Student ______________________________________________________ Instructor ____________________________________________________

PERFORMANCE CHECKLIST SKILL 7-1 HAND HYGIENE

Date _________________________ Date _________________________

S
ASSESSMENT

NP

Comments

1. Inspected surface of hands and fingers for cuts or breaks. 2. Inspected hands for visible soiling. 3. Inspected nails for condition and length.
NURSING DIAGNOSIS

1. Developed appropriate nursing diagnoses.

PLANNING

1. Identified expected outcomes.

IMPLEMENTATION

1. Removed jewelry and pushed clothing or wristwatch above wrist level. 2. Performed hand antisepsis using an instant alcohol waterless antiseptic rub: a. Dispensed ample amount of product into palm of hand. b. Rubbed hands together, covering all surfaces of hands and fingers with antiseptic. c. Rubbed hands together until the alcohol was dry. Allowed hands to dry completely before applying gloves. 3. Performed hand hygiene with antimicrobial soap and water: a. Stood at sink without touching sink with hands or uniform. b. Turned on water. c. Avoided splashing. d. Regulated water flow. Adjusted water temperature to warm. e. Wet hands and wrists, keeping hands and forearms lower than elbows. f. Applied antimicrobial soap to hands. g. Lathered hands and applied friction to skin surfaces for 10 to 15 seconds; interlaced fingers and rubbed palms and backs of hands in circular motion.

Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published.

S h. Cleaned thoroughly under fingernails. i. Rinsed thoroughly, keeping hands below elbows. j. Dried hands thoroughly, wiping from fingers up to wrists and forearms. k. Discarded paper towel properly. l. Turned off water at sink with paper towel or pedal. m. Applied lotion to hands.
EVALUATION

NP

Comments

1. Inspected surface of hands. 2. Identified unexpected outcomes.

Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published.