As a healthcare worker, you know just how important good hand hygiene is. No matter whether you're an NP or a PT, you know that failing to clean your hands properly could have potentially serious consequences for your patients' safety. The problem is that there are a lot of handcleaning techniques out there, and far too many of them either gloss over or completely skip crucial steps in the sanitizing process.
To help you cut through the noise, we talked to the experts at the Centers for Disease Control and Prevention (CDC) to get their take on proper hand hygiene techniques.
Let’s Start With the Basics: What Do We Mean by 'Hand Hygiene'?
According to the CDC, proper hand hygiene refers to the methods used to remove or kill bacteria on hands. It recommends two methods for routine handcleaning: handwashing with soap and water or hand antisepsis using an alcohol-based hand rub.
Washing Hands vs. Alcohol-Based Sanitizer: Which Is Better?
The CDC says that hand antisepsis is the preferred hand hygiene method in most clinical situations. However, handwashing should be performed whenever your hands become visibly soiled or you may have been exposed to spores. Why? Spores may not be killed or removed by alcohol-based hand rubs. C. difficile is an example of a diarrheal illness caused by spores.
To be most effective, alcohol-based hand rubs should have 60 to 95 percent alcohol. If you’re washing your hands, you may use antimicrobial soap, but this is not recommended over plain soap.
When Should You Use Hand Sanitizer vs. Handwashing?
The CDC provided us with the following list of scenarios for when you should either perform hand antisepsis or wash your hands.
When to Perform Hand Antisepsis With Alcohol-Based Hand Rub
- When hands are not visibly soiled
- Before coming into contact with a patient
- Before putting on gloves
- Before putting on gloves to insert a sterile device (e.g. urinary, intravenous catheters)
- During care when moving from a contaminated body site to a clean body site
- After contact with the patient
- After contact with surfaces or equipment in the patient environment
- After removing gloves
When to Wash Your Hands With Soap & Water
- When hands are visibly soiled
- After using the restroom
- Before eating
- After caring for a patient with an acute diarrheal illness
- After touching surfaces or equipment used in the care of a patient with an acute diarrheal illness
What’s the Right Way to Wash Your Hands?
The World Health Organization (WHO) created a nine-step process for safe handwashing. The steps are as follows:
- Step 1: Wet your hands.
- Step 2: Apply soap.
- Step 3: Rub palms together for about five seconds.
- Step 4: Rub your hands over each other for six seconds.
- Step 5: Interlace fingers and rub the backs of your hands with your fingertips.
- Step 6: Scrub each thumb for three seconds.
- Step 7: Rub each palm with the fingertips of the other hand for three seconds.
- Step 8: Rinse the soap off your hands until the water runs clear and you don't see suds.
- Step 9: Dry your hands with paper towels or a hand dryer.
If you want to learn more about the proper techniques for handwashing, or how to prevent your hands from drying out, take a look at our article, "The Proper Handwashing Procedure for Nurses."
What’s the Best Way to Apply Hand Sanitizer?
When applying hand sanitizer, make sure to take the following steps:
- Apply the appropriate amount of sanitizer to the palm of one hand. (The label should guide you on the recommended amount.)
- Rub the sanitizer along your palms, thumbs, fingers, and the backs of your hands.
- Continue rubbing your hands until all the hand sanitizer is absorbed and your hands are dry (about 20 seconds).
Some Additional Hand Hygiene Tips From the CDC
The CDC provided us with a few extra tips for maintaining proper hand hygiene:
1) Keep your hands healthy.
- Short, natural fingernails harbor less bacteria than artificial or painted fingernails, especially if fingernail polish is chipped. Follow your healthcare facility policy about fingernails.
- Protect your skin by only using lotions provided by your healthcare facility. Do not bring lotions from home, as they may not be compatible with the products provided at work.
2) Wear gloves to protect yourself and your patients.
- Use gloves according to Standard Precautions when providing care involving water and when caring for a patient with an acute diarrheal illness.
- Change gloves and perform hand hygiene during care whenever the gloves may become contaminated and between patient contacts.
- Wearing gloves does not replace the need to perform hand hygiene. Hands may become contaminated during glove removal.
Originally published on July 6, 2018.
Updated on March 8, 2020.