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

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

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.

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

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.

Moving the Resident to the Side of the Bed

Residents are usually kept in the center of the bed for safety reasons. However, moving a resident to the side of the bed is an important step to take before turning a resident onto his or her side. Performing this action allows the resident to end up side lying in the center of the bed and not smashed up against the side rail.