Far Eastern University

Institute of Health Sciences and Nursing

PERFORMANCE EVALUATION TOOL FOR

MEDICAL HAND WASHING

NAME: __________________________________________________ DATE: ______________ SCORE: _______________

SEC & GRP NO: ________________ CONCEPT: ______________________ FACULTY: __________________________

Direction: Rate the learners based on the competencies listed below.

RATING SCALE QUANTITATIVE DESCRIPTION

3 ACCEPTABLE Demonstrates expected procedures / behaviors correctly
2 MODERATELY ACCEPTABLE Demonstrates expected procedure/behavior with minimal error
1 SLIGHTLY ACCEPTABLE Demonstrates expected procedure/behavior with many error
0 UNACCEPTABLE Missed procedure or procedure done but entirely incorrect

PERFORMANCE CRITERIA
RATING REMARKS
A. PREPARATION
1. If appropriate, introduced self and verified client’s identity. 0 1 2 3
2. Informed client of the procedure and its importance 0 1 2 3
3. Assembles all the articles needed and brings to bedside 0 1 2 3
B. PROCEDURE
4. Turned on water and adjusted the flow so the water was
0 1 2 3
warm.
5. Wets the hands thoroughly by holding them under running water, and
applies soap to the hands. If the soap is liquid, apply 2-4 ml (1 tsp). If it is
0 1 2 3
a bar soap, granules, or sheet, rubs them firmly between the hands and
rinses them
6. Holds the hands lower than the elbows so that the water flows from the
0 1 2 3
arms to the fingertips
7. Washes and rinses the hands thoroughly 0 1 2 3
8. Following the steps below:
a. Rub hands palm to palm; 0 1 2 3
b. Rub back of each hand with palm of other hand with fingers interlaced; 0 1 2 3
c. Rub palm to palm with fingers interlaced; 0 1 2 3
d. Rub with back of fingers to opposing palms with fingers interlocked; 0 1 2 3
e. Rub each thumb clasped in opposite hand using a rotational movement; 0 1 2 3
f. Rub tips of fingers in opposite palm in a circular motion; 0 1 2 3
g. Rub each wrist with opposite hand; 0 1 2 3
9. Rinses hand with running water letting it run from wrist to fingertips 0 1 2 3

/revised as of June 2015/

Name: ____________________________ Medical Handwashing Page | 2

RATING REMARKS
10. Dries hand and arms thoroughly with a paper towel 0 1 2 3
11. Discards the paper towel in appropriate receptacle 0 1 2 3
12. Turns off the water using a new paper towel to grasp a hand operated
control faucet 0 1 2 3
C. AFTER CARE
13. Disposes supplies and materials used accordingly 0 1 2 3

Procedure

Total Score ÷ 57 X 100 = _______

______________________________________ _________________________________________
Signature of Student Signature of Faculty

/revised as of August 2022/