Hand Hygiene for Practical Nurses

Handwashing in nursing is critical for patient safety

Proper hand hygiene in a healthcare setting includes hand washing with soap and water, and also an alcohol-based sanitizer.Healthcare-associated infections (HAI) are a serious issue in hospitals and other healthcare institutions. When you are a practical nurse, the last thing you want to do is to spread a patient’s infection to yourself, to other patients, or to loved ones at home. What are the things an LPN needs to know about infection prevention?

When you are in nursing school to become an LPN, you will learn about Standard Precautions that are designed to help prevent the transmission of diseases. These precautions cover everything from protective equipment (like masks, gowns, and gloves) to needlestick protocols to waste disposal.

This article looks at one key tool in the fight against infection, and that is proper hand hygiene. Washing your hands may sound like a simple task, but doing it right can make a world of difference to the health of your patients and yourself.

The guidelines below are a summary of the Centers for Disease Control and Prevention’s hand hygiene recommendations. Whether you are a seasoned nurse who’s been practicing for 20 years, or a brand new LPN, it never hurts to review these procedures.

Soap versus hand sanitizer

Alcohol-based hand sanitizer is more effective than soap at killing most germs. Therefore, you should use alcohol-based hand sanitizer to clean your hands at all times, with these exceptions:

  • Use soap and water if your hands are visibly dirty or soiled.
  • Use soap and water if c. difficile or infectious diarrhea has been diagnosed. Alcohol-based sanitizers do not kill these germs.
  • Use soap and water before eating and after using the rest room.

When to wash

As every practical nurse knows, you wash your hands dozens of times a day…maybe even 100 times a day! Here are the times that the CDC recommends washing:

  • Before direct contact with a patient
  • Before putting on safety gloves, if you are doing a procedure that is invasive, like inserting a catheter
  • After you have direct contact with a patient’s skin (even if the skin is unbroken)
  • After you have contact with any bodily fluids: excretions, broken skin, blood, wound dressings, saliva, etc.
  • After you remove safety gloves

How to wash properly with alcohol-based hand sanitizer

Handrub is only effective at killing germs if you use it properly. Here are the recommendations for using alcohol-based hand sanitizer:

  • Read the container and dispense the recommended amount in the palm of one hand.
  • Rub both hands together. Make sure the entire surface of your hands (including between your fingers, backs of hands, and under your fingernails) gets covered by the handrub.
  • Continue rubbing your hands until your hands are dry.

How to wash properly with soap and water

Washing with soap and water will take longer, and it’s important to follow all of these steps in order to be effective at washing away the germs.

  • Wet your hands and forearms.
  • Read the soap container and dispense the recommended amount in the palm of one hand.
  • Rub your hands together for 20 seconds, away from the stream of water. Be sure that the soap is being rubbed on every surface of your hand, including between your fingers, under your fingernails, the backs of your hands, and your forearms.
  • Rinse thoroughly. Rinsing is important for removing the germs from your hands.
  • Dry thoroughly with a sanitary paper towel. Drying your hands carefully is also important to ensure that contaminants are removed.
  • Before you throw away your paper towel, use it to turn off the sink.

Tips on wearing gloves

Standard Precautions explain thoroughly when you should wear gloves. Here are the main points to remember:

  • Wear gloves whenever you might be in contact with bodily fluids, such as blood, saliva, urine, etc.
  • Never re-use gloves. After caring for a patient, remove the gloves and dispose of them properly.
  • Never wear the same gloves to care for more than one patient.
  • Do not wash gloves.

What to do about fingernails

Fingernails are a great place for bacteria and other germs to hide out. This is unfortunate if you are someone who likes to have long fingernails! Here are the recommendations on fingernails:

  • Cut your fingernails to ¼ inch or shorter. This is true of artificial nails too (if they are allowed by your employer).
  • For nurses working with high-risk patients, they should not wear artificial nails at all.

We hope these hand hygiene tips are a helpful reminder to you, whether you are an RN, LPN, nursing assistant, or home health aide. Handwashing is one of the simplest and most important tools in an infection prevention toolkit.

As a nurse, you are an everyday hero who is on the front line helping patients every day. By following standard precautions, you can feel assured that you are doing the most you can to keep your patients safe from healthcare-associated infections and diseases. And remember, these precautions protect not only your patients, but also yourself! It’s worth the time and effort to get it right.

These hand washing tips come from the CDC’s hand hygiene guidelines and the article “Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.”

For more information from the CDC, visit the CDC’s Hand Hygiene in Healthcare Settings resource website.


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