UNIVERSITY OF TECHNOLOGY
CARIBBEAN SCHOOL OF NURSING
HAND HYGIENE CHECKLIST
NAME_______________________________________ ID#_______________________________
PERFORMING HAND HYGIENE
Purpose:
✓
✓
✓
✓
✓
Remove pathogens which can cause personal harm or disease
Reduces cross-contamination
Break the chain of infection spread
Prevent nosocomial infection
Protects the health care worker from disease and illness
Rating Scale 0= Not done; 1= Fair Performance; 2=Average Performance; 3= Good Performance
PROCEDURE
• Stand in front of, but away from sink *
• Remove wrist and hand jewelry, as indicated*
• Bare below the elbow/roll up sleeves*
• Wet hands under running water*
• Apply enough soap to cover all surfaces of the hand
• Rub hands palm to palm
• Rub right palm over left dorsum with interlace
fingers and vice versa
• Rub palm to palm with fingers interlace
• Rub back of fingers to opposite palms with fingers
interlock
• Rotate rubbing of left thumb clasped in right hand
and vice vera
• Rotate rubbing backwards and forwards with
clasped fingers of right hand into left palm and vice
versa
• Rinse hands under running water keep fingers
pointed downwards*
• Dry hands thoroughly with a single use towel with
fingers pointed up *
• Use a towel/elbow to turn off tap, if indicated *
• Provide rationale for steps in procedure*
TOTAL
/45
%
0
1 2 3
COMMENTS
Student Signature___________________________________ Date __________________________
Examiner’s Signature ________________________________
Date __________________________