Handwashing

Proper handwashing is the single most effective way to prevent the spread of infection. This skill is observed in every clinical skills evaluation.

11 steps·6 evaluator checkpoints·5 common mistakes

1Step-by-Step Procedure

1
Turn on the faucet using a paper towel or your wrist to avoid contaminating your hands.
2
Adjust water temperature to warm — not hot.
3
Wet your hands thoroughly under running water, keeping your fingertips pointed downward.
4
Apply liquid soap from a dispenser (approximately 1 teaspoon).
5
Lather all surfaces: palm to palm, back of each hand, between fingers, backs of fingers (interlaced), thumbs using rotational friction, and fingertips/nails against the opposite palm.
6
Scrub vigorously for at least 20 seconds.
7
Keep fingertips pointed down throughout washing.
8
Rinse hands thoroughly under running water from wrists down to fingertips.
9
Dry hands with a clean paper towel, patting from fingertips toward wrists.
10
Use the paper towel to turn off the faucet without re-contaminating your hands.
11
Discard the paper towel in the trash without touching the trash can lid with your hands.

✓
Hands are wet before applying soap.
✓
All hand surfaces are lathered including between fingers, backs of hands, and under nails.
✓
Friction is applied for a full 20 seconds.
✓
Fingertips remain pointed downward during washing and rinsing.
✓
Faucet is turned off using a paper towel, not bare hands.
✓
Hands are not re-contaminated after drying.

⚠
Turning off the faucet with bare hands after washing — this re-contaminates your hands.
⚠
Washing for less than 20 seconds — always count or hum "Happy Birthday" twice.
⚠
Missing the thumb and between-finger surfaces.
⚠
Shaking hands over the sink or touching the sides of the sink during washing.
⚠
Not keeping fingertips pointed downward throughout the procedure.

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Handwashing is evaluated in every single skill — perform it perfectly at the start and end of each skill.
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Sing or silently count to 20 while scrubbing; evaluators are watching the clock.
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Practice the faucet paper-towel technique until it is completely automatic.
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If you accidentally touch the sink during washing, start the 20-second count over.

Also study the written exam topics

Physical Care Skills makes up 45% of the written exam — the same procedures you just reviewed will appear as multiple-choice questions.

Free practice questions with instant feedback and explanations.