Clinical Skills - Hand Hygiene


This series follows along with our Clinical Nursing Skills Flashcards, which provide step-by-step instructions and best practices for most skills used by practicing nurses and for the skills tested by most nursing schools during the laboratory portion of fundamentals.

What is good hand hygiene?

Good hand hygiene involves using the proper technique to thoroughly wash hands. The following steps should be taken to ensure good hand hygiene, using soap and water.

Remove jewelry

Before washing hands, remove all jewelry, e.g., no rings.

Wet hands and wrists thoroughly

If wearing a watch or long sleeves, make sure that they are pushed up well past the wrist.

Turn on the sink.

With warm water, wet the hands and wrists thoroughly, keeping hands and forearms below the elbows while washing. This allows the water to stream back into the sink, and not up the arms.

How much soap should be used for good hand hygiene?

To practice good hand hygiene 3 – 5 mL of antiseptic soap should be used when washing hands.

What is a good technique for washing hands?

A good technique for washing hands involves rubbing the hands together vigorously for at least 15 seconds, making sure to get between the fingers, under the fingernails, and across finger beds. Make sure to wash thumbs and palms thoroughly.

Consider scratching the palm a little with the fingernails as hands are being washed, to make sure the palms get cleaned.

How to rinse hands and wrists

When ready to rinse, keep the hands tilted down. The water should flow toward the fingertips. This is to prevent the water from running from the hands up the arm.

How to dry hands

Pat hands dry, starting at the fingertips and moving up to the wrists and then the forearms.

What is the proper technique for turning off a faucet?

When turning off a faucet, use a clean, dry paper towel. This prevents coming into contact with the dirty sink. Discard the used paper towel.

Remember not to let any part of the body touch the sink basin

When using a sink to wash hands, make sure no part of the body touches the surface of the sink, including the sink basin.

Do not lean over the sink. This is to keep a distance between tummy and sink. Consider when doing dishes in the kitchen at home and, having leaned into the sink, discovering a line of wetness across your tummy. In a hospital or an acute facility, there are pathogens everywhere, hence the need to keep the body and sink apart.

Full Transcript: Clinical Skills - Hand Hygiene

Hi, I'm Ellis with LevelUpRN, and in this video, I'm going to be demonstrating how to perform hand hygiene with soap and water. I'm going to be following along on the steps that we have included in our Clinical Nursing Skills deck. So if you have this deck, go ahead and grab it, get this card out, and follow along with me.

If you don't have the deck and you're interested in checking them out, head on over to Before I wash my hands, I've already removed my jewelry, so no rings.

And if I have something like a watch or even long sleeves, I want to make sure that they're pushed up well past my actual wrist. When I'm working with the sink itself, I want to make sure my body never touches the surface. I don't want to lean over it. How many times have you done your dishes in the kitchen and you lean into the sink and you get that line of wetness across your tummy? We don't want that because this is a hospital or an acute facility, and there are pathogens everywhere. So keeping that distance between your tummy and the sink.

So I'm going to go ahead and turn on the sink. I'm going to wet my hands. I keep my hands pointed down so the water never runs. I'm going to get three to five milliliters of soap. I'm scrubbing vigorously. I'm making sure to get between my fingers, my fingernails, my finger beds, my thumbs, my palms. I like to actually kind of scratch my palm a little bit with my fingernails, make sure they get cleaned.

All right. Once I'm ready to rinse, I still keep my hands tilted down. I don't want the water to run from my hands up my arm. All right, I'm keeping them tilted down. They're rinsed. At no point do I touch the sink basin itself. I'm going to grab my towel. I'm going to pat them dry starting at my fingertips and moving up.

Pat this one dry. Then I'm going to use a paper towel to go ahead and turn my sink off so that I'm not coming into contact with the dirty sink I turned on. And then I discard that and I'm ready to go.

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