UPHSL/DJGTMU-ACAD

06-02-014-00

UNIVERSITY OF PERPETUAL HELP SYSTEM LAGUNA

UNIVERSITY OF PERPETUAL HELP-DR. JOSE G. TAMAYO MEDICAL UNIVERSITY

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Student's Name: _____________________________
Section/Group No. ___________________

PERFORMANCE CHECKLIST IN HANDWASHING

PERFORMANCE POINTS 4 3 2
ASSESSMENT
Inspects hands for breaks / cuts in the skin or cuticles.
1 Report and covers affected part, if possible.
care.
2 Inspects hands for heavy soiling / dirt, and nails for length.
PLANNING
Prepares the following :
a. soap and soap dish d. tissue paper
3
b. orange stick e. lotion (optional)
c. towel
IMPLEMENTATION

4 Rolls uniform sleeves above elbow. Wristwatch and

rings should be removed prior to handwashing.

5 Stands in front of sink, keeping hands and uniform away

from sink surface.

6 Turns on water by turning faucet on or using knee/foot

control to regulate water flow and temperature.
7 Be careful not to splash water into uniform.
8 Wets hands and elbow thoroughly under running water.
9 Hands and forearms should be lowered during washing.
10 Applies a small amount of antiseptic. Lather thoroughly.

Builds lather and uses plenty of friction for minimum of

11 10-15 secs. Interlace fingers. Rubs palms and dorsum
back of hands using circular motion at least 5x for each
hand.
12 Keeps fingertips down.

13 Uses both hands to clean fingernails using additional

soap and orange stick.

14 Rinses hands and wrists thoroughly, keeping elbows up

and hands down.
 15 Makes a lather starting from the elbow, applies soap in
rotating motion.
16 Rinses thoroughly, keeping hands lower than elbows.
Uses paper towel, single use towel or warm dryer to dry
17 hands. Dries hands thoroughly from fingers to wrists
and forearms.
18 Discards soiled paper towel properly.
19 Turns off water
Uses clean, dry flow using
paper foot
towel to or knee
turn pedals.
off hand faucet.
20 Avoid touching it with bare hand.
Applies a small amount of lotion or barrier cream if
21 hands are dry or chapped.
22 After care of equipment/environment
88/

STUDENT'S SIGNATURE: _________________________________

CLINICAL INSTRUCTOR'S SIGNATURE: ______________________
4/11/2020
 UPHSL/DJGTMU-ACAD -RDC-10B
06-02-014-00

NIVERSITY

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