Handwashing for CNAs

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Handwashing Procedure

Equipment needed: sink, soap, and paper towels

Turn on faucet and adjust water temperature to a comfortable setting.
If necessary, roll up sleeves. From this point forward, avoid readjusting the water temperature or touching any part of the sink.
Wet hands, keeping arms angled downward, so the water runs from cleanest area (wrists) to the dirtiest area (fingertips).
Apply soap to hands.
Create a lather by rubbing hands together. Scrub all surfaces of the wrists, hands, fingers, spaces between fingers, thumbs, and cuticles for a minimum of 15 seconds.
Clean beneath fingernails by gently scratching them in the palm of the opposite hand or by scraping under each nail individually.
Thoroughly rinse all cleansed surfaces to remove any remaining suds. Remember to angle arms to keep the fingers lower than the wrists.
Use a clean, dry paper towel to dry hands. Discard the used paper towel. Don’t shake hands to dry them.
Use another clean paper towel to turn off the faucet. Discard the used paper towel.
If hands are contaminated at any point in this process, stop and repeat steps 1-9.

The Importance of Handwashing

Handwashing is considered the single most important practice to prevent the spread of infection [1]. Even when hands look clean, they could potentially be crawling with dangerous microorganisms and pathogens. Using soap and friction during handwashing helps loosen the oils on the skin, allowing dirt and pathogens to be rinsed away.

In the health care setting, handwashing is a key component of standard precautions and an infection control measure that applies to all patients regardless of their infection status [2]. Failure to wash one’s hands puts the patient receiving care, other patients, and the health care worker at risk of infection. All health care workers are expected to wash their hands before and after every patient encounter, between cases, before and after wearing gloves, and any time the hands are soiled. Using proper handwashing technique helps break the chain of infection and creates a safer environment for all individuals.

References

1. https://www.osha.gov/SLTC/etools/hospital/hazards/infection/infection.html

2. http://www.cdc.gov/hai/settings/outpatient/basic-infection-control-prevention-plan-2011/fundamental-of-infection-prevention.html

More Resources

Making an Occupied Bed

If a patient is bedridden or on bedrest, the bed linens will need to be changed while the patient is in the bed. For safety reasons, the nurse’s aid should avoid making an occupied bed if the patient is able to get out of bed. Bed linens should be changed according to the facility’s policy or anytime they are wet or soiled.

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient.

Logrolling the Resident

Logrolling is a technique used to roll a resident onto their side without the resident helping, and while keeping the resident’s spine in a straight line. This is especially important for residents who have had spinal surgery or injury.

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

Dressing and Undressing a Patient

Patients who have suffered a stroke or have weakness or injury to one side of their body may struggle with dressing and undressing. In order to help these patients regain their strength and independence, it is important that the nurse’s aide only assist them as needed. The nurse’s aide may need to teach patients how to dress and undress safely with their limitations.