Handwashing III: During the Procedure and Post-Procedure Steps

Friction from rubbing movements loosens dirt and organisms from between fingers, skin crevices of knuckles, palms, backs of hands, wrists, and forearms. These mechanical actions are essential for removing contaminants that water alone cannot eliminate, making proper technique critical for effective hand hygiene and infection prevention.

Wash hands before less contaminated areas, starting with palms and fingers, then progressing to wrists and forearms. Rub palms together, then the back of each hand with interlaced fingers, rub palms with fingers interlaced, rub backs of fingers with interlocked fingers, rub thumbs in circular motions, and finally rub fingertips rotationally.

Damp hands encourage the multiplication of bacteria. Thorough drying with paper towels removes moisture that would otherwise promote bacterial growth. This step is essential because wet skin provides an ideal environment for microorganisms to proliferate, compromising the effectiveness of handwashing.

Turn off the faucet with a paper towel or use your elbow to prevent contact with the faucet. This prevents recontamination of clean hands from the faucet handle. Dispose of paper towels in a foot-operated waste bin to avoid touching contaminated surfaces after washing.

Soap residue can lead to irritation and damage to the skin. Damaged skin does not provide a barrier to infection for the healthcare worker and can become colonized with potentially pathogenic bacteria. This damaged skin can lead to cross-infection in patients, compromising infection prevention efforts.

Areas that are missed during handwashing can be a source of cross-infection. Ensuring all surfaces of the hands are cleaned is critical because any remaining contaminated areas can transfer pathogens to patients or other surfaces, directly compromising infection prevention efforts and patient safety.

Rub the palm over the dorsum (back) of the opposite hand with interlaced fingers, then switch hands. With fingers interlocked, rub the backs of the fingers of the opposite hands. These techniques ensure thorough cleaning of areas where organisms commonly hide and are easily missed during casual handwashing.