Handwashing In Patient Care

[Music] running water is an important element since it acts to flush foreign material off the hands the water temperature should be that which is comfortable to the skin while very hot water may destroy some organisms it can also cause chapping and breakin related compounds due to their detergent properties are also effective in the mechanical cleansing of hands soap lather permits water to penetrate the skin pores and wash away dirt another foreign matter friction is still another aid in mechanical removal of organisms and is produced by vigorously rubbing together the hands and fingers where frequent hand-washing is necessary brushes are not generally recommended since they tend to injure and excoriate the skin chemical destruction of microorganisms or disinfection is a means of attaining medically sepsis in hand-washing it must be borne in mind however that some chemicals will injure the hands there are several soaps and detergents containing chemicals like hexa chlorophenol specific strengths which serve to inhibit the growth of bacteria without producing damage to the skin Pikul removal of dirt and microorganisms from the skin to carry out this principle in hand-washing certain essentials are required running water soaps and related compounds and friction finally the length and the frequency of the hand wash is an important consideration in achieving medically sepsis before and after caring for each patient a thorough hand wash out this is also important at intervals during patient care when there is danger of spreading organisms from one part of the body to another the life the demonstration to follow involves a hand-washing procedure that can be used primarily in hospitals equipped with foot controlled water faucets and liquid soap dispensers first it is important that patient care personnel distinguish between the clean and the contaminated objects in the facility in this procedure we will consider the clean objects to be hand lotion paper towels foot operated soap dispenser and water faucet they will be touched only with clean hands the contaminated objects are the sink Bowl and the used nail cleaning sticks during the hand wash the nurse should use body mechanics which will permit comfortable operation of the foot pedals and prevent her uniform from touching the contaminated sink her position should be such that the soap lather and rinse water will fall into the bowl and not on the floor before the hand wash all jewelry except a plain wedding band should be removed from the hands and wrists fingernails should be well groomed and nail polish should not be worn these precautionary measures will eliminate additional harborage areas for microorganisms the area to be washed should extend about one inch beyond the line of contamination in this case the mid forearm first with the foot pedal turn on the water and wet the hands thoroughly Palmer and dorsal surfaces 10 or more friction motions are suggested Russell services rinse the hands thoroughly with an orange stick for the blood end of a toothpick clean all fingernails carefully rinsing the toothpick after each finger the bliss card the toothpick and continue rubbing the hands with a friction motion now give both hands and forearms a complete and final rinse with a paper towel dry both hands and one for arm from wrist to elbow using a patting motion with a clean towel again dry both hands and the other forearm use additional towels as needed to complete the hand washing procedure always apply a lotion to the hands and forearms this helps keep the skin soft and free from chapping many hand-washing facilities frequently do not have foot operated water faucets and soap dispensers in such cases hand operated faucets and cake soaps are used these require a slight modification of the hand-washing procedure the faucet handles and the soap are considered to be contaminated they should not be touched with clean hands first wet the hands thoroughly take the cake of soap and work up a generous lather using the same friction motion as demonstrated earlier retain the soap and the hands throughout the procedure rinse the hands again allowing the water to flow off the sides now wet and soak each forearm transfer the soap from hand to hand between each lathering operation after a thorough rinse of each forearm soak the hands once again holding the soap by the fingertips rinse and let drop into soap container continue washing the hands and cleaning the nails ending the procedure with a drying of both hands and forearms with the last paper towel turn off the water faucets the towel will prevent recontamination of the hands by the faucet handles in caring for sick and debilitated patients it may not always be possible to carry out hand washing procedures in which the principles of medically sepsis can be applied in such cases improvised methods are necessary in order to remove as much dirt and contamination as possible for example when caring for a patient in isolation and where running water from a faucet is not available in the room and assistant may pour water over the hands during the hand wash in some situations it may be necessary to wash in a soap solution or other chemical this method however is undesirable since mechanical removal of organisms by running water cannot be achieved emergencies may arise where there is no water available here swabbing or rinsing the hands with 70% alcohol may provide a relative measure of cleanliness as expedience these improvised measures should be used only in emergency or disaster situations a more desirable hand-washing should be carried out as soon as possible a conscientious practice of hand washing whether done in the hospital the home or under emergency conditions is a vital function in providing safer nursing care for the sick and debilitated it is considered one of the most effective means for preventing and controlling the spread of disease producing organisms all those specific procedures and techniques of hand washing may vary the basic principles of medically sepsis should remain constant if the details of the procedures are kept simple and practical effective hand-washing can be performed [Music]