Clean hands are the most important factor in preventing the spread of disease and antibiotic resistance in settings across the continuum of health care.
Hand hygiene is a general term that refers to a method of removing microorganisms from the hands so the germs cannot be transmitted to anyone else. The two most common types of hand hygiene are hand washing with soap and water and using an alcohol-based hand rub.
- Soap and water should be used when hands are visibly dirty, contaminated, or soiled, after using the restroom, and before eating or preparing food. Washing hands with soap and water is also recommended to prevent the spread of certain organisms (such as Clostridium difficile).
- Alcohol-based hand rubs are products that kill germs on the hands. They are fast-acting, convenient, and generally can be used for all situations other than the ones described above. Be sure to use hand rubs that contain 60-95% ethanol or isopropanol (types of alcohol).
Hand hygiene is part of standard precautions because it is a prevention measure that should be applied to all patients in all settings, all the time.
Patients can take action by asking both their healthcare providers and visitors to practice appropriate hand hygiene.
How and When to Perform Hand Hygiene in the Healthcare Setting
- Wet hands with water, apply soap, and rub hands together (for at least 15 seconds).
- Rinse hands well under running water.
- Dry hands with a disposable towel.
- Use a towel to turn off the faucet.
Alcohol-based hand rubs
- Apply to the palm of one hand.
- Rub hands together, making sure to cover all surfaces.
- Continue rubbing until hands are dry.
- Manufacturer will instruct on how much to use.
- Putting on gloves
- Handling or administering medication
- Insertion of invasive devices (such as catheters)
- Touching your eyes, nose, or mouth
- Preparing or eating food
Before and After
- Contact with a patient/resident
- Changing wound dressings or bandages
- Removing gloves
- Contact with blood, body fluids, or non-intact skin
- Touching surfaces or objects in a patient or resident’s room that may be contaminated (such as bed rails, door knobs, or bedside tables)
- Handling garbage
- Using the restroom
- Blowing your nose, coughing, or sneezing
Tools and Resources
The Art of Washing Hands – innovative resource to educate children about hand hygiene
- Guidelines for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force, 2002
- WHO (World Health Organization) Guidelines on Hand Hygiene in Healthcare, 2009
Hand Hygiene in Healthcare Settings (CDC website) – contains information on hand hygiene basics, guidelines, training, measurement, and promotional campaigns
- Hand hygiene interactive training course
- Patient admission video – video for hospital patients and visitors that teaches the importance of practicing hand hygiene while in the hospital and that it is appropriate to ask or remind healthcare providers to practice hand hygiene as well; available in English and Spanish
Hand Hygiene and Personal Protective Equipment Monitoring Tool by Precaution Type – for assisted living facilities and nursing homes; can be edited to apply to other settings
Hand Hygiene: Why, How & When? (WHO brochure) – includes the “5 Moments for Hand Hygiene” and descriptions on “How to Handrub” and “How to Handwash”
Handwashing: Clean Hands Save Lives (CDC website) – more hand hygiene resources for the general public, including in non-healthcare settings
Measuring Hand Hygiene Adherence: Overcoming the Challenges – document from The Joint Commission to help healthcare organizations target their efforts in measuring hand hygiene performance
Save Lives: Clean Your Hands (WHO website) – WHO’s global annual campaign on hand hygiene, containing tools and resources for training and education, system change, and evaluation and feedback
Hand Hygiene Toolkit for Ambulatory Surgical Centers (ASC Quality Collaboration)