Hand-washing is an important measure in preventing the spread of microorganisms. Good aseptic technique involves limiting the transfer of organisms from one person to another. By washing her hands after contact with a patient, the nurse can limit the spread of microorganisms to other people, particularly other patients. In hand-washing, both mechanical and chemical means are used to remove and destroy organisms. The running water mechanically washes away organisms, while soaps emulsify foreign matter and lower surface tension, thus facilitating the removal of oils, greases and dirt.

For cleansing after contact with a person or an object such as sputum cup which harbors pathogenic organisms, it is recommended that a two minute wash be done with an alkaline detergent or a bar of ordinary soap. In surgical asepsis, hand-washing is indicated prior to working with sterile equipment in order to render the hands as free as possible from bacterial. In either medical or surgical asepsis it is advantageous to wash one’s hands at a deep sink where the water can be regulated by a foot or leg control.

Importance of hand washing
1. Hand-washing as the best way to control the spread of infection.
2. To prevent the spread of microorganisms.
3. Practicing it properly in a given situation or at all time can bring out a healthy life..
4. To limit the transfer of organisms from one person to another.

Basic things used for hand washing:
• Soap
• Running water
• Dry clean towel

Procedures for hand-washing
1. Roll up sleeves above elbows and remove watch.
2. Clean the fingernails as necessary. Disposable sticks are often provided for this purpose.
3. Wash hands and arms to the elbow thoroughly with soap and warm water. Wash in continuously running water, using a rotary motion and taking care to clean the inter-digital spaces:
• In surgical asepsis, always hold the hands higher than the elbows so that water will flow from the cleanest to the dirtiest area. A surgical scrub brush is sometimes used, although the danger of creating abrasions on the skin needs to be considered.
• In medical asepsis, hold the hands lower than the elbows while washing in order to prevent microorganisms from contaminating the arms.
4. Rinse hands and arms, allowing water to flow freely.
5. Repeat steps 3 and 4.
6. Dry hands thoroughly with paper towels or a fresh clean towel. Many agencies now use hot air hand driers, which eliminates the use of paper or cloth towels. During the drying process the hands and arms are held higher than the elbows whichever method of drying is used.

When washing her hands, the nurse should take pre-cautions to protect her uniform from getting wet. She should stand so that her uniform does not touch the wash basin and should hold her hands and arms away from her body when she is drying them. When turning off water as a sink that does not have foot and leg controls, a dry towel is used to handle the taps; they are considered grossly contaminated. The basin is considered contaminated also. If a break in technique occurs – for example, if the nurse accidentally touches the side of the basin during or after the hand-washing --- the wash should be repeated from the beginning. It is important that the nurse keep the skin on her hands in good condition. Hand lotions or creams should be used frequently.

During a hand-wash for medical asepsis, the hands are kept lower than the elbows to keep microorganisms away from the elbows.

The hand are held higher than the elbows during a surgical asepsis hand-wash so that the water will flow from the hands to the elbows, i.e., from the cleanest to the dirtiest areas.