Handwashing
Proper handwashing is the single most effective way to prevent the spread of infection. This skill is observed in every clinical skills evaluation.
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.
What the Examiner Is Watching For
- ✓
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.
Common Mistakes That Cause Failure
- ⚠
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.
Tips for Exam Day
- →
Handwashing is evaluated in every single skill — perform it perfectly at the start and end of each skill.
- →
Sing or silently count to 20 while scrubbing; evaluators are watching the clock.
- →
Practice the faucet paper-towel technique until it is completely automatic.
- →
If you accidentally touch the sink during washing, start the 20-second count over.
Also prep for the written exam
The written NNAAP exam tests the same knowledge behind these clinical skills — use the study guides to reinforce the concepts in multiple-choice format.
Browse All 6 Study Guides →Recommended Study Books
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Whitenton & Walker — Focused prep — ideal for last-minute review.
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