Handwashing procedure

The purpose of handwashing is to remove resident bacteria and thus reduce the risk of cross-infection.

Equipment:
The equipment needed comprises hot and cold running water, appropriate cleansing agent, paper towels and a waste bin (preferably foot operated). The procedures and rationales are given below.

Procedure	Rationale
Roll up sleeves (if applicable) and remove jewellery/wristwatch (if worn)	To promote thorough washing of areas where bacteria can accumulate
Turn on taps and regulate temperature. The water should be hot but comfortable	Hot water improves the efficacy of the cleansing agent, but ensure safety – do not scald
Wet hands and wrists thoroughly	Aids dispersion of cleaning agent
Dispense cleaning agent from dispenser, apply enough agent to produce lather	For effective cleaning, covering all surfaces
Do not use bars of soap	Soap bars can harbour bacteria
Wash hands • using friction on all surfaces • rub palms together • hand-over-hand washing between the fingers • wash fingertips in the palm of each hand, rubbing the palms also • wash fingertips and nails individually • wash thumbs and wrists • wash beneath wedding ring if worn • pay attention to non-dominant hand	To clean effectively all areas paying attention to those frequently missed, e.g. thumbs, between fingers, fingertips and wrists Non-dominant hand is often not washed as well as the dominant hand, therefore pay greater attention to this hand
The use of nail brushes is not generally recommended	Nail brushes can damage the skin and therefore increase the infection risk
Rinse hands under tolerably hot running water, with hands held downwards, until all cleaning agent removed	Promotes the removal of residual cleaning agent and bacteria. Any residual cleaning agent may cause irritation to the skin
Turn off taps using elbow tap, or use a paper towel if standard tap	Ideally ‘elbow’ taps should be used to prevent recontamination from touching the tap. If standard tap in use, a clean paper towel should be used to turn off the tap to prevent recontamination
Dry hands thoroughly with clean disposable paper towels	Bacteria flourish in moist areas. Hot air dryers do not dry effectively and communal towels are generally contaminated from previous use
Dry from fingertip upwards	Reduces the risk of recontamination from the forearms
Dispose of paper towel in foot-operated bin	Prevents recontamination from touching bin. If hand-operated, use a clean paper towel to protect hand whilst opening, as with taps
Apply hand cream but avoid using communal tubes or bottles as these have been found to promote cross-infection	Reduces the potential for cracking and splitting