PERFORMANCE EVALUATION TOOL FOR SURGICAL HAND WASHING

In Accordance with NHS Foundation and Association for Perioperative Practice Nursing Standards

Directions: Below is a list of criteria to evaluate the student's skill in surgical hand washing. Indicate your
evaluation by writing the score using the following descriptive scale.
0 – not done 1 - incorrectly done 2 - correctly done

Student’s Name:________________________________ Date: _____________________

Group No.: ____

Procedure 0 1 2 Remarks
1. Regulate the flow and temperature of the water.
2. Open package containing nailbrush lie the brush
on the back of the scrub sink still in the opened
package.
3. Rinse hands and arms thoroughly, allowing the
water to run from the hands to the elbows. Do not
retrace or shake the hands and arms; let the water
drip from the elbow.
4. Remove the sterile brush and pick from opened
package. Clean under nails with pick and discard.
5. Moisten brush and work up a lather. Lather
fingertips with sponge-side of brush; then, using
bristle side of brush, scrub the spaces under the
fingernails of the right or left hand. Repeat for
other hand. When scrubbing the hands must
remain above the level of the elbows and away
from theatre attire to avoid contamination from
splashing.
6. Lather fingers. Wash on all four sides of the
fingers using the sponge side only.
7. Brush palms, back of palms, forearm until 2
inches above the elbow using firm strokes.
8. Hands and arms must be rinsed thoroughly from
fingertip to elbow without retracing, allowing the
water to drip from the elbow before approaching
the gown pack.
9. Pick up one hand towel from the top of the gown
pack and step back from the table. Grasp the
towel and open it fully. Do not allow the towel to
touch any unsterile object or unsterile parts of
your body. Hold your hands and arms above your
elbow, and keep your arms away from your body
10. Holding one end of the towel with one hand dry
the fingers of the opposite hand using a blotting
rotational motion
11. Move to the dry area of the towel and continue in
this manner down the forearm to the elbow.
Do not retrace any areas. Discard this towel in an
appropriate receptacle.
12. Repeat with the other towel from the pack for the
other hand/arm.