WEBVTT 00:00:00.000 --> 00:00:03.360 [Tone, countdown] 00:00:03.360 --> 00:00:04.990 [Music] 00:00:04.990 --> 00:00:07.150 [The U.S. Department of Health, Education and Welfare, 00:00:07.150 --> 00:00:13.660 Public Health Service, Presents] 00:00:13.660 --> 00:00:17.970 [Handwashing in Patient Care] 00:00:17.970 --> 00:00:20.250 [Narrator:] Hands play an active and vital role in 00:00:20.250 --> 00:00:24.450 in our everyday living. 00:00:24.450 --> 00:00:29.180 They help to express tender devotion to our loved ones. 00:00:29.180 --> 00:00:32.140 [Music] 00:00:32.140 --> 00:00:35.950 To handle and care for the many objects around us. 00:00:35.950 --> 00:00:38.800 [Music] 00:00:38.800 --> 00:00:44.420 And to minister to our own personal needs. 00:00:44.420 --> 00:00:47.030 But as useful as hands are, they can also 00:00:47.030 --> 00:00:51.080 serve as vehicles for spreading disease agents. 00:00:51.080 --> 00:00:52.660 From person to person 00:00:52.660 --> 00:00:56.340 and from place to place. 00:00:56.340 --> 00:00:58.500 The danger of spreading infectious organisms 00:00:58.500 --> 00:01:02.360 is especially great when caring for the sick and debilitated, 00:01:02.360 --> 00:01:05.980 whether in the hospital or in the home. 00:01:05.980 --> 00:01:09.930 Not only are sick individuals highly susceptible to infection, 00:01:09.930 --> 00:01:13.120 they also serve as sources of disease agents, 00:01:13.120 --> 00:01:15.030 even though the signs and symptoms 00:01:15.030 --> 00:01:19.330 of infection may not be apparent. 00:01:19.330 --> 00:01:22.210 When caring for the sick, the simplest way to prevent 00:01:22.210 --> 00:01:23.730 the spread of agents 00:01:23.730 --> 00:01:26.800 is to conscientiously practice handwashing 00:01:26.800 --> 00:01:31.010 based on the fundamental principals of medical asepsis. 00:01:31.010 --> 00:01:33.270 The aim of this technique is to reduce the number 00:01:33.270 --> 00:01:35.740 of pathogenic organisms. 00:01:35.740 --> 00:01:38.720 It must not be confused with surgical asepsis, 00:01:38.720 --> 00:01:45.620 where elimination of all organisms is the goal. 00:01:45.620 --> 00:01:49.310 The primary principle of medical asepsis involves mechanical removal 00:01:49.310 --> 00:01:52.980 of dirt and microorganisms from the skin. 00:01:52.980 --> 00:01:55.550 To carry out this principle in handwashing, 00:01:55.550 --> 00:01:58.900 certain essentials are required. 00:01:58.900 --> 00:02:03.000 Running water. 00:02:03.000 --> 00:02:08.750 Soaps and related compounds. 00:02:08.750 --> 00:02:12.400 And friction. 00:02:12.400 --> 00:02:14.110 Running water is an important element, 00:02:14.110 --> 00:02:18.890 since it acts to flush foreign material off the hands. 00:02:18.890 --> 00:02:20.630 The water temperature should be that 00:02:20.630 --> 00:02:24.430 which is comfortable to the skin. 00:02:24.430 --> 00:02:27.420 While very hot water may destroy some organisms, 00:02:27.420 --> 00:02:30.640 it can also cause chafing and breaks in the skin, 00:02:30.640 --> 00:02:35.120 thereby affording harborage for pathogenic microorganisms. 00:02:35.120 --> 00:02:38.010 Infection may then incur, thus increasing the danger 00:02:38.010 --> 00:02:43.340 of hands as spreaders of disease. 00:02:43.340 --> 00:02:46.920 Soaps and related compounds, due to their detergent properties 00:02:46.920 --> 00:02:51.330 are also effective in the mechanical cleansing of hands. 00:02:51.330 --> 00:02:54.620 Soap lather permits water to penetrate the skin pores 00:02:54.620 --> 00:03:02.020 and wash away dirt and other foreign matter. 