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Hand washing: hygienic and antiseptic

Hygienic measures that aim to eliminate as many pathogenic microorganisms as possible from the hands through the technique of hand washing with water, neutral soap and antiseptic.


– Prevent the spread and transmission of pathogenic microorganisms. – Decrease the bacterial flora of the hands before a procedure. – Decrease the prevalence of nosocomial infection in healthcare facilities.


– Hand washing basin.


– Water. – Neutral and antiseptic soap. – Alcoholic hand disinfectant solution. – Disposable brush. – Disposable towel if possible.


– Start the manual washing by turning on the water. – Wet hands.

– Soap hands and wrists from the front and back, insisting on the interdigital spaces for 40-60 seconds. – Rinse hands and wrists. – Shut off the water with your elbows or a disposable towel. – Dry hands and wrists with cellulose towels and discard. – Perform alcohol hand disinfection if necessary. This is done by gently rubbing the palms, backs and fingers of the hands for 15-30 seconds, until the hands are dry. The amount of product to be used will depend on the solution used. – In the antiseptic wash use antiseptic soap. Apply about 5cm3 for about 2 minutes.


Hand washing with alcohol solution is indicated in the following si- tuations:

1. Rapid hand antisepsis. 2. Antisepsis of the hands before and after contact with patients or potentially contaminated materials. 3. Before performing any nursing procedure of short duration that requires sterile environment. 4. After removing gloves, it is advisable to perform a hygienic hand washing or other washing with alcohol solution. – Do not use nail varnish. – Keep nails short and clean. The use of artificial nails is forbidden. – Do not apply creams on the hands during the working day as they interfere with the effectiveness of antiseptic solutions. – Apply protective creams to the hands at the end of the working day.

When hands are visibly stained or contaminated by organic fluids there are two alternatives:

1. Hand washing with normal soap and water and then application of the alcohol solution. 2. Hand washing with antiseptic soap and water. – Hygienic washing is indicated in: 1. upon arrival and departure from the work unit. 2. Before and after the distribution of meals and eating. 3. Before and after blood extractions, except for blood cultures, which is an antiseptic wash. 4. After handling objects in contact with the patient. 5. Before and after using clean gloves. 6. Before and after preparing medication.

7. After using the toilet, sneezing or blowing your nose. 8. After using sterile gloves. 9. After performing invasive techniques. 10. After contact with secretions, excretions and blood of the patient.

Antiseptic hand washing, as an alternative to alcoholic hand disinfection, is indicated in:

1. Before and after administration of parenteral medication, bronchial aspiration, catheter handling and catheterization. 2. Before and after changes of dressings or cures. 3. Before the use of sterile gloves. 4. Before and after caring for a patient with suspected infection in high-risk areas. 5. When handling immunosuppressed patients.

If the hands are not visibly stained, alcoholic disinfection of the hands should be carried out:

1. Before coming into direct contact with patients. 2. Before putting on sterile gloves to insert a central catheter. 3. Before inserting urinary catheters, peripheral vascular catheters or other devices requiring non-surgical invasive procedures. 4. After contact with the patient’s intact skin (e.g. when taking a pulse or blood pressure). 5. After contact with body fluids or excretions, mucous membranes, non-intact skin and wound dressings. 6. When changing activity on the same patient if contact has been made with a contaminated surface. 7. After contact with inanimate objects (including medical equipment) in the immediate environment of the patient. 8. Immediately after removal of gloves.

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