HANDWASHING

Student’s Name : _______________ Rating : ____________

Level/Group No. : _______________ CI Name : ____________
Date : _______________

Directions: Evaluate each step/task by putting (✔) under the proper heading. A numerical number may also
be assigned and a minimum passing level determined.

Rate the students from 2 - 0, where:

( 2 ) Performed Correctly Students performed the step according to the standard procedure or guidelines
( 1 ) Attempted Not Correctly Students unable to perform the steps/task according to procedure or guidelines
( 0 ) Not Done Students did not do the step/task
(NO) Not Observed (NO) Evaluator unable to observe the step/task for various reasons like interruptions/inattentiveness,.

STEP Performed Attempted Not Not

Correctly Not Done Observed
(2) Correctly (0) (NO)
(1)

1. Remove jewelries

2. Turn on the faucet with a clean paper towel. (elbow or foot for flow
control gadgets if available)

3. Adjust water to acceptable temperature.

4. Angle arms down holding hands lower than elbows. Wet hands and
wrists using friction or by rubbing. (preliminary hand washing).

5. Put soap in hands (palm and back). Rinse soap before returning to
the soap dish.

6. Lather all areas of elbow, wrists and hands, interlace fingers and
thumb and move hands back and forth for 10-15 seconds. Rubbing
vigorously.

7. Clean areas under and around nails with an orange stick.

8. Rinse thoroughly, running water down from elbow, wrist to

fingertips. Rinse faucet handles well without touching.

9. When hands are heavily contaminated, repeat steps 2-8 and

extend time to 2-3 minutes.

10. Pat dry with paper towel

11. Turn off faucet with paper towel and discard towel immediately

Computation for student rating:

Raw score X 60 + 40
Perfect score

Student’s Signature and Date: ______________________

Signature of Clinical Instructor and Date: ______________________