Nursing & Healthcare Programs

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

  1. Turn on faucet and adjust water temperature to a comfortable setting.
  2. If necessary, roll up sleeves. From this point forward, avoid readjusting the water temperature or touching any part of the sink.
  3. Wet hands, keeping arms angled downward, so the water runs from cleanest area (wrists) to the dirtiest area (fingertips).
  4. Apply soap to hands.
  5. 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.
  6. Clean beneath fingernails by gently scratching them in the palm of the opposite hand or by scraping under each nail individually.
  7. Thoroughly rinse all cleansed surfaces to remove any remaining suds. Remember to angle arms to keep the fingers lower than the wrists.
  8. Use a clean, dry paper towel to dry hands. Discard the used paper towel. Don’t shake hands to dry them.
  9. Use another clean paper towel to turn off the faucet. Discard the used paper towel.
  10. 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

Perineal Care of the Female Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Proper technique is important for maintaining hygiene, preventing infection, and avoiding skin breakdown. Because of the close proximity between a woman’s urethra, vagina, and anus, it is essential to only wipe in a front to back motion. Wiping in the opposite direction is associated with a greater risk for developing a urinary tract infection.

person wearing orange and white silicone band

Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Rectal Temperature with Electronic Thermometer

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods.

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Measuring the Respirations

Respiration is a vital sign that is measured frequently in the healthcare setting. Taking this measurement requires no equipment and relatively little time. However, it is a measurement that must be taken accurately, as a change in respiration may indicate the worsening of a patient’s condition.