Hand Washing
USF COLLEGE OF NURSING
The Clinical Setting
 Name of Location:
•
Nutre Hogar
 Description:
•
•
•
•
Nutre Hogar provides malnourished children a balanced diet until
they reach full recovery.
The program is sponsored by Their Good Neighbors Foundation
General Bank.
The association has over 300 volunteers helping around the
country at the recovery centers.
This is the only private institution specifically focused on severe
malnutrition.
Client Population
 Panamanian People


Found in Central America
Primary language:
Spanish
 Urban and Rural
Communities.
 School aged children

Ages 4-6.
Health Needs of the Population
 Life expectancy at birth (both sexes): 77 yrs
 Distribution of causes of death in children under 5 yrs
(as of 2010):
1. Congenital anomalies~ 24%
2. Other diseases~23%
3. Prematurity~14%
4. Diarrhea~11%
5. Pneumonia~9%
Health needs continued…
 Other health concerns in Panama include:
 Child malnutrition
 HIV/AIDS
 Tuberculosis
 Road safety
Health needs continued…
 Improved sanitation and water sources have allowed
an increase in the population from 1990 to 2010


Since using better water sources, the population has increased
from 82% to 97%
While enforcing better sanitation, the population has increased
from 60% to 72%
Goal
CHILDREN WILL UNDERSTAND THE
IMPORTANCE OF HAND WASHING AND HOW
TO PROPERLY WASH THEIR HANDS.
Rationale for Service Learning Project
 According to the CDC, hand washing is the most
important action that needs to be taken in order to
prevent the spread of germs. Many diseases are spread by
not washing hands with soap and clean water
("Handwashing: Clean hands," 2013). Records show that
in parts of Central America, tens of thousands of people,
with the majority being children, were diagnosed with
Influenza because of this issue. UNICEF recently
launched a National Hand Washing Campaign to
improve childhood health and hygiene. The campaign
claims that in a short amount of time, the number of
outbreaks of Influenza will lessen and children will gain
more knowledge about the importance of hand washing.
Rationale cont’d
 The rationale for this Service Learning Project is clear.
Although UNICEF began their campaign in Panama City,
we cannot assume that children in Chitre have received the
same kind of information about the importance of hand
washing. We want to provide simplified information, to the
children in the school settings, so that they are able to grasp
a true understanding of why one should learn to wash their
hands.
Healthy People 2020
 The United States
government has
identified the Social
Determinants of
Health as an objective
for Healthy People 2020
“Create social and physical
environments that promote good
health for all.”
Healthy People 2020
 “Health starts in our homes, schools, workplaces,
neighborhoods, and communities…”
 Education is the key to change
 Teaching about proper hand washing techniques,
germs, and routes of transmission can increase
health and decrease rates of illness
 The Service Learning Project will help build an
environment that promotes healthy habits for all
Additional Healthy People 2020 Objectives
 PHI-16
(Developmental) Increase the proportion of
Tribal, State, and local public health agencies that have
implemented an agency-wide quality improvement process
 EH-16 Increase the proportion of the Nation’s
elementary, middle, and high schools that have official
school policies and engage in practices that promote a
healthy and safe physical school environment
 EH-24 Reduce the global burden of disease due to poor
water quality, sanitation, and insufficient hygiene
 AH-5.6
Decrease school absenteeism among
adolescents due to illness or injury
Goal and Objectives
 Goal: Children will understand the importance of hand
washing and how to properly wash their hands.
 Objectives:



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After educating the class on hand hygiene the children will be able to
explain how poor hand hygiene contributes to the spread of disease
80% of the time. (Comprehension)
After educating the class on hand hygiene, the children will recall the
importance and benefits of hand hygiene 90% of the time.
(Knowledge)
After educating the class on hand hygiene, the children will be able to
determine when it is appropriate to wash their hands 90% of the
time. (Analysis)
After watching a demonstration, the children will be able to
implement proper hand washing techniques 99% of the time.
(Application)
SLP Plan Modifications
 Our original script and project plan was not age-
appropriate for the group of children at Nutre Hogar
(ages 2-7 years)
 The group as a whole made adjustments to the script
and used games/activities to demonstrate the
importance of hand washing
 Premade brochures were given to the staff membersthe rest were distributed at a local health fair
Implementation
 We introduced ourselves
We stated our goals and objectives.
 Presented some material to be learned
 The information was made concise and simple to fit our age group
 Played Hot Potato Game (Remix)
 We tossed the germs back and forth, not really paying attention to
time.
 This was more appropriate for our age group.
 Demonstrated appropriate hand washing technique
 We all partnered up with one child
 Bought them to the sink and helped them use the soap and water to
wash their hands
 The Song Yo me lavo los manos played in the background

Implementation (continued)
 We gain played the glitter transmission of germs demonstration.
 We all put glitter in our hands and high-fived all of the kids
 Evaluation of learning
 We went back to the sink, pared up once again and watched the
children demonstrate their handwashing skills.
 We did not play germ tag but felt it was appropriate to hand out
beaded necklaces to each child.
Second Implementation
 We introduce ourselves
 We handed each individual a handwashing flyer.
 Allowed them to demonstrate their hand washing technique
with Hand sanitizer
 We rewarded them with 3 lollipops.
Nutre Hogar Children Responses
 We presented our SLP to children (ages 2-5) at
NutreHogar.
 Although the children may not have been able to stay
attentive while we were presenting the factual
information (because of their age), they were able to
reciprocate the process of washing their hands.
 They also thoroughly enjoyed the games that we
incorporated into our SLP.
“Yo me lavo las
manos”
“Con jabon y un poquito de agua”
Future Actions
 Designate specific times for hand-washing each day.
 Continuously provide children with information regarding
the importance of hand washing.
 Inform parents of newly implemented hand-washing
procedures and have them practice them with their
children at home.
 If applicable, provide children with supplies for daily hand
washing.
Health Policy
 Gives specific guidelines for hand washing in
healthcare settings for workers

Practiced before and after each patient, before beginning work,
after using the rest room and prior to leaving work.
 Helps prevent spread of germs and disease from
patient to patient.
(Centers for Disease Control and
Prevention, 2011)
Evidence Based research article
Hand washing is used to decontaminate and
prevent spread of infection.
• Washing with soap and water is the most effective
form of hand washing.
• Stressing the importance of the proper hand
washing technique is crucial.
• Many resource-poor countries use one bowl of
water per family to rinse their hands. This may
spread infection rather than decontaminate.
(Regina I Ejemot-Nwadiaro)
•
References
Centers for Disease Control and Prevention CDC. (2013). Handwashing:
Clean hands save lives. Retrieved from
http://www.cdc.gov/handwashing/
Centers for Disease Control and Prevention. (2011). Hand hygiene for all
heathcare workers. Retrieved from
http://www.cdc.gov/handhygiene/guidelines.html
Mayo Clinic. (2011). Hand-washing: Do’s and don’ts. Retrieved from
http://www.mayoclinic.com/healthhand-washing/HQ00407
References
Regina I Ejemot-Nwadiaro. Hand washing for preventing
diarrhoea. Retrieved from
http://onlinelibrary.wiley.com.ezproxy.hsc.usf.edu/doi/10.100
2/14651858.CD004265.pub2/full
World Health Organization (2013). Global Health Observatory.
Panama: health profile. Retrieved from
http://www.who.int/countries/pan/en/