Step 1: Wet your hands.

Make sure that you're using running water of at least 100 degrees Fahrenheit and that you've
removed any jewelry (e.g., rings or bracelets) before you begin because they can trap germs.

Tip: If you’re worried about losing your rings, wear them on a chain around your neck when
you’re at work, or keep them in a ring dish near the sink.

Step 2: Apply soap to your hands.

Remove your hands from the water and use a squirt of soap to remove soil and transient
microorganisms from your skin.

Step 3: Rub your palms together.

With hands still out of the water, rub palm to palm for about five seconds to create a rich lather.

Step 4: Rub your hands over each other.

Massage the back of your left hand over your right palm for three seconds to spread the soap.
Repeat the above process with your left palm on the back of your right hand.

Step 5: Interlace your fingers.

Rub your palms over one another, this time interlacing your fingers. Keeping your fingers
interlaced, run the backs of your fingers along the back of the opposing hand. Do this for three
seconds.

Step 6: Scrub your thumbs.

Rub your right thumb with your left hand, clasping it tightly while rotating for three seconds.
Repeat the above with your left thumb.

Step 7: Rub fingertips against palms.

Using the fingers of your right hand, rub your left palm in a circling motion for three seconds,
going both clockwise and counterclockwise. Repeat the above process with your left fingers
and right palm.

Step 8: Rinse your hands.

Once you've been cleaning for 20 to 30 seconds, rinse the soap off your hands until the water
runs clear and you don't see suds. When you're finished, use a paper towel to turn off the
faucet. Because you've touched it with dirty hands, there's a good chance that it's harboring
the bacteria and germs you just washed off.

Step 9: Dry your hands.

Dry your hands with paper towels or a hand dryer rather than a cloth towel, which collects
bacteria. Also, be sure not to wipe your hands on your scrubs.
 When Should Nurses Wash Their Hands?
According to the CDC experts, you should always wash your hands:

 When hands are visibly soiled

 After using the restroom
 Before eating
 After caring for a patient with an acute diarrheal illness
 After touching surfaces or equipment used in the care of a patient with an acute diarrheal
illness
HAND HYGIENE
Aseptic technique
Aseptic technique is a set of practices and procedures used to prevent contamination from
pathogens during medical procedures
It involves applying strict rules to minimize the risk of infection and is used by healthcare
providers in surgery rooms, clinics, outpatient care centers, and other healthcare settings
Aseptic technique is important because it helps prevent the spread of pathogens that cause
infection
The Joint Commission has identified four chief aspects of aseptic technique: barriers, patient
equipment and preparation, environmental controls, and contact guidelines
Aseptic technique is used in most medical settings, and procedures that involve aseptic
technique include handling surgery equipment, inserting catheters, and administering
injections

what are the benefits of using aseptic technique

The benefits of using aseptic technique are numerous and include:
1. Preventing the spread of infection: Aseptic technique helps prevent the transfer of
germs to or from an open wound and other susceptible areas on a patient's body,
reducing the risk of infection
2. Protecting patients and healthcare workers: Aseptic technique protects patients from
dangerous germs and healthcare workers from contact with blood and other bodily
fluids
3. Reducing healthcare-associated infections: Good aseptic technique procedures help
prevent and control healthcare-associated infections
4. Minimizing the presence of pathogenic organisms: Aseptic technique employs infection
control measures that minimize, as far as practicably possible, the presence of
pathogenic organisms
5. Improving patient outcomes: Healthcare providers using aseptic technique have
demonstrated reduced variability and improved patient outcomes
6. Standardizing healthcare practices: Aseptic technique is a standard healthcare practice
that helps ensure consistency and safety in healthcare settings

Overall, aseptic technique is an essential practice that helps protect patients and
healthcare workers from infection and improves patient outcomes
what is the difference between aseptic technique and clean technique
The main differences between aseptic technique and clean technique are:
Aseptic Technique:
 Aims to eliminate germs, which are disease-causing microorganisms
 Requires proper training and the use of specialist equipment
  Involves the use of sterile gloves, gowns, and other barriers to prevent the transfer of
germs
 Used in procedures such as surgery, inserting catheters, and running IVs
 Sterile to sterile contact is allowed, while sterile to non-sterile contact is not allowed
Clean Technique:
 Focuses on reducing the number of microorganisms in general
 Easier to achieve at home and does not always require specialist equipment
 Involves using clean hands or clean gloves instead of sterile gloves
 Used in minor procedures like physical exams and dressing wounds
 Allows for some contact between sterile and non-sterile objects, such as using clean
scissors or clean gauze for wound care
Both aseptic technique and clean technique are important in healthcare settings, and
healthcare professionals learn and use them in different situations to ensure patient safety and
prevent the spread of infection

