practices; the basic building blocks.” Journal of Hospital Infection. Elsevier. 65 (1): 1-8.

World Health Organization (July 2008). “WHO Guidelines on Hand Hygiene in Health Care.”

World Health Organization (July 2008). “How to hand rub and how to hand wash.”

Redway, Keith, Fawdar, Shameem (2008) “A comparative study of three different hand drying methods: paper towel, warm air dryer and jet air dryer.” School of Biosciences, University of Westminster London.

Cowling, Benjamin J.; et al. (2009). "Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households". Annals of Internal Medicine. 151 (7): 437–46.

Borges, Lizandra Ferreira de Almeida; Silva, BL; Gontijo Filho, PP (2007). "Hand washing: Changes in the skin flora". American Journal of Infection Control. 35 (6): 417–420.

Howard et al. (2002) “Healthy Villages A guide for communities and community health workers: Personal, domestic and community hygiene”. WHO; CHAPTER 8

Handwashing

_______________________________________________

Participant’s Name

_______________________________________________

Participant’s Email Address

1. ____________________________________ is the single

most important means of preventing the spread of disease.

2. ____________________ infections are spread within and

facility and are also called ___________________________.

3. Name 5 pathogens transported by your hands: ________

________________________________________________

4. Name 6 things Staphylococcus cause: _______________

________________________________________________.

5. What is the first step of handwashing? ______________

________________________________________________.

6. What is the second step of handwashing? ____________

________________________________________________.

7. What is the fourth step of handwashing? _____________

________________________________________________.

8. Name 3 types of soap: ___________________________

________________________________________________

9. What is the third “moment” for hand hygiene? ________

________________________________________________

10. Over 80% of deaths are spread by _________________

________________________________________________.

____________________________________________ Facility Name

11. Name 3 links of the chain of infection: _____________

________________________________________________

12. What does PPE stand for? _______________________

_______________________________________________

13. Name 2 times gloves should be worn: _____________

_______________________________________________

14. Name 3 times it is not necessary to wear gloves: ____

_______________________________________________.

15. Describe the first step of removing gloves? _________

_______________________________________________

16. Describe the last step of removing gloves? _________

_______________________________________________

17. Describe 2 Do’s of handwashing: _________________

_______________________________________________

18. Describe 2 Dont’s of handwashing: _______________

_______________________________________________

19. Define handwashing: ___________________________

________________________________________________

20. ______________________________ is the single most

important means of preventing the spread of disease.

Certificate of Continuing Education Completion

The undersigned participant is awarded 1.0 contact hour for completion of this continuing education inservice/seminar

Handwashing

___________________________________ Participant’s Name

___________________________________ Facility Name

___________________________________ Facilitator’s Signature

___________________________________ CW Scrubs Sponsor - Wayne Russell, CEO

Provider Name: CW Scrubs This inservice/seminar has been approved for 1.0 contact hour by the NDBON according to NDCC 43-12.1-20 and NDAC Chapter 54-02-05. Full attendance to the Live activity is required. Partial credit will not be awarded. Reproduction of any or all content is prohibited without consent of CW Scrubs.

_________________________ Date of Attendance

_________________________

Date

Provider Number: NDBON #1735

This inservice/seminar is designed for RNs, LPN/LVNs, CNAs, NAs, administrators, social workers, physical and occupational therapists, dietary staff, and other allied health professionals and can be presented to applicable governing boards or bodies for review. This certificate shall be retained by CW Scrubs for a minimum of two licensure renewal cycles (four years).