4.2 Hand Hygiene & Standard Precautions
Key Takeaways
- Hand hygiene is the single most important infection-control action and is always tested on the Florida CNA skills exam.
- Use soap and water when hands are visibly soiled and after caring for residents with diarrhea or C. diff; otherwise alcohol-based rub is acceptable.
- Handwashing requires friction for at least 20 seconds, fingers pointed down when rinsing, and a clean paper towel to turn off the faucet.
- Standard precautions treat all blood, body fluids, non-intact skin, and mucous membranes as infectious for every resident, every time.
- Gloves never replace hand hygiene; perform hand hygiene before gloving and again after glove removal.
Hand Hygiene
Hand hygiene protects the resident, the CNA, and the facility, and on the Florida Prometric skills exam handwashing is the one skill that is always tested. Hand hygiene is required before and after resident contact, before and after gloves, after contact with body fluids, before feeding, and after touching contaminated surfaces.
Soap And Water Versus Alcohol Rub
| Method | When To Use |
|---|---|
| Soap and water | Hands visibly soiled; after contact with stool, urine, vomit; after caring for a resident with diarrhea or known C. diff; when the skill requires it |
| Alcohol-based hand rub | Hands not visibly soiled and the situation allows it |
Alcohol-based rub does not reliably kill spores such as C. diff, so soap and water is required after that care.
Scored Handwashing Steps
On the skills test the handwashing sequence is scored, so practice it until it is automatic:
- Turn on water and wet hands and wrists.
- Apply soap and work up a lather.
- Rub all surfaces with friction for at least 20 seconds, including between fingers, backs of hands, and under nails.
- Rinse with fingertips pointed downward.
- Dry from fingertips toward wrists with a clean paper towel.
- Turn off the faucet with a clean, dry paper towel.
- Avoid recontaminating clean hands on the sink, towel, or uniform.
Standard Precautions
Standard precautions mean treating all blood, all body fluids except sweat, non-intact skin, and mucous membranes as potentially infectious for every resident, regardless of diagnosis. They include hand hygiene, PPE based on expected exposure, respiratory and cough etiquette, safe sharps handling, environmental cleaning, and careful linen and waste handling.
Gloves Are Not A Substitute
Gloves reduce exposure but can have unseen tears and become contaminated during removal. Perform hand hygiene before putting gloves on and again immediately after taking them off. On the exam, if one answer washes hands and another skips straight to care, the hand hygiene answer is usually correct unless immediate life safety comes first.
A Florida CNA finishes perineal care for a resident with diarrhea. Which hand hygiene method is required?
Standard precautions apply to which residents?