HAND HYGIENE
DESCRIPTION
The exercise of proper hand hygiene is one of the essential parts of daily life. Many people
may
not understand the merits of hand washing. The infection prevention and control of
communicable diseases like; COVID19, Diarrhea, Ebola and others is highly possible through
the application of proper hand washing
DESCRIPTION The exercise of proper hand hygiene is one of the essential parts of daily life.
Many people may not understand the merits of hand washing. The infection prevention and
control of communicable diseases like; COVID19, Diarrhea, Ebola and others is highly
possible through the application of proper hand washing

BACKGROUND INFORMATION
Hand hygiene has been a central component of personal hygiene and a religious and cultural
custom for many years. However, the link between hand hygiene and health was first made
less than two centuries ago. Ignaz Semmelweis, a Hungarian doctor working in Vienna
General Hospital, is known as the father of Hand hygiene. In 1846, he introduced that women
giving birth in the medical student/doctor-run maternity in his hospital were much more likely to
develop a fever and die compared to adjacent midwife-run maternity ward. He then decided to
investigate. Upon his investigation he realized the doctors and medical students, right after
doing autopsy goes directly to the maternity ward to perform procedures and takes along
cadaverous particles on their hands which they carried to the maternity ward. Midwives did not
perform surgeries or autopsies so were not exposed to this particle. As a result, Semmelweis
imposed a new rule mandating hand washing with chlorine for Doctors, which made mortality
at the maternity fall drastically. This was the first proof that hand washing could prevent
infection. However most of the Doctors stood against it, with the argument that the water used
in hand washing caused infection and not the Doctors and so they stopped washing their
hands. A few years later in Scutari, Italy, the Crimean war brought about a new hand washing
champion, Florence Nightingale. At a time when most people believed infection was caused by
foul odors called miasmas, Nightingale implemented hand washing and other hygiene
practices in the war hospital. Whiles the target of this practice was to fight miasmas,
Nightingale’s hand washing practice achieved a reduction in infection.

Unfortunately the hand hygiene promoted by Semmelweis and Nightingale were not widely
adopted, general promotion stood still over a century. It was not until the 1980s, when a string
of food born outbreaks and healthcare- associated infections led to public concerns that the
United State Centers for Disease control and Prevention identified hand hygiene as an
important way to prevent spread of infection. In recent years, hand washing with soap and
other forms of hand hygiene have been gaining recognition as a cost effective, essential tool
for achieving good health and nutrition. Now the use of alcohol base sanitizing has been
introduced as one of the forms of hand hygiene, but as a temporal measure.

Outline At the end of the end of the seminar we should be able to know the following;
1. Describe what hand hygiene is.
2. Purpose of hand hygiene
3. Types of hand hygiene
4. Principles and Concepts surrounding hand hygiene
5. Reasons
6. Indicators of hand hygiene
7. Items or Supplies needed when performing hand hygiene
8. Procedure

DESCRIPTION
Hand Hygiene is any method that removes or destroys microorganisms on hands.“ (CDC’s
Definition of Hand Hygiene). WHO definition for Hand hygiene as a general term that applies
to hand washing, antiseptic washing, antiseptic hand rub or surgical hand sepsis. Hand
washing is under the umbrella of hand hygiene. Therefore hand washing 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. This is the most effective measure of reducing nosocomial infection. It is the
single most effective infection control.

Hand washing with soap removes germs/microorganisms from hands. This helps prevent
infections because, People frequently touch their eyes, nose, and mouth without even realizing
it. Germs can get into the body through the eyes, nose and mouth and make individuals sick.
Germs from unwashed hands can get into foods and drinks while people prepare or consume
them. These microorganisms can multiply in some types of foods or drinks, under certain
conditions and cause some diseases .Germs from unwashed hands can be transferred to
other objects, like handrails, table tops, or toys, and then transferred to another person’s
hands. Removing germs through hand washing therefore helps prevent diarrhea and
respiratory infections and may even help prevent skin and eye infections
PURPOSE OF HAND HYGIENE
1. To avoid pathogenic microorganisms and to avoid transmitting them.
2. To prevent infection or nosocomial infection
3. To keep the hands clean.

TYPES OF HAND HYGIENE

1. Routine or social hand washing; this is the use of water and non- anti-microbial soap for
the purpose of removing soil and transient microorganisms.
2. Hygienic or antiseptic hand washing; the use of water and antimicrobial soap eg. triclosan,
Chlorhexidine, iodine etc for the purpose of removing microorganisms and reduce resident
flora.
3. Alcohol- Based or Antiseptic hand rubs; this is the use of alcohol base rub.
4. Surgical hand wash or scrub ; use of water and antimicrobial soap for the purpose of
removing or destroying transient microorganisms and reduce resident flora. Recommended
duration is 2-6 minutes

