Hand hygiene (for nursing assistant training)

When assisting with client care, consistent, proper, and meticulous hand hygiene is the single easiest and most effective practice to reduce the risk of transmission of infection to and from the client.

Hand hygiene mainly includes handwashing with soap and water and using an alcohol-based hand rub.

Now, depending on your facility’s policy, you may need to perform hand hygiene at different times.

In any case, it’s important to at least perform hand hygiene upon entering and leaving a client’s room and before and after every contact with a client in general.

You should also perform hand hygiene before and after applying personal protective equipment, like gloves; after handling any waste; after exposure to items or surfaces that could possibly be contaminated with blood, body fluids, secretions, or excretions; and after contact with non-intact skin, mucous membranes, or wound dressings.

Likewise, remember to perform hand hygiene before and after handling a client’s meal or drink, before coming in the room where clean supplies are maintained, before touching clean clothing or linen, and after helping a client back from the bathroom.

And, of course, perform hand hygiene upon entering and leaving the facility; before and after drinking, eating, or smoking; before and after putting in contact lenses; before and after doing your make-up or fixing your hair; after picking something off the floor; after using the bathroom; and after coughing, sneezing, or using a tissue.

Now, when practicing hand hygiene, there are some general considerations you need to keep in mind.

First of all, it’s important to pay special attention to the places where pathogens can easily hide and the places that can be frequently missed, like the back of your hands, between the fingers, and under or around your nails.

What can help with this is to keep the fingernails short; wear no nail polish, artificial nails, acrylics, or wraps; and remove jewelry, including rings and bracelets.

You should also keep in mind that practicing hand hygiene frequently might cause the hands to become dry and cracked, which will create openings for microbes.

This can be prevented by applying a facility-approved hand lotion or cream afterward.

Okay, when it comes to choosing between washing your hands with soap and water and using an alcohol-based rub or sanitizer, these are mostly interchangeable.

However, remember not to use alcohol-based hand sanitizer if you have visible dirt, blood, or body secretions on your hands or if you're working with a client who has Clostridium difficile or another spore producing pathogen.

In these cases, hand washing with soap and water is a must.

Okay, before starting to wash your hands, gather the supplies you’ll need if they are not already there, including soap or the handwashing agent chosen by your facility; clean paper towels; as well as a nail brush, orange stick, and hand lotion or cream if needed.

So, start by approaching the sink but make sure that you don’t let your hands, body, or clothes come in contact with the sink at any time.

Roll up your sleeves and remove or push up your watch if you are wearing one.

You can then turn on the warm water with a clean paper towel: Using warm water when washing your hands helps to protect the oils in your skin.

Dispose of the paper towel safely and according to your facility’s policy.