Taking Vital Signs： Temperature, Pulse, Respiration,

Blood pressure
Definition:
Taking vital signs are defined as the procedure that takes the sign of basic physiology that includes
temperature , pulse, respiration and blood pressure. If any abnormality occurs in the body, vital
signs change immediately.

Purpose:
1. To assess the client’s condition
2. To determine the baseline values for future comparisons
3. To detect changes and abnormalities in the condition of the client

Fig.23 Equipments required of taking a vital signs

Equipments required:
1. Oral/ axilla / rectal thermometer (1) 7. Paper bag (2): for clean (1)
2. Stethoscope (1) for discard (1)
3. Sphygmomanometer with appropriate cuff 8. Record form
size (1) 9. Ball- point pen: blue (1)
4. Watch with a second hand (1) black (1)
5. Spirit swab or cotton (1) red (1)
6. Sponge towel (1) 10. Steel tray (1): to set all materials
 Fig.24 Stethoscope
Astethoscope consists of : ear pieces, tubing, two heads such as the bell and the diaphragm.

Fig.25 The bell of head of stethoscope Fig. 26 The diaphragm of head of stethoscope

The bell has cup-shaped and is used to correct The diaphragm is flat side of the head and is used to test
low-frequency sounds, such as abnormal heart high-frequency sounds: breath, normal breath, and bowel
sounds. sounds.

Fig. 27 Aneroid manometer

40
Aneroid manometer is a kind of sphygmomanometer. Sphygmomanometer consists of: an
inflatable bladder, attached to a bulb and a diameter, enclosed in a cuff, with a deflating
mechanism

41
 a. Taking axillary temperature by glass thermometer
Definition:
Measuring/ monitoring patient’s body temperature using clinical thermometer
Purpose:
1. To determine body temperature
2. To assist in diagnosis
3. To evaluate patient’s recovery from illness
4. To determine if immediate measures should be implemented to reduce dangerously elevated
body temperature or converse body heat when body temperature is dangerous low
5. To evaluate patient’s response once heat conserving or heal reducing measures have been
implemented

Procedure:
Care Action Rationale
1. Wash your hands.  Handwashing prevents the spread of infection
2. Prepare all required equipments  Organization facilitates accurate skill
performance.
3. Check the client’s identification.  To confirm the necessity
4. Explain the purpose and the procedure to the  Providing information fasters cooperation and
client. understanding
5. Close doors and/or use a screen.  Maintains client’s privacy and minimize
embarrassment.
6. Take the thermometer and wipe it with cotton swab from  Wipe from the area where few organisms are
bulb towards the tube. present to the area where more organisms are present to
limit spread of infection
7.Shake the thermometer with strong wrist  Lower the mercury level within the stem so
movements until the mercury line falls to at least 95 ℉ that it is less than the client’s potential body
(35 ℃). temperature
8. Assist the client to a supine or sitting position.  To provide easy access to axilla.
9. Move clothing away from shoulder and arm  To expose axilla for correct thermometer bulb
placement
10. Be sure the client’s axilla is dry. If it is moist, pat it  Moisture will alter the reading. Under the condition
dry gently before inserting the thermometer. moistening, temperature is generally
measured lower than the real.
11. Place the bulb of thermometer in hollow of axilla at  To maintain proper position of bulb against blood vessels
anteriorinferior with 45 degree or horizontally. in axilla.
(Fig.28)
12. Keep the arm flexed across the chest, close to the  Close contact of the bulb of the thermometer with the
side of the body ( Fig. 29) superficial blood vessels in the axilla ensures
a more accurate temperature registration.
13.Hold the glass thermometer in place for 3  To ensure an accurate reading
minutes.
 Care Action
14.Remove and read the level of mercury of
thermometer at eye level.
15. Shake mercury down carefully and wipe the
thermometer from the stem to bulb with spirit swab.
Rationale
 To ensure an accurate reading
 To prevent the spread of infection

16. Explain the result and instruct him/her if he/she  To share his/her data and provide care needed
has fever or hypothermia. immediately
17. Dispose of the equipment properly. Wash your  To prevent the spread of infection
hands.
18. Replace all equipments in proper place.  To prepare for the next procedure
19. Record in the client’s chart and give signature on the  Axillary temperature readings usually are lower than oral
chart. readings.
 Giving signature maintains professional
accountability
20. Report an abnormal reading to the senior staff.  Documentation provides ongoing data collection

Fig.28 Placing the glass thermometer into the axilla Fig. 29 Keeping the forearm across the chest
 b. Measuring a Radial Pulse

Definition: Checking presence, rate, rhythm and volume of throbbing of artery.