00:03:02.020 --> 00:03:05.730 Friction is still another aid in mechanical removal of organisms, 00:03:05.730 --> 00:03:10.580 and is produced by vigorously rubbing together the hands and fingers. 00:03:10.580 --> 00:03:12.980 Where frequent handwashing is necessary, 00:03:12.980 --> 00:03:15.240 brushes are not generally recommended, 00:03:15.240 --> 00:03:24.560 since they tend to injure and excoriate the skin. 00:03:24.560 --> 00:03:29.050 Chemical destruction of microorganisms or disinfection, 00:03:29.050 --> 00:03:32.660 is a means of obtaining medical asepsis in handwashing. 00:03:32.660 --> 00:03:34.460 It must be borne in mind, however, 00:03:34.460 --> 00:03:38.320 that some chemicals will injure the hands. 00:03:38.320 --> 00:03:41.030 There are several soaps and detergents containing chemicals 00:03:41.030 --> 00:03:44.060 like hexachlorophene in specific strengths 00:03:44.060 --> 00:03:46.150 which serve to inhibit the growth of bacteria, 00:03:46.150 --> 00:03:56.950 without producing damage to the skin. 00:03:56.950 --> 00:03:59.470 Finally, the length and the frequency of the hand wash 00:03:59.470 --> 00:04:03.790 is an important consideration in achieving medical asepsis. 00:04:03.790 --> 00:04:07.460 Before and after caring for each patient, 00:04:07.460 --> 00:04:11.330 a thorough hand wash should be carried out. 00:04:11.330 --> 00:04:14.260 This is also important at intervals during patient care 00:04:14.260 --> 00:04:16.530 when there is danger of spreading organisms 00:04:16.530 --> 00:04:19.850 from one part of the body to another. 00:04:19.850 --> 00:04:22.500 The length of the hand wash depends upon the degree 00:04:22.500 --> 00:04:25.710 of suspected hand contamination, 00:04:25.710 --> 00:04:28.080 the use of soap or detergent, 00:04:28.080 --> 00:04:30.760 and the vigor of friction applied. 00:04:30.760 --> 00:04:38.080 One to two minutes is generally recommended. 00:04:38.080 --> 00:04:41.320 The demonstration to follow involves a handwashing procedure 00:04:41.320 --> 00:04:43.830 that can be used primarily in hospitals equipped 00:04:43.830 --> 00:04:48.880 with foot-controlled water faucets and liquid soap dispensers. 00:04:48.880 --> 00:04:51.280 First, it is important that patient care personnel 00:04:51.280 --> 00:04:54.470 distinguish between the clean and the contaminated objects 00:04:54.470 --> 00:04:56.680 in the facility. 00:04:56.680 --> 00:05:01.180 In this procedure we will consider the clean objects to be: 00:05:01.180 --> 00:05:03.650 Hand lotion. 00:05:03.650 --> 00:05:06.460 Paper towels. 00:05:06.460 --> 00:05:11.070 Foot-operated soap dispenser. 00:05:11.070 --> 00:05:12.910 And water faucet. 00:05:12.910 --> 00:05:17.390 They will be touched only with clean hands. 00:05:17.390 --> 00:05:20.220 The contaminated objects are the sink bowl 00:05:20.220 --> 00:05:24.100 and the used nail-cleaning sticks. 00:05:24.100 --> 00:05:26.820 During the hand wash, the nurse should use body mechanics 00:05:26.820 --> 00:05:33.060 which will permit comfortable operation of the foot pedals 00:05:33.060 --> 00:05:38.280 and prevent her uniform from touching the contaminated sink. 00:05:38.280 --> 00:05:41.090 Her position should be such that the soap lather 00:05:41.090 --> 00:05:42.460 and rinse water will fall 00:05:42.460 --> 00:05:46.730 into the bowl and not on the floor. 00:05:46.730 --> 00:05:48.940 Before the hand wash, all jewelry 00:05:48.940 --> 00:05:50.630 except a plain wedding band, 00:05:50.630 --> 00:05:54.740 should be removed from the hands and wrists. 