PRINCIPLES AND CONCEPTS SURROUNDING HAND HYGIENE

1. Wash your hands under running water and not in a basin.
2. When washing your hands do not use only water but rather, water with soap - antimicrobial
soap if necessary.
3. Rub hands together for at least 20-30 seconds, paying attention to all parts.
4. It is advisable to keep finger nails short and keep already worn jewelry on eg. Rings, as this
traps germs. The jewelry is kept so that it can be washed also.
PRINCIPLES AND CONCEPTS SURROUNDING HAND HYGIENE
1. Wash your hands under running water and not in a basin.
2. When washing your hands do not use only water but rather, water with soap - antimicrobial
soap if necessary. 3. Rub hands together for at least 20-30 seconds, paying attention to all
parts.
4. It is advisable to keep finger nails short and keep already worn jewelry on eg. Rings, as this
traps germs. The jewelry is kept so that it can be washed also.
5. It is advisable to use disposable paper tissue to dry and after washing in order not to use
twice. But in a case where there is no disposable tissue, the towel use can be used ones
(single use), washed and dried in the sun. Hand drier is also preferred.
6. 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
7. Dispensers of soaps should be used until completely empty. Once emptied it should be
washed before refilled

INDICATORS OF HAND HYGIENE

1. Before touching a patient
2. Before clean/ Aseptic procedure.
3. After body fluid exposure risk.
4. After touching a patient.
5. After touching a patient surrounding eg. any object or furniture in the patient’s immediate
surroundings

ITEMS NEEDED 1. Soap; liquid/ cake, antiseptic/ non antiseptic 2. Running water with a sink
or receiver 3. Towel; disposable or reusable 4. Alcohol base sanitizer 5. Antiseptic cleaner 6.
Finger nail brush 7. Plastic cuticle

PROCEDURE

A. ROUTINE OR SOCIAL HAND WASHING

1. Wet hands with running water and apply a generous amount of soap to hands.
2. Rub palm to palm in circular motions. Rotate clockwise and anti-clockwise.
3. With your fingers linked through the other hand, use your right palm to rub the back of your
left hand. Then vice versa.
4. Interlace your fingers together, facing each other, into clasped hands. Then rub your palms
and fingers together. 5. Cup your fingers together, with your right hand over and your left hand
under. With your fingers interlocked, rub the backs of them against your palm. Vice versa.
6. Enclose your right hand around your left thumb and rub as you rotate it, then vice versa.
7. Rub your fingers over your left palm in a circular motion then vice versa.
8. Rinse both hands under running water.
9. Dry hands with a clean disposable towel.
10. In the absence of a foot peddle, or a sensor use another clean towel to turn of faucet.

B. ANTISEPTIC HANDRUB
1. Ensure jewelry has been removed; alcohol can change the color of the jewelry
2. Pour a reasonable amount of alcohol- based hand rub into cupped hand.
3. Rub palm to palm together
4. Right palm over left dorsum with interlaced fingers and vice-versa
5. Palm to palm with fingers interlaced
6. Back of fingers to opposing palms with fingers interlaced
7. Rotational rubbing, of left thumb clasped in palm and vice versa
8. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm
and vice versa.
9. Rub hands together until dry before continuing with patient care

C. ANTISEPTIC HAND WASH

1. Stand in front of the sink with available running water. Open tap using the faucet or foot
peddle or sensor
2. Keep hands lower than elbow to allow water to flow towards the finger tips. Wet hands to
wrist
3. Apply a generous amount of soap to hands to cover all the areas of hand.
4. With firm rubbing and circular motion, wash the palm to palm, back of the hands, each
fingers, the knuckles, wrist and forearms. Continue this friction motion for 20- 30sec.
5. Rinse hands thoroughly with water flowing towards the finger tips.
6. Pat hands dry, beginning with the fingers and moving towards forearms, with a paper towel
or reusable towel and discard immediately.
7. In the absence of a foot peddle, or a sensor use another clean towel to turn of faucet.
D. SURGICAL ANTISEPSIS
1. Remove all pieces of jewelry
2. Wet hands using sterile water or warm water.
3. Pour a generous amount of antimicrobial soap or povidone - iodine.
4. Clean subungual areas with a nail file
5. Scrub each sides of each finger, between the fingers, and the backs and fronts of the hands
for about 4 minutes. 6. Proceed to scrub the hands, keeping the hands higher than the arm at
all times, to prevent bacteria-laden soap and water from contaminating the hand.
7. Rinse the hands and arms by passing them through the flowing water in one direction only,
from fingertips to elbow.
8. Dry hands and arms using sterile towel observing aseptic technique

SUMMARY Hand hygiene is the general term that applies to hand washing, antiseptic hand
washing, antiseptic hand rub or surgical hand antiseptic. Hand washing is the washing of
hands with non-antimicrobial soap and water. Frequent hand washing reduces the risk of
infection. REFERENCE 1. WHO Guidelines on hand hygiene in health-care facilities (2009).
2. www.open.edu 3. www.jpsiconline.com 4. Global hand washing.org 5. Nurse labs.com