Hand washing – OSCE guide

Introduction

This hand washing OSCE guide provides a step-by-step approach to performing effective hand washing in an OSCE setting, with an included video demonstration.

When to wash your hands

The 5 moments of hand hygiene approach describes the key points at which healthcare workers should perform hand hygiene:

1. Before touching a patient.

2. Before clean/aseptic procedures.

3. After body fluid exposure/risk.

4. After touching a patient.

5. After touching patient surroundings.

How to wash your hands with alcohol hand rub

You should clean your hands using an alcohol-based formulation if your hands are not visibly soiled.

The entire process of hand washing with alcohol-based formulations should take around 20-30 seconds.

The benefits of alcohol-based formulations over soap and water include:

• Faster to clean your hands
• More effective 
• Better tolerated by the skin on your hands

Limitations of alcohol-based formulations:

• Not effective if hands are visibly soiled
• Not effective at eradicating spore-forming organisms (e.g. C.difficile)

Step-by-step guide

1. Apply a palmful of alcohol hand rub into your cupped hand.

2. Rub your hands together palm to palm.

3. Rub your right palm over the dorsum of your left hand, with your fingers interlaced and vice versa.

4. Rub your hands together, palm to palm, with your fingers interlaced.

5. Rub the backs of your fingers on the palm of your other hand, with your fingers interlocked and vice versa.

6. Place your left thumb in your clasped right palm and rotationally rub the thumb, then repeat using your right thumb and clasped left palm.

7. Rotationally rub the clasped fingers of your right hand into the left palm and vice versa.

8. Allow your hands to dry completely.

How to wash your hands with soap and water

The entire process of hand washing with soap and water should take around 40-60 seconds.

You should wash your hands with soap and water if:

• They are visibly soiled with blood or bodily fluids.
• You suspect you have come into contact with spore-forming organisms (e.g. C.difficile).
• You have just been to the toilet.

Step-by-step guide

1. Wet your hands with water from a running tap.

2. Apply enough soap to cover all hand surfaces.

3. Rub your hands together palm to palm.

4. Rub your right palm over the dorsum of your left hand, with your fingers interlaced and vice versa.

5. Rub your hands together, palm to palm, with your fingers interlaced.

6. Rub the backs of your fingers on the palm of your other hand with your fingers interlocked and vice versa.

7. Place your left thumb in your clasped right palm and rotationally rub the thumb, then repeat using your right thumb and clasped left palm.

8. Rotationally rub the clasped fingers of your right hand into the left palm and vice versa.

9. Rinse your hands with water from the running tap.

10. Dry your hands thoroughly with a single-use paper towel.

11. Use the paper towel to turn off the tap.

References

1. WHO Guidelines On Hand Hygiene In Health Care. 1st ed. Geneva: World Health Organization, 2009. Available from [LINK].