00:05:54.740 --> 00:05:56.100 Fingernails should be well-groomed, 00:05:56.100 --> 00:05:59.720 and nail polish should not be worn. 00:05:59.720 --> 00:06:01.400 These precautionary measures will eliminate 00:06:01.400 --> 00:06:07.870 additional harborage areas for microorganisms. 00:06:07.870 --> 00:06:10.270 The area to be washed should extend about one inch 00:06:10.270 --> 00:06:13.850 beyond the line of contamination. 00:06:13.850 --> 00:06:18.350 In this case, the mid-forearm. 00:06:18.350 --> 00:06:20.780 First, with the foot pedal turn on the water 00:06:20.780 --> 00:06:31.550 and wet the hands thoroughly. 00:06:31.550 --> 00:06:34.700 Next, apply liquid soap from the dispenser, 00:06:34.700 --> 00:06:37.150 working up a good lather by rubbing together 00:06:37.150 --> 00:06:41.570 the palmar and dorsal surfaces. 00:06:41.570 --> 00:06:55.810 ten or more friction motions are suggested. 00:06:55.810 --> 00:06:57.440 With the fingers interlaced, 00:06:57.440 --> 00:07:11.010 continue with about ten more friction motions. 00:07:11.010 --> 00:07:13.180 After a repeat rubbing of the palmars, 00:07:13.180 --> 00:07:15.210 rinse the hands thoroughly, 00:07:15.210 --> 00:07:21.920 allowing the water to flow off the sides. 00:07:21.920 --> 00:07:25.810 Next, wet one forearm, 00:07:25.810 --> 00:07:30.460 and from the soap dispenser, apply liquid soap. 00:07:30.460 --> 00:07:41.600 Work up a lather employing a rotary friction motion. 00:07:41.600 --> 00:07:45.400 Now wet the other forearm 00:07:45.400 --> 00:08:02.450 and repeat the lathering as before. 00:08:02.450 --> 00:08:05.160 Rinse both hands and forearms, allowing the water 00:08:05.160 --> 00:08:14.190 to flow from the fingertips to the elbow. 00:08:14.190 --> 00:08:26.410 Once again soap the hands and work up another lather. 00:08:26.410 --> 00:08:29.340 With an orange stick, or the blunt end of a toothpick, 00:08:29.340 --> 00:08:31.240 clean all fingernails carefully, 00:08:31.240 --> 00:08:35.210 rinsing the toothpick after each finger. 00:08:35.210 --> 00:08:37.490 The blunt end is used since it lessens the possibility 00:08:37.490 --> 00:08:42.300 of injuring the soft tissues under the nails. 00:08:42.300 --> 00:08:44.620 It may not always be necessary to clean the nails 00:08:44.620 --> 00:08:51.470 each time the hands are washed. 00:08:51.470 --> 00:08:53.600 When finished, discard the toothpick 00:08:53.600 --> 00:09:03.130 and continue rubbing the hands with a friction motion. 00:09:03.130 --> 00:09:16.060 Now give both hands and forearms a complete and final rinse. 00:09:16.060 --> 00:09:19.190 With a paper towel, dry both hands and one forearm 00:09:19.190 --> 00:09:40.060 from wrist to elbow using a patting motion. 00:09:40.060 --> 00:09:47.010 With a clean towel, again dry both hands and the other forearm. 00:09:47.010 --> 00:09:50.490 Use additional towels as needed. 00:09:50.490 --> 00:09:52.820 To complete the hand washing procedure, 00:09:52.820 --> 00:09:58.130 always apply a lotion to the hands and forearms. 00:09:58.130 --> 00:10:16.280 This helps keep the skin soft and free from chapping. 00:10:16.280 --> 00:10:19.110 Many handwashing facilities frequently do not have 00:10:19.110 --> 00:10:22.680 foot-operated water faucets and soap dispensers. 00:10:22.680 --> 00:10:27.700 In such cases, hand-operated faucets and cake soaps are used. 00:10:27.700 --> 00:10:32.400 These require a slight modification of the handwashing procedure. 00:10:32.400 --> 00:10:37.630 The faucet handles and the soap are considered to be contaminated. 00:10:37.630 --> 00:10:42.300 They should not be touched with clean hands. 00:10:42.300 --> 00:10:46.440 First, wet the hands thoroughly. 