Nursing Skill: Hand Hygiene

A student nurse in the clinic asks the following question: "Why do you wash your hands for so long and how do you know when to use soap and water instead of hand sanitizer?" The nurse responds with several reasons listed below. Match each reason with the rationale the nurse would give to the student nurse.

1. Adequate time & friction and rubbing 2. Visibly soiled 3. Between clients & after client care

When applying hand sanitizer, the base should be at least 60% alcohol and should not be wiped off.

60%, should not

Which scenarios require hand hygiene to be performed using ONLY soap and water? Select all that apply.

After contact with objects contaminated with blood When hands are visibly soiled After caring for a client with clostridium difficile (C. diff) infection

Which cue indicates that you must wash your hands with soap and water instead of hand sanitizer?

C. diff positive lab result

Which assessment findings require further follow-up prior to the skill being performed? Drag the assessment findings that require follow-up to the box on the right.​

Isolation precautions Jewelry on the nurse Out of order sign Nurse positioning at the sink

Which boxes in the Isolation row of the Assessment section should be checked for this client? Select all that apply.

Isolation precautions: Y Contact

After educating a client and family about hand hygiene, which statements or observed actions would indicate the need for further educational support? ​

Needs Further Education Shows Understanding Needs Further Education Shows Understanding Needs Further Education

Due to the findings of increased infections on the unit, the committee has decided to educate clients and staff on the clinical situations in which hand hygiene is indicated. Review the list of clinical situations and specify if hand hygiene is indicated or not indicated. ​

Not Indicated Sitting at nurse's station Talking to HCP

Reflect on the hand hygiene skill video you watched earlier. Arrange the steps of hand hygiene in the proper order, from first to last.

Remove all jewelry​. Turn the faucet on to start the flow of warm water​. Wet both hands completely. Apply 3-5 mL of soap to the hands​. Rub hands vigorously together for a minimum of 20 seconds, covering all surfaces of hands and fingers​. Rinse all surfaces of the hands, pointing fingers down. Dry all surfaces of the hands with fingers pointing up using a dry, disposable towel. Turn the water off using a new, dry, disposable towel​.

After educating the nurses and clients on your unit about infection control, the nurse educator evaluates four nurses performing hand hygiene to determine if the education was effective. Specify whether the hand hygiene evaluation requires follow-up or does not require follow-up.

Requires Follow-Up Does Not Requires Follow-Up Requires Follow-Up

After reviewing the Respiratory Illness Rate for the City, Last 10 weeks graph shown here, choose the priority education points regarding hand hygiene that should be included in the demonstration. Select all that apply.

Residents should understand hand hygiene is an important measure to avoid germ transmission Residents can utilize hand sanitizer or soap and water

Designate whether the supplies and equipment are indicated or not indicated for performing the skill of hand hygiene.​

Sink with clean, running, cold water - Not Indicated Betadine - Not Indicated Reusable towel - Not Indicated Antimicrobial or regular soap - Indicated Trash receptacle - Indicated Clean Gloves - Not Indicated

At a committee meeting, it is reported that your unit has had an increase in infections that could be prevented by hand washing. Which observed behaviors from hand hygiene surveillance could have contributed to this increase? Select all that apply.​

Washing hands for 10 seconds Using hand sanitizer (C. diff)

The nurse in the skill video documented the following after educating a C. diff positive client on hand hygiene. Highlight the incorrect information the nurse documented.

hand sanitizer, 10 seconds, palms of the hands

Hand sanitizer is an effective method of hand hygiene because it kills removes microorganisms on the hands. It cannot be utilized if hands are exposed to spore-forming organisms (C. diff, Bacillus anthracis, or norovirus). It can be utilized before putting on sterile gloves.​

kills, cannot, can

Prior to performing hand hygiene using soap and water, the nurse would remove all jewelry. Then the nurse would wet both hands before applying soap and rub the hands vigorously together for a minimum of 20 seconds, covering all surfaces of the hands and fingers. ​

remove all jewelry, wet both hands, 20