SCRIPT IN RD (HANDWASHING)
Blue- own dialogue
Red - checklist
Green - rationale
Greeting for you maam (insert name). I’m Ma. Alrose R. Holgado of BSN 1-A. And I’ll be performing
the Return demonstration for Medical handwashing. So before we proceed to the procedure, let’s
identify first about what is medical handwashing
Medical handwashing is the cleaning of hands thoroughly to reduce if not to remove all dirt and
microorganisms. It is the easiest and the most effectuve way to prevent the spread of pathogens,
since hands are most agile of the body and considered the culprit in the spread of infectious disease.
The purposes of the procedures are:
To reduce the number of microorganisms on the hands
To reduce the risk of transmission of microorganisms to clients.
To reduce the risk of cross contamination of infectious organisms to oneself.
To reduce the risk of transmission of infectious organisms to oneself.
The materials needed for the procedures are:
Liquid soap
Warm running water
Towels
Tissues
Nail file
Non petroleum based hand moisturizers ( this is optional but if you want to put something in
your hand that can smoothen your hands, you can add some hand moisturizers)
Now in determining the need for handwashing by assessing….
a) Present factors increasing susceptibility to infection and possibility of undiagnosed infection (e.g.
HIV)
b) Use of immunosuppressive medications (a class of medicines that inhibit or decrease the
intensity of the immune response in the body)
c) Recent diagnostic procedures or treatments that penetrated the skin or a body cavity.
d) Current nutritional status
e) Signs and symptoms indicating the presence of an infection:
localized signs: swelling, redness, pain, or tenderness with a palpation or movement, palpable
heat at site, loss of function of affected body part, presence of exudate.
Systematic indications are fever, increased pulse and respiratory rate, lack of enery, anorexia,
enlarged lymph nodes
Handwashing should be done in all of the following:
At the beginning and end of every procedure done.
Before and after prolonged contact with a client.
Before invasive procedure.
Before contact especially woth susceptible clients.
Before and after handling client’s article or dressing/equipment used in his care.
After contact with body discharges, evern when gloves are worn.
Anytime you are in doubt about the necessary for handwashing.
Now let’s proceed to the implementation of handwashing procedure. For the preparation, we should
asess our hands first. The nail should be trimmed in short (because short nails are less likely to harbor
microorganisms) As you can see, everything is trimmed. Now, we remove all jewelries we are wearing
(because microorganisms can lodge in the settings of jewelry and under rings). As you can see, I’m not
wearing anything. and then the last thing to do in assessing our hand is check hands for breaks in the
skin or open wounds. (because a nurse who was open wound/sores may require a work assignment
with decreased risk of transmission of infectious organisms.) As you can see, I don’t have any open
wound or sores in my hand.
So now, let’s proceed to the procedure for proper medical handwashing. Why handwashing is
necessary? Regular handwashing is one of the best ways to remove germs, avoid getting sick, and
prevent the spread of germs to others.
Now, stand in front but away in sink. (the uniform should not touch the sink to avoid
contamination)
Roll sleeves above the elbows if you’re wearing a long sleeve ( because moist clothing facilitates
transfer of microorganisms)
Turn on the faucet and adjust the flow so that the water is warm ( warm running water aids in
removing microorganisms without removing excess skin oils so that’s why it is recommended
to wash our hands with warm water. In hot water, it may opens your skin pores than can
cause to dryness. Then in cold water, it is not effective in removing microorganisms)
Then after turning on the faucet, wet the hands thouroughly by holding them under the running
water. Holds the hands lower than the elbows so that the water flows from the arms ( the
water should flow from the least contaminated to the most contaminated area.) So as you can
see , my hands are the most contaminated area.
Apply 1- 2 drops or 4-5 ml of liquid soap. If it’s bar soap, rinse first the soap then rub them firmly
between your hands ( the used of 4-5 ml of liquid soap is recommended by the APIC or “
association for professionals in infection control and epidemiology)
And then, lather arms and hands well. If bar soap is usedm drop the bar soap without touching
the sink because as I said earlier, the sink is alerady contaminated.
Used firm and rubbing and circular movements to wash the palm, back and wrist of each ahnd.
The WHO recommends these steps which are:
First, right palm over left dorsum with interlaced fingers and vice versa ( interlacing the
fingers and thumbs cleans the interdigital spaces)
Palm to palm with finger interlaced.
Then, backs of fingers to opposing palms with fingers interlocked.
Then, rotational rubbing of left thumb clapsed in right palm and vice versa ( the
circular action creatse friction that helps remove microorganism mechanically) do this
in 30 seconds.
Then after the 30 seconds of rotational rubbing, rub the fingertips against the palm of
the opposite hand. ( the nails and fingertips are commonly missed during hand
hygiene)
Rinse hands thoroughly starting from the elbow and move down to the arms ( the
water should flow from the least contaminated to the most contaminated area)
Resoap your hands. Rewash and rerinse as needed if heavily contaminated. ( this is
done if hand is heavily contaminated to ensure the removal of microorganisms.)
Turn off the faucet with a paper towel or tissue if not foot operated ( to prevent
transfer of microbes from faucet to your hands)
Thorougly pat dry the hands from finger to forearm by blotting a towel on the skin
without srubbing (drying the skin thoroughly prevents chapping. This helps in
preventing skin irritation.)
Tidy the sink area and wipe excess with a paper towel. ( moisture allows
microorganisms to grow)
And that is the proper procedure in doing medical handwashing. Thank you maam and GOD BLESS.