Purpose:
1. To determine number of heart beats occurring per minute( rate)
2. To gather information about heart rhythm and pattern of beats
3. To evaluate strength of pulse
4. To assess heart's ability to deliver blood to distant areas of the blood viz. fingers and lower extremities
5. To assess response of heart to cardiac medications, activity, blood volume and gas exchange
6. To assess vascular status of limbs

Procedure:
Care Action
1. Wash hands.
2. Prepare all equipments required on tray.
3. Check the client’s identification
4. Explain the procedure and purpose to the client.
5. Assist the client in assuming a supine or sitting 
position.
1) If supine, place client’s forearm straight alongside body
with extended straight (Fig.30ⓐ) or upper abdomen
with extended straight( Fig.30ⓑ)
2) If sitting, bend client’s elbow 90 degrees and support
lower arm on chair (Fig.31ⓐ) or on
nurse’s arm slightly flex the wrist (Fig. 31ⓑ)
Rationale
 Handwashing prevents the spread of infection
 Organization facilitates accurate skill problems
 To confirm the necessity
 Providing information fosters cooperation and
understanding
To provide easy access to pulse sites
 Relaxed position of forearm and slight flexion of wrist
promotes exposure of artery to palpation without
restriction.

6. Count and examine the pulse

1) Place the tips of your first, index, and third finger over  The fingertips are sensitive and better able to feel the
the client's radial artery on the inside of the wrist on the
thumb side.
2) Apply only enough pressure to radial pulse
3) Using watch, count the pulse beats for a full minute.
4) Examine the rhythm and the strength of the pulse.
pulse. Do not use your thumb because it has a strong
pulse of its own.
 Moderate pressure facilitates palpation of the pulsations.
Too much pressure obliterates the pulse, whereas the
pulse is imperceptible with too little pressure
 Counting a full minute permits a more accurate reading
and allows assessment of pulse strength
 and rhythm.
 Strength reflects volume of blood ejected against arterial
wall with each heart contraction.

7.Record the rate on the client’s chart.  Documentation provides ongoing data collection
Sign on the chart.  To maintain professional accountability
8. Wash your hands.  Handwashing prevents the spread of infection
9. Report to the senior staff if you find any  To provide nursing care and medication properly
abnormalities. and continuously
Fig. 30 ⓐ Care Action 5. 1) → 6.

Placing the client's forearm straight alongside body and

putting the fingertips over the radial pulse

Fig. 31 ⓐ Care Action 5. 2) → 6.

Placing the client’s forearm on the armrest of chair and putting

your the fingertips over the radial pulse

Fig. 30 ⓑ 5.1) →6.

Placing the client’s forearm straight of across upper abdomen

and putting the fingertips over the radial pulse

Fig. 31 ⓑ 5.2) →6.

Supporting the client’s forearm by nurse’s palm

with extended straight and your putting three fingertips

 c. Counting Respiration
Definition: Monitoring the involuntary process of inspiration and expiration in a patient
Purposes:
1. To determine number of respiration occurring per minute
2. To gather information about rhythm and depth
3. To assess response of patient to any related therapy/ medication

Procedure:
Care Action
1. Close the door and/or use screen.
2. Make the client's position comfortable, preferably sitting
or lying with the head of the elevated 45 to
60 degrees.
3. Prepare count respirations by keeping your
fingertips on the client’s pulse.
4. Counting respiration:
1) Observe the rise and fall of the client’s (one inspiration
and one expiration).
2) Count respirations for one full minute.
3) Examine the depth, rhythm, facial expression, cyanosis,
cough and movement accessory.
5. Replace bed linens if necessary. Record the rate on the
client’s chart. Sign the chart
6. Perform hand hygiene
7. Report any irregular findings to the senior staff.
Rationale
 To maintain privacy
 To ensure clear view of chest wall and abdominal
movements. If necessary, move the bed linen.
 A client who knows are counting respirations may
not breathe naturally.
 One full cycle consists of an inspiration and an
expiration.
 Allow sufficient time to assess respirations, especially
when the rate is with an irregular
 Children normally have an irregular, more rapid rate.
Adults with an irregular rate require more careful
assessment including depth and rhythm
of respirations.
 Documentation provides ongoing data collection.
 Giving signature maintains professional
accountability
 To prevent the spread of infection
 To provide continuity of care
 d. Measuring Blood Pressure
Definition: Monitoring blood pressure using palpation and/or sphygmomanometer