00:10:46.440 --> 00:10:49.350 Take the cake of soap and work up a generous lather, 00:10:49.350 --> 00:10:53.950 using the same friction motion as demonstrated earlier. 00:10:53.950 --> 00:11:10.160 Retain the soap in the hands throughout the procedure. 00:11:10.160 --> 00:11:12.270 Rinse the hands, again allowing the water 00:11:12.270 --> 00:11:18.810 to flow off the sides. 00:11:18.810 --> 00:11:25.410 Now, wet and soap each forearm. 00:11:25.410 --> 00:11:27.180 Transfer the soap from hand-to-hand 00:11:27.180 --> 00:11:51.170 between each lathering operation. 00:11:51.170 --> 00:11:53.670 After a thorough rinse of each forearm, 00:11:53.670 --> 00:12:06.320 soap the hands once again. 00:12:06.320 --> 00:12:09.230 Holding the soap by the fingertips, rinse, 00:12:09.230 --> 00:12:12.610 and let drop into soap container. 00:12:12.610 --> 00:12:15.640 Continue washing the hands and cleaning the nails, 00:12:15.640 --> 00:12:24.610 ending the procedure with a drying of both hands and forearms. 00:12:24.610 --> 00:12:28.440 With the last paper towel, turn off the water faucets. 00:12:28.440 --> 00:12:31.010 The towel will prevent recontamination of the hands 00:12:31.010 --> 00:12:39.720 by the faucet handles. 00:12:39.720 --> 00:12:42.560 In caring for sick and debilitated patients, 00:12:42.560 --> 00:12:45.890 it may not always be possible to carry out handwashing procedures 00:12:45.890 --> 00:12:50.060 in which the principles of medical asepsis can be applied. 00:12:50.060 --> 00:12:52.700 In such cases, improvised methods are necessary 00:12:52.700 --> 00:12:56.940 in order to remove as much dirt and contamination as possible. 00:12:56.940 --> 00:13:00.390 For example, when caring for a patient in isolation, 00:13:00.390 --> 00:13:03.850 and where running water from a faucet is not available in the room, 00:13:03.850 --> 00:13:13.000 an assistant may pour water over the hands during the hand wash. 00:13:13.000 --> 00:13:15.300 In some situations, it may be necessary to wash 00:13:15.300 --> 00:13:18.180 in a soap solution or other chemical. 00:13:18.180 --> 00:13:21.020 This method, however, is undesirable since mechanical removal 00:13:21.020 --> 00:13:29.470 of organisms by running water cannot be achieved. 00:13:29.470 --> 00:13:33.350 Emergencies may arise where there is no water available. 00:13:33.350 --> 00:13:36.750 Here, swabbing or rinsing the hands with 70 percent alcohol 00:13:36.750 --> 00:13:43.080 may provide a relative measure of cleanliness. 00:13:43.080 --> 00:13:46.700 As expedients, these improvised measures should be used only 00:13:46.700 --> 00:13:50.120 in emergency or disaster situations. 00:13:50.120 --> 00:13:51.630 A more desirable handwashing 00:13:51.630 --> 00:13:59.760 should be carried out as soon as possible. 00:13:59.760 --> 00:14:02.040 A conscientious practice of hand washing, 00:14:02.040 --> 00:14:03.760 whether done in the hospital, 00:14:03.760 --> 00:14:06.690 the home, or under emergency conditions, 00:14:06.690 --> 00:14:09.700 is a vital function in providing safer nursing care 00:14:09.700 --> 00:14:11.960 for the sick and debilitated. 00:14:11.960 --> 00:14:13.690 [Music] 00:14:13.690 --> 00:14:16.000 It is considered one of the most effective means 00:14:16.000 --> 00:14:22.340 for preventing and controlling the spread of disease-producing organisms. 00:14:22.340 --> 00:14:26.550 Although specific procedures and techniques of handwashing may vary, 00:14:26.550 --> 00:14:31.400 the basic principals of medical asepsis should remain constant. 00:14:31.400 --> 00:14:35.040 If the details of the procedures are kept simple and practical, 00:14:35.040 --> 00:15:24.195 effective handwashing can be performed.