12.2.2: Procedure- Hand Washing

1. Ensure all materials needed are on hand at the sink. This includes soap, paper towels and/or a cotton towel if paper towels are unavailable. Be sure the soap is within arm’s length so you do not have to touch the sink to reach it.
2. Roll up your sleeves and remove your watch and jewelry. These items may hold bacteria.
3. Stand away from the sink. Do not let your hands, body, or uniform touch the sink at any time, as the sink is contaminated.
4. Wet your hands and wrists thoroughly under warm, running water.
5. Apply soap to your hands.
6. Keep your hands and forearms lower than your elbows, with your fingertips down. Your hands are dirtier than your forearms. If you allow water to run from your hands to arms, you will contaminate those areas.
7. Rub your hands together and lather all surfaces of your wrists, fingers, and hands.
8. Clean your nail beds by rubbing them in the palm of your other hand. Pay attention to knuckles and the sides of your fingers. Ensure all your fingers are washed, including thumbs and little fingers, which can easily be missed. Interlace your fingers and use a rubbing motion to ensure all surfaces of your hands and fingers are washed.
9. Use friction by rubbing your hand surfaces together for at least 20 seconds, which is the appropriate length of time to cleanse hands according to the CDC current guidelines. Humming or singing the “Happy Birthday” song twice from beginning to end is one way you can time 20 seconds.
10. Rinse all surfaces of your forearms, wrists, hands, and fingers, ensuring that you keep your hands below your elbows, and allow the water to rinse off, starting from forearms to wrists down to fingers. This prevents dirty water from your hands from running onto your forearms and contaminating those areas.
11. Be sure to not touch the sink while washing your hands.
12. Use a clean, dry paper towel or clean cotton towel to dry your hands. Dry your hands starting with your fingers, and move up to your wrists, and then forearms.
13. Dispose of the paper towel in a garbage can without touching the garbage can or other surfaces.
14. With a clean and dry paper towel, turn off the faucet. Faucets are dirty, and you risk contaminating your hands if you use your hands and not a paper towel to turn off the faucet. Use a clean and dry paper towel, rather than the wet one used to dry your hands. This prevents bacteria and other pathogens from transferring onto the paper towel and then your hands.
15. Dispose of the paper towel.
16. Apply cream or lotion to your hands as needed to prevent your skin from cracking or drying. Cracked or dried skin leads to skin breakdown. Skin breakdown leads to open areas for bacteria and other pathogens to easily enter your skin.

Use of Alcohol-Based Hand Sanitizer:

1. In the case when no running water is unavailable, you may use an alcohol-based cleanser that contains at least 60% alcohol.
2. Apply a generous amount of alcohol-based sanitizer to the palm of one hand.
3. Rub your hands together, covering all surfaces of your hands and fingers. Use friction as you would when washing your hands with soap and water by rubbing hand surfaces together.
4. Interlace your fingers and rub hands together to ensure all surfaces of your hands have been covered with the cleanser.
5. Rub the palm of one hand over the back of the other.
6. Rub the thumb of one hand in the palm of the other. Do the same with your other thumb.
7. Rub the fingers of one hand into the palm of the other to clean nail beds. Repeat to clean the nail beds of your other hand.
8. Rub hands together until the product has completely dried.
9. Remember, hand sanitizers are not as effective at removing germs as washing your hands. You should use soap and water when hands are visibly soiled or dirty.