Hand washing technique: point fingers up or down?

[cmw6v8]

I had my first nursing class today, basically an intro to nursing (an intersession summer class before my full-time curriculum begins next month). My instructor demonstrated hand washing for us, and she told us that we want to have our fingers pointed up to prevent becoming contaminated by stuff further down the arm.

But my textbook, along with several videos I've found online, say to point your fingers downward to prevent re-contamination. I trust my instructor but I was just wondering which way you all have learned and why. Thoughts? Thanks!

[happy2learn]

I was told to point down. That is what it said on our state test for nurse aides.

[sandyfeet]

I was taught to point down, but this was as part of a (reputable) volunteer program at one of the top hospitals in my area. I wouldn't want anything I'm trying to wash off my hands dripping up onto my arms.

[StangGang92]

On the CNA skills list (Iowa) it states fingers pointed down & wrist lower than elbow.

[healthstar, BSN, RN]

I learned that when you wash your hands you should point your fingers down BUT a surgeon holds the hand above the elbow ( fingers pointing up).

[MInurse.st]

In CNA training we learned hands down. Dirty water straight into the sink, no splashing, and doesn't get on the arms, scrubs, etc.

If your arms aren't wet/you're not washing them, how would they effect your hands?

[Islandgirl245]

In the operating room we point our hands up b/c you'll recontaminate your hands if they were pointing down. Your upper arms are considered unsterile anyways even though you are gowned. Hope that helps some....

[NAZIZ]

I am a surgical tech and in the operating room hands are pointed up but in nursing school I am told to point hands down

[cmw6v8]

Thanks for the responses everyone. So it seems like they're both right in certain cases. I'm just confused as to why everyone wouldn't use the same technique? Does anyone know the reason for the difference in OR use vs. non-OR?

[MInurse.st]

I am a surgical tech and in the operating room hands are pointed up but in nursing school I am told to point hands down

Do you know the rationale behind the difference? Is it because in surg you wash to the elbows, but in nursing don't? Just curious.

[anonymousstudent]

Thanks for the responses everyone. So it seems like they're both right in certain cases. I'm just confused as to why everyone wouldn't use the same technique? Does anyone know the reason for the difference in OR use vs. non-OR?

There are a lot of things that vary based on the type of asepsis you are seeking - medical or surgical.

But general nursing practice, even when washing your hands before a sterile technique is performed, is fingers pointed DOWN.

[Intern67]

There are a lot of things that vary based on the type of asepsis you are seeking - medical or surgical.

Yep, and when using the alcohol gel, point them any way you want.