Why Candidates Fail the Handwashing Skill
Handwashing is evaluated as part of every clinical skill. A single mistake here can fail you not just on this skill, but on every other skill where you wash your hands.
How this skill is evaluated
The evaluator scores each skill on a pass/fail checklist. You do not get partial credit. A single critical error — or several minor ones — will fail you on this skill entirely. You must pass all 5 randomly selected skills to pass the clinical exam.
The 5 Most Common Failure Points
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.
Exactly What the Evaluator Is Watching
These are the specific checkpoints on the evaluator's score sheet for this skill.
- ✓
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.
How to Avoid These Mistakes on Exam Day
These tips come from the most common failure patterns in Handwashing.
- →
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.
Practice the written exam too
The written NNAAP test covers the knowledge behind every clinical skill. 501 free questions.
Take the Practice Test →