Purpose:
1. To obtain baseline data for diagnosis and treatment
2. To compare with subsequent changes that may occur during care of patient
3. To assist in evaluating status of patient’s blood volume, cardiac output and vascular system
4. To evaluate patient’s response to changes in physical condition as a result of treatment with fluids or
medications

Procedure: by palpation and aneroid manometer

Care Action Rationale
1. Wash your hands.  Handwashing prevents the spread of infection
2. Gather all equipments. Cleanse the stethoscope 's  Organization facilitates performance of the skill.
ear pieces and diaphragm with a spirit swab wipe.  Cleansing the stethoscope prevents spread of infection.

3. Check the client’s identification. Explain the
purpose and procedure to the client.
4. Have the client rest at least 5 minutes before
measurement.
5. Determine the previous baseline blood pressure , if
available, from the client’s record.
6. Identify factors likely to interfere which accuracy of blood  Exercise and smoking can cause false elevations in blood
pressure measurement : exercise, coffee
and smoking
7. Setting the position:
1) Assist the client to a comfortable position. Be sure
room is warm, quiet and relaxing.
2) Support the selected arm. Turn the palm upward. (Fig.
32 )
3) Remove any constrictive clothing.
 Providing information fosters the client’s
cooperation and understanding.
 Allow the client to relax and helps to avoid falsely
elevate readings.
 To avoid misreading of the client’s blood pressure and
find any changes his/her blood pressure from
the usual
pressure.
 The client's perceptions that the physical or interpersonal
environment is stressful affect the blood pressure
measurement.
 Ideally, the arm is at heart level for accurate
measurement. Rotate the arm so the brachial pulse is
easily accessible.
 Not constricted by clothing is allowed to access the
brachial pulse easily and measure accurately. Do not use
an arm where circulation is compromised in any way.

Fig. 32 Care Action 7. 2)

Placing the selected arm on the bed and turn the palm upward
 Care Action
8. Checking brachial artery and wrapping the cuff:
1) Palpate brachial artery.
2) Center the cuff’s bladder approximately 2.5 cm (1 inch)
above the site where you palpated the brachial pulse
3) Wrap the cuff snugly around the client’s arm and secure
the end approximately(Fig. 33)
4) Check the manometer whether if it is at level with the
client’s heart (Fig. 34 ).
Fig. 33 Care Action 8. 3)
Wrapping the cuff with appropriate way
Care Action
Rationale
 Center the bladder to ensure even cuff inflation over the
brachial artery
 Loose-fitting cuff causes false high readings. Appropriate
way to wrap is that you can put only 2 fingers between
the arm and cuff. (Fig. 33)
 Improper height can alter perception of reading.
Fig. 34 Care Action 8. 4)
Placing manometer at the level of heart
Rationale
9.Meausre blood pressure by two step method:
(A) Palpatory method
1) Palpate brachial pulse distal to the cuff with fingertips of
nondominant hand.
2) Close the screw clamp on the bulb.
3) Inflate the cuff while still checking the pulse with other
hand. (Fig. 35 )
4) Observe the point where pulse is not longer palpable.
5) Inflate cuff to pressure 20-30 mmHg above point at
which pulse disappears.
6) Open the screw clamp, deflate the cuff fully and wait 30
seconds.
(B) Auscultation
1) Position the stethoscope’s earpieces comfortably in your
ears( turn tips slightly forward). Be sure sounds are clear,
not muffled.
2) Place the diaphragm over the client’s brachial artery. Do
not allow chestpiece to touch cuff or clothing. (Fig. 36 )
 Palpation identifies the approximate systolic reading.
Estimating prevents false low readings, which may result
in the presence of an auscultory gap.
 Maximal inflation point for accurate reading can be
determined by palpation.
 Short interval eases any venous congestion that may
have occurred.
 Each earpiece should follow angle of ear canal to
facilitate hearing.
 Proper stethoscope placement ensures optimal sound
reception.
 Stethoscope improperly positioned sounds that often
result in false low systolic and high diastolic
readings.
 Care Action
9. (B)
3) Close the screw clamp on the bulb and inflate the cuff
to a pressure30 mmHg above the point where the pulse
had disappeared
4) Open the clamp and allow the aneroid dial to fall at rate
of 2 to 3 mmHg per second.
5) Note the point on the dial when first clear sound is
heard. The sound will slowly increase in intensity.
6) Continue deflating the cuff and note the point where the
sound disappears. Listen for 10 to 20 mmHg after the
last sound.
7) Release any remaining air quickly in the cuff and
remove it.
8) If you must recheck the reading for any reason, allow a
1 minute interval before taking blood pressure again.
10. Assist the client to a comfortable position.
Advise the client of the reading.
11. Wash your hands.
12. Record blood pressure on the client’s chart. Sign on the
chart. Report any findings to senior staffs.
13. Replace the instruments to proper place and
discard.
Fig. 35 Care Action 9. (A) 3) : Palpatory method Inflating the cuff while checking brachial artery
Rationale
 Ensure that the systolic reading is not underestimated.
 If deflation occurs too rapidly, reading may be inaccurate.
 This first sound heard represents the systolic pressure or
the point where the heart is able to force blood into the
brachial artery.
 This is the adult diastolic pressure. It represents the
pressure that the artery walls exert on the blood at rest.
 Continuous cuff inflation causes arterial occlusion,
resulting in numbness and tingling of client’s arm.
 The interval eases any venous congestion and provides
for an accurate reading when you repeat
the measurement.
 Indicate your interest in the client's well-being
and allow him/her to participate in care.
 Handwashing prevents the spread of infection.
 Documentation provides ongoing data collection.
 Giving signature maintains professional
acountability
 To prepare for the next procedure.
 Fig. 36 Care Action 9. (B) 2) : Auscultation Placing the diaphragm without touching the cuff

