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Andrew Pollack-Gray

Nursing Notes

Hand Hygiene

4 min read

When & Why?

Hand hygiene prevents the transmission of microorganisms between patients, healthcare workers, and the environment.
Perform hand hygiene:

  • Before and after patient contact.
  • Before clean or aseptic procedures.
  • After contact with bodily fluids or contaminated surfaces.
  • After removing gloves.
  • When moving from contaminated to clean tasks.

Before You Start

Choose the appropriate method:

MethodWhen to Use
Alcohol-based hand rubPreferred for most patient care when hands are not visibly soiled
Soap & waterVisibly dirty hands, after restroom use, before eating, and during certain infectious diarrhea outbreaks

Steps

Soap & Water

  1. Turn on sink,
  2. Wet hands under clean, running water.
  3. Apply soap.
  4. Scrub all surfaces for at least 20 seconds, including between fingers, thumbs, fingertips, and under nails. Also, up to two inches up wrist.
  5. Rinse thoroughly under running water.
  6. Dry with a disposable towel.
  7. Use a different towel to turn off the faucet.

Alcohol-Based Hand Rub

  1. Apply the manufacturer’s recommended amount.
  2. Rub all hand surfaces, including fingertips, thumbs, and between fingers.
  3. Continue rubbing until completely dry (approximately 20 seconds).

Safety & Observations

  • Gloves never replace hand hygiene.
  • Avoid touching contaminated surfaces after cleaning.
  • Change gloves and perform hand hygiene between contaminated and clean tasks as appropriate.
  • During C. difficile or norovirus outbreaks, follow facility guidance for soap-and-water washing.
  • Keep nails short and clean; follow facility restrictions on artificial nails and jewelry.

What Should I Remember?

  • Before touching, after touching, after gloves.
  • Clean thumbs, fingertips, and between