The water should be set to a comfortable temperature for your specific preferences. In order for water to be effective at reducing microbial contamination, it would have to be at or near the point of boiling; therefore it is almost impossible to wash hands with water that is hot enough to reduce the bacteria levels. Students should use water that is a comfortable temperature for them.

This is not a recommended practice. Since the test is very specific on requiring 20 seconds minimum of friction, and the evaluator is using a watch or a clock to time the student, the student should make every effort to ensure accuracy on this point. By singing a song, such as the birthday song or the ABCs, the student is not using a reliable method of time measurement. It is common for students to speed up during the exam due to anxiety, which may result in a failing grade.

Use enough soap to ensure a generous lather. The student should not rinse hands during the lathering process as it is important to ensure adequate soap contact with the skin during the friction process to remove bacteria from the skin surfaces. You are graded on bubble production!

Hands should be washed before and after every skill. Hands should also be washed if visibly soiled, after glove removal, or after coming into contact with a potentially contaminated item in the patient environment.

Every student taking Prometric’s CNA exam will be graded on hand washing at the beginning of the first skill they are asked to perform and the end of the first skill. Students will not be told to wash their hands because the evaluator is observing not just the hand washing procedure, but also the student’s knowledge of when hand washing is appropriate.

Wet paper towels may rip and re-contaminate your hands, often without your knowledge.  You would then take that contamination to your patient.  Using a clean, dry paper towel to turn the faucet off minimizes the risk of contamination and allows you to inspect the paper towel easily prior to discarding it.

Shaking your hands flings water droplets around the room, tapping them together confines the water droplets to the sink area only.  Since pathogens thrive in a warm, dark, moist environment (there is usually no A/C vent in the bathroom and we are trained to turn off the light when we leave), flinging water around creates an ideal breeding ground for pathogens.

No.  You must provide 20 seconds of rubbing (all surfaces of the hands and wrists) before moving on to the nails.  The 20 seconds begins when you get soap in your hand and begin rubbing.

Yes. This allows the soap to lather and be spread around to all surfaces. Soap does not lather well on dry surfaces.