Laboratory Tests

A laboratory test is a procedure in which a sample of blood, urine, other bodily

fluid, or tissue is examined to get information about a person’s health. Some
laboratory tests provide precise and reliable information about specific health
problems. Other tests provide more general information that helps doctors identify or
rule out possible health problems. Doctors often use other types of tests, such as
imaging tests, in addition to laboratory tests to learn more about a person’s health.
Laboratory tests check a sample of your blood, urine, or body tissues. A technician
or your doctor analyzes the test samples to see if your results fall within the normal
range. The tests use a range because what is normal differs from person to person.
Many factors affect test results. These include

 Your sex, age and race

 What you eat and drink

 Medicines you take

 How well you followed pre-test instructions

Your doctor may also compare your results to results from previous tests. Laboratory
tests are often part of a routine checkup to look for changes in your health. They also
help doctors diagnose medical conditions, plan or evaluate treatments, and monitor
diseases.
A laboratory (lab) test is a procedure in which a health care provider takes a
sample of your blood, urine, other bodily fluid, or body tissue to get information about
your health. Some lab tests are used to help diagnose, screen, or monitor a specific
disease or condition. Other tests provide more general information about your organs
and body systems.
Lab tests play an important role in your health care. But they don't provide a complete
picture of your health. Your provider will likely include a physical exam, health history,
and other tests and procedures to help guide diagnosis and treatment decisions.
Why do I need a lab test?
Lab tests are used in many different ways. Your health care provider may order one or
more lab tests to:

 Diagnose or rule out a specific disease or condition

 Screen for a disease. A screening test can show if you are at a higher risk for
getting a specific disease. It can also find out if you have a disease, even if you
have no symptoms.

 Monitor a disease and/or treatment. If you've already been diagnosed with a

disease, lab tests can show if your condition is getting better or worse. It can also
show if your treatment is working.

 Check your overall health. Lab tests are often included in a routine checkup.
Your provider may order tests of various organs and systems to see if there have
been changes in your health over time. Testing can help find health problems
before symptoms appear.
What factors can affect my results?
There are many factors that can affect the accuracy of your test results. These include:

 Certain foods and drinks

 Medicines

 Stress

 Vigorous exercise

 Variations in lab procedures

 Having an illness

 sex

 age

 race

 medical history

 general health

 specific foods

 drugs you are taking

 how closely your follow preparatory instructions

  variations in laboratory techniques

 variation from one laboratory to another

What do my results mean?

