Lessons · Medicine foundations · hand hygiene, in order
Hand hygiene: the order is the technique
Wet, soap, rub every surface in turn, rinse, dry with a single-use towel, and turn the tap off with that towel.
Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.
What it is for
It is the first thing assessed in every practical examination and the first thing anybody watches you do on a ward, and it is graded as an order rather than as an effort. The two steps people drop are the ones at the end, where the hands are clean and the tap is not.
How to think about it
Learn it as a sequence rather than a description, and say the steps out loud while your hands do them. Every surface means palms, between the fingers, the backs of the hands, the thumbs, the fingertips and the wrists, and the thumbs and fingertips are the two that get missed.
Worked example
Wet the hands with waterBefore the soap. Soap on dry hands does not spread and does not lather.
Apply enough soap to cover every surfaceEnough is a quantity decision, and too little is the common one.
Rub palm to palm, between the fingers, backs of the hands, thumbs, fingertips, wristsA fixed circuit, so nothing is left to memory in the moment.
Rinse the hands with waterAll the soap, or what is left dries onto the skin.
Dry thoroughly with a single-use towelWet hands pick things up again, so drying is part of the cleaning.
Turn the tap off with the towel, then discard itThe tap is the thing your dirty hands touched first. Last step, every time.
Your turn
Write the step that comes straight after rinsing and before the tap is turned off.
Rinse, then thoroughly with a single-use towel.
Solve one, graded on the server
The trap
Turning the tap off with a bare hand at the end. Everything before it was done properly and the last second of the procedure undoes it, which is exactly why the towel is kept until after the tap.