Hand Hygiene

Key Points

• Proper hand hygiene is the easiest and most effective way to break infection transmission.
• Use soap and water when hands are visibly soiled or after exposure to specific spore-forming pathogens.
• Use facility-approved alcohol-based hand rub (ABHR) when soap-and-water washing is not required.

Equipment

• Facility-approved soap and running water access
• Clean towels or disposable paper towels
• Facility-approved ABHR (70-90% alcohol concentration)

Procedure Steps

1. Identify the care moment requiring hygiene (before touching patient, before aseptic task, after body-fluid contact, after touching patient/environment, and after glove removal).
2. Assess hand condition and exposure type before choosing method.
3. If hands are visibly soiled, exposed to blood/body fluids, or exposure risk includes C. difficile, norovirus, or Bacillus anthracis, select soap-and-water handwashing.
4. For soap-and-water method: wet hands, apply approved soap, and lather all hand surfaces including palms, backs, between fingers, fingertips, thumbs, and wrists.
5. Scrub with friction for at least 20 seconds; complete total handwashing procedure in about 40-60 seconds.
6. Rinse thoroughly under clean running water and dry from fingers toward wrists.
7. Use a clean towel to turn off the faucet to avoid recontamination.
8. If soap-and-water method is not required, apply facility ABHR and rub all hand surfaces for at least 20 seconds until fully dry.

Common Errors

• Inadequate friction or short scrub time → reduced microorganism removal
• Missing high-risk surfaces (thumbs, fingertips, wrists, nail areas) → persistent contamination risk
• Using ABHR when soap-and-water is required → incomplete pathogen removal in critical exposures

Related

• standard-precautions - Hand hygiene is a required baseline action in all patient care.
• chain-of-infection - Effective hand hygiene interrupts the most common transmission pathway.