Lab results are often shown as a set of numbers known as a reference range. A
reference range may also be called "normal values." You may see something like this
on your results: "normal: 77-99mg/dL" (milligrams per deciliter). Reference ranges are
based on the normal test results of a large group of healthy people. The range helps
show what a typical normal result looks like.
But not everyone is typical. Sometimes, healthy people get results outside the reference
range, while people with health problems can have results in the normal range. If your
results fall outside the reference range, or if you have symptoms despite a normal
result, you will likely need more testing.
Your lab results may also include one of these terms:

 Negative or normal, which means the disease or substance being tested was

not found

 Positive or abnormal, which means the disease or substance was found

 Inconclusive or uncertain, which means there wasn't enough information in the

results to diagnose or rule out a disease. If you get an inconclusive result, you
will probably get more tests.
Tests that measure various organs and systems often give results as reference ranges,
while tests that diagnose or rule out diseases often use the terms listed above.

What are false positive and false negative results?

A false positive result means your test shows you have a disease or condition, but you
don't actually have it.
A false negative result means your test shows you don't have a disease or condition,
but you actually do.
These incorrect results don't happen often, but they are more likely to happen with
certain of types tests, or if testing was not done right. Even though false negatives and
positives are uncommon, your provider may need to do multiple tests to make sure your
diagnosis is correct.
Why does your doctor use lab tests?
Your doctor uses laboratory tests to help:

 identify changes in your health condition before any symptoms occur

  diagnose or aid in diagnosing a disease or condition,

 plan your treatment for a disease or condition,

 evaluate your response to a treatment, or

 monitor the course of a disease over time.

How are lab tests analyzed?
After your doctor collects a sample from your body, it is sent to a laboratory.
Laboratories perform tests on the sample to see if it contains different substances, and
how much. Depending on the test, the presence, absence, or amount of an analyte may
mean you do have a particular condition or it may mean that you do not have the
particular condition. Sometimes laboratories compare your results to results obtained
from previous tests, to see if there has been a change in your condition.
What do lab tests show?
Some types of lab tests show whether or not your results fall within normal ranges.
Normal test values are usually given as a range, rather than as a specific number,
because normal values vary from person to person. What is normal for one person may
not be normal for another person.
Other types show whether there is a particular substance present or absent, such as a
mutation in a gene, or an infectious organism, which indicates whether you have a
disease, an infection, or may or may not respond to a therapy.
Some laboratory tests are precise, reliable indicators of specific health problems, while
others provide more general information that gives doctors clues to your possible health
problems. Information obtained from laboratory tests may help doctors decide whether
other tests or procedures are needed to make a diagnosis or to develop or revise a
previous treatment plan. All laboratory test results must be interpreted within the context
of your overall health and should be used along with other exams or tests.
10 STEPS TO SETTING SMART OBJECTIVES

Setting effective objectives to guide your team and organization is very important
for a leader to get right. Badly formulated objectives will steer an organization in the
wrong direction. I found this ten steps approach to setting SMART objectives from the
National Primary and Care Trust:
Sort out the difference between objectives and aims, goals and/or targets before
you start. Aims and goals relate to your aspirations, objectives are your battle-plan. Set
as many objectives as you need for success.
SMART stands for Specific, Measurable, Achievable, Realistic and Timely.
 1. Sort out the difference between objectives and aims, goals and/or targets before
you start. Aims and goals relate to your aspirations, objectives are your battle-
plan. Set as many objectives as you need for success.
2. SMART stands for Specific, Measurable, Achievable, Realistic and Timely.
3. Don't try to use that order M-A/R-S-T is often the best way to write objectives.
4. Measurable is the most important consideration. You will know that you've
achieved your objective, because here is the evidence. I will know too! Make
sure you state how you will record your success.
5. Achievable is linked to measurable. Usually, there's no point in starting a job you
know you can't finish, or one where you can't tell if or when you've finished it.
How can I decide if it's achievable?
o You know it is measurable.

o Others have done it successfully (before you, or somewhere else.)

o It's theoretically possible (i.e. clearly not 'not achievable'.)

o You have the necessary resources, or at least a realistic chance of getting

them.
o You've assessed the limitations.

6. If it's achievable, it may not be realistic. If it isn't realistic, it's not achievable. You
need to know:
o Who's going to do it?

o Do they have (or can they get) the skills to do a good job?

o Where's the money coming from?

o Who carries the can?

Realistic is about human resources, time, money, opportunity.

7. The main reason it's achievable, but not realistic is that it's not a high priority.
Often something else needs to be done first, before you'll succeed. If so, set up
two (or more) objectives in priority order.
8. The devil is in the specific detail. You will know your objective is specific enough
if:
o Everyone who's involved knows that it includes them specifically.

o Everyone involved can understand it.

 o Your objective is free from jargon.

o You've defined all your terms.

o You've used only appropriate language.

