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

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Applying Elastic Support Hose

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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.

Moving the Resident from a Bed to a Stretcher or Gurney

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed.

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.

Fowler’s Position

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.