Hand Washing
Albert Jerome Y. Jopida RN., MSN-AHN
Clinical Instructor for Fundamentals of Nursing
Manila Doctors College of Nursing
Manila Tytana College
Definition of Handwashing
Refers to a method of using
combination of mechanical and chemical
force to remove dirt, stains, dead skin
and microbes
Rationale of Handwashing
It is the cheapest method of infection
control since the “hands” are one of the
most efficient means of contamination.
It breaks infection transmission by
disrupting the Mode of Transmission by
Direct (hand to body surface) and Indirect
(hand to and object and then object to
another person) contact.
Historical Perspective
Florence Nightingale
Encourage Handwashing on her belief that
it will remove “miasma (poison in the air)”
during her heroic act in the Crimean War
(globalhandwashing.org. 2021).
Historical Perspective
Ignaz Semmelweis
encourage handwashing when he observe
child delivery related deaths amongst their
patients (Nester and Nester, 2009).
Historical Perspective
Even the Bible
required handwashing and cautioned
against dirty hands especially before
eating (Mark 7:1-5).
Effectiveness of Hand Washing
Semmelweis from 15% reduced
deaths due to post partum
infections to 2%
While Nightingale reduced
death in Crimean war together
with all aspect of cleanliness
from 60% to less than 2%.
Handwashing was recognized as crucial!
Handwashing never became a
standard of practice until the
Germ Theory of Causation by
Robert Koch and Pasteurization
of Luis Pasteur became known
many years later.
Today in 2021
It is widely accepted, promoted
and strictly enforced to
practice handwashing
When to use Practice Hand Washing
1. Before and after providing Nursing
Care
2. Before and after Nurse – Patient
Interaction.
3. Before and After entering Isolation /
Quarantine Rooms
4. Before and After meals
5. Before and After going to the Toilet
What Type of Soap to use?
According to Communicable Diseases In Nursing: A Multi
Disciplinary Approach (Emerson Aliswag, 2020):
Mild Liquid Soap to prevent drying of hands and use a
Dispenser for more hygienic access to soap.
Antibacterial or antimicrobial soap are not needed since
the action of soap is to reduce surface tension and
promote emulsification then wash off dirt and microbes
through running water.
Therefore, as long as the soap can produce a rich lather
(bubbles), it can easily achieve the purpose of removing
dirt and microbes.
Soap are natural killers of gram negative bacteria
and envelop viruses but not other types. Still, soap
is not meant to kill microbes, IT IS MEANT TO
REMOVE IT BY CHEMICAL (emulsification) AND
PHYSICAL FORCE (rubbing and running water).
The use of Antibacterial and antimicrobial chemicals
such as alcohol may be used in situations where
soap and water are not available.
Hand Hygiene
Refers to method of promoting hygiene of
the hands by suing soap and water
alternative when such are not available.
These are the use of 70% alcohol or Hand
Sanitizers with at least 60% alcohol
content.
The method of application and rubbing of
these disinfectants are the same strategy
used in handwashing with soap and water.
Remember:
There are many versions of
handwashing but choose one officially
accepted by international experts and
one that is most practical or easy to
use!
Thus I chose Handwashing from World
Health Organization in Cooperation
With John Hopkins Hospital
Summary of Procedures for Handwashing
Step 0: Wet Hands With Water
Apply Enough Soap to Cover Hands
Step 2: Rub Hands Palm to Palm
Step 3: Right Palm over left dorsum with
interlaced fingers and vice versa.
Step 4: Palm to Palm with Fingers
Interlaced.
Step 5: Back of Fingers to Opposing
Palms with Fingers Interlocked.
Step 6: Rotational Rubbing of Left Thumb
Clasped in Right Palm and Vice Versa
Step 7: Rotational Rubbing, Backwards and
Forwards, with Clasped Fingers of Right Hand in
Left Palm and Vice Versa
Step 8: Rinse Hands with Water
Step 9: Dry Hands with Single Use Paper
Towel.
Step 10: Your Hands are Now Safe.
Step 11: Use Towel to Turn Off Faucet
Film Showing You Tube Links
ForHand Washing:
https://www.youtube.com/watch?v=Iisgnb
MfKvI
ForHand Hygiene:
https://www.youtube.com/watch?v=4E7Uk
DlnvZA