9. Timely means setting deadlines. You must include one, otherwise your objective
isn't measurable. But your deadlines must be realistic, or the task isn't
achievable. T must be M, and R, and S without these your objective can't be top-
priority.
10. It is worth this effort! You'll know you've done your job well, and so will others.
Preventive Measures
Medical and Surgical Asepsis
MEDICAL ASEPSIS - Medical asepsis, sometimes called clean technique, is based
on maintaining cleanliness to prevent the spread of infectious diseases and to assure
that the environment is as free of microorganisms as possible. Medical asepsis involves
confining microorganisms to specific areas and making objects either clean or dirty.
The basic principles of medical asepsis include:
 Cleanse hands frequently, but especially before handling foods, before eating,
after using handkerchief, after going to the toilet, before and after each client
contact, and before and after removing gloves.
 Keep soiled items and equipment from touching clothing.
 Do not place soiled bed linens or other items on the floor.
 Avoid having the patient cough, sneeze, or breathe directly on others.
 Move equipment away from you when sweeping, dusting, or scrubbing articles.
 Clean the least soiled items first then the more soiled ones
 Dispose of soiled or used items directly into the appropriate containers.
 Pour liquids that are to be discarded directly into the drain to avoid splattering in
the sink and onto you.
 Avoid leaning against sinks, supplies, and equipment.
 Avoid touching your eyes, face, and mouth.
 Use practices of personal grooming that help prevent spreading
microorganisms.
 Follow your facility’s guidelines for isolation and barrier techniques as prescribed
by your agency.
SURGICAL ASEPSIS, also called sterile technique, requires strict adherence to
ordered and specific procedures which render an area free from all microorganisms
including pores. An object or area is described as being sterile or not sterile, it is used in
the operating room delivery room, during surgical procedures, catheterization, and
during dressing changes.
Basic principles include:
  Only a sterile object can touch another sterile object.
 Open sterile packages so that the first edge of the wrapper is directed away from
the worker to avoid the possibility of a sterile wrapper touching non-sterile
clothing.
 Avoid spilling any solution on a cloth or paper used as a field for sterile set up.
 Hold sterile objects above the waist level.
 Avoid talking, coughing, sneezing, and reaching over a sterile field or object.
 Never walk away from or turn your back on a sterile field.
 All items brought into contact with broken skin or used to penetrate the skin in
order to inject substances into the body, or to enter normally sterile body cavities,
should be sterile
 Use dry, sterile forceps when necessary.
 Consider the edge (outer 1 inch”) of a sterile field to be contaminated.
 Consider an object contaminated if you have any doubt as to its sterility.
Aseptic Technique
Bacteria are everywhere, and some are good for us while others are harmful.
Bacteria, viruses, and other microorganisms that cause disease are called pathogens.
To protect patients from harmful bacteria and other pathogens during medical
procedures, healthcare providers use aseptic technique.
Aseptic technique means using practices and procedures to prevent
contamination from pathogens. It involves applying the strictest rules to minimize the
risk of infection. Healthcare workers use aseptic technique in surgery rooms, clinics,
outpatient care centers, and other health care settings.
Aseptic technique vs. clean technique
Keeping the environment as clean as possible is always important in preventing
infections. However, some situations call for aseptic technique while others call for
clean techniques.
Healthcare providers learn both aseptic and clean techniques as part of their
training. The goal of the aseptic technique is to eliminate germs entirely. The goal of
the clean technique is to reduce the number of germs whenever possible. Clean
techniques are important for all healthcare providers and their patients because they
prevent infections every day.
Examples of clean techniques include washing hands and putting on clean
gloves when needed. Healthcare providers keep a patient’s surroundings as clean as
possible, but they aren’t using sterile items or aseptic technique.
Healthcare professionals commonly use clean techniques when they’re:

 giving an injection
 emptying a urinary catheter drainage bag
 giving a bed bath
 inserting a peripheral IV (an IV in a smaller vein)
  removing a peripheral IV
 removing a urinary catheter
Hand washing
Hand washing (or handwashing), also known as hand hygiene, is the act of cleaning
hands for the purpose of removing soil, dirt, and microorganisms.
Purpose of hand washing
1. Remove all dirt and debris
2. Reduce cross contamination from microbes
3. Interrupt the fecal – oral route of infection
4. Reduce risk of hands acting as vectors
5. Breaks a link in a chain of infections
6. Increase the image of cleanliness of health care personnel.