A basic list of things to consider when washing hands.


Things to DO when washing your hands:

· Avoid wearing rings other than a plain band.

. Remove your wristwatch or push it to the middle of your forearm.

· Stand before the sink, keeping your hands and clothing away from the sink surface.

· Turn on the water and adjust the temperature to warm.

· Wet your hands and wrists thoroughly under the running water.

· Keep your hands and forearms lower than your elbows to prevent water from flowing from the most to the least contaminated area.

· Apply 3 to 5mL of liquid soap to your hands and lather thoroughly. If you must use bar soap, rinse it before and after you use it.

· Using plenty of lather and friction, wash your hands for 10 to 15 seconds. Vigorously wash the palms and backs of your hands, each finger, the areas between fingers, and your knuckles, wrists, and forearms. Wash at least 2.5 cm (1 inch) above any area of contamination. If you hands aren't visibly soiled, wash to 1 inch above your wrists.

· Use a clean orangewood stick or a nail-brush to clean under your fingernails.

· Keeping your hands down, rinse your hands and wrists thoroughly.

· With a clean paper towel, blot your hands from the fingers toward your wrists and forearms.

· Turn off the water; if using a hand-operated tap, cover it with a paper towel to avoid contaminating your hands.

· Discard the paper towel in a proper receptacle.

· Apply lotion to your hands to prevent chapped skin, which can harbor bacteria.


Things you DON'T do when washing your hands:

· Don't touch the sink; it's contaminated. If your hands touch the sink or tap at any time, start over again.

· Don't splash water on your clothing. The rinse water from your hands could carry bacteria and so you would end up spreading contamination from your clothes.

· Don't use hot water, warm water is best. Hot water tends to open the pores and remove skin oils.


Procedure & Rationale:

Remove jewelry before hand wash procedure
     Eliminate source of organisms

Rinse hands in warm running water
     This allows for suspension and washing away of the loosened microorganisms

Lather with soap and, using friction, cover all surfaces of the hands and fingers
     The minimum duration for this step is 10 seconds; more time may be required if hands are visibly soiled; antiseptic agents require 3-5 mL (one application from dispenser); frequently missed areas are thumbs, under nails, back of fingers and hands

Rinse under warm running water
     To wash off microorganisms and residual hand washing agent

Dry hands thoroughly with single use towel
     Drying achieves a further reduction in number of microorganisms; reusable towels are avoided because of the potential for microbial contamination

Turn off tap with towels used to dry hands
     To avoid recontaminating hands

Maintain short neatly trimmed finger nails; do not use finger nail polish or artificial nails
     Long nails, artificial nails or chipped nail polish may increase bacterial load


Important areas of the hands to wash:

Following is a graphic which colours in red areas of the hands most frequently missed in washing.

Make sure attention is given to these areas as well!

Image from: Taylor LJ. An evaluation of handwashing techniques. Nursing Times, Jan 1978

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