UPHSL/DJGTMU - ACAD- RDC – 10A

06-02-2014 - 00

UNIVERSITY OF PERPETUAL HELP SYSTEM LAGUNA

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

COLLEGE OF NURSING

PERFORMANCE CHECKLIST IN
HANDWASHING
Student’s Name: ____________________________
Section/Group No. __________________ Rating

RETURN DEMONSTRATION CHECKLIST LEVEL1

Legend:
4 Competent. ( Performs consistently in an effective
and efficient manner)

3 Progress Acceptable (Performance is usually effective and efficient but not always).

2 Needs Improvement ( Progress in performance is too slow to judge satisfactorily. Task is not done properly
to majority of the time).

1 Progress unacceptable ( No progress in performance has been demonstrated, and/or performance is

consistently ineffective and inefficient).

PERFORMANCE POINTS RATIONALE

ASSESSMENT

1 Inspects hands for breaks / cuts in the skin or cuticles. Report and Improper personal sanitation as well
covers affected part, if possible care. as an enclosed space of the skin
create breeding grounds for
microorganisms and therefore
should be cleaned with additional
care.

2 Inspects hands for heavy soiling / dirt, and nails for length.

PLANNING

3 Prepares the following: For easy accessibility and to

prevent being delayed or to waste
a. soap and soap dish d. tissue paper as little time as possible.

b. orange and soap dish e. lotion (optional)

c. towel

IMPLEMENTATION

4 Rolls uniform sleeves above elbow. Wristwatch and rings should To minimize exposure, sleeves
be removed prior to handwashing. should not come into contact with
the sink since bacteria flourish in
moist environments, humidity may
add to uniform infection.

5 Stands in front of sink, keeping hands and uniform away from sink Contamination is avoided by not
surface. reaching into the sink as well as
gripping the edges.

6 Turns on water by turning faucet on or using knee/foot control to Extremely hot water might cause
regulate water flow and temperature. skin irritation .

7 Be careful not to splash water into uniform. Splattering may lead to

dissemination of microbes to other
locations, particularly your clothing,
it can occur if you are using even
more pressure.

8 Wets hands and elbow thoroughly under running water. Microbes and dust are washed
away in the sink by flowing water.
 9 Hands and forearms should be lowered during washing. Water must flow first from least
towards the most contaminated site,
with the hands being much more
infected than with the lower
forearms.

10 Applies a small amount of antiseptic. Lather thoroughly Soap lather helps to emulsify lipids
and cleanse the skin. The sink is
infected, and losing liquid or bar
soap adds to the problem.

Builds lather and uses plenty of friction for minimum of 10 – 15 -Firm rubbing and circular motions
secs. Interlace fingers. Rubs palms and dorsum back of hands produce friction, which helps
using circular motion at least 5 X for each hand. dislodge dirt and bacteria and
further completes sanitizing.

- Microbes are removed from

>Right palm over left dorsum with interlaced fingers and vice between the fingers.

11 versa

>Palm to palm with fingers interlaced

>The interdigital gaps are cleaned by interconnecting the

fingers and thumbs.

>Backs of fingers to opposing palms with fingers interlocked

12 Keeps fingertips down.

Uses both hands to clean fingernails using additional soap and To remove dirt under the nails
13
orange stick.

Rinses hands and wrists thoroughly, keeping elbows up and This orientation constrains
hands down. microorganisms from becoming
14 rinsed away from the most infected
to the least infected parts of the
hand.

Makes a lather starting from the elbow, applies soap in rotating To ensure removal of dirt
15
motion.

16 Rinses thoroughly, keeping hands lower than elbows.

Uses paper towel, single use towel or warm dryer to dry hands. Restricts skin from chapping, since
Dries hands thoroughly from fingers to wrists and forearms. fingers and hands are already the
17 cleanest portions, and dryness must
move between clean towards less
clean.

18 Discards soiled paper towel properly.

Turns off water flow using foot or knee pedals. Protects clean hands against
19 coming into direct contact with
contaminated tap.

Uses clean, dry paper towel to turn off hand faucet. Avoid Protects clean hands against
20 touching it with bare hand. coming into direct contact with
contaminated tap.

Applies a small amount of lotion or barrier cream if hands are dry Lotion prevents dryness of skin
21
or chapped.

22 After care of equipment / environment

TOTAL

STUDENT’S SIGNATURE: ________________CLINICAL INSTRUCTOR SIGNATURE ____________________