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HAND WASHING

Student Name: __________________________________________  

PROCEDURE

Satisfactory

Unsatisfactory

1.

Remove jewelry, e.g., rings, watches, bracelets

2.

Turns on water to the desired temperature and sets the flow to avoid splashing during hand washing

3.

Applies an adequate amount of hospital approved soap and rubs hands together for a minimum of 15 seconds, covering all surfaces of the wrists, hands (backs and palms), and fingers (between digits and around cuticles)

4.

Rinses wrists and hands with water and dries with a clean paper towel

5.

Uses paper towel to turn off faucet and this properly discards paper towel

Use alcohol-based hand sanitizer when hands are not visibly soiled

6.

Apply the recommended amount of product to palm of one hand and rub hands together – covering all surfaces of the wrists, hands (backs and palms), and fingers (between digits and around cuticles) – until hands are dry

RATING

Satisfactory (performs without supervision)

Competent (no critical errors, corrects with some coaching)

Unsatisfactory (critical errors, requires remediation)

Evaluator Signature: ________________________________________________________    Date: ___________________

Comments/Remedial Action Plan:  _______________________________________________________________________

Student Signature: _________________________________________________________    Date: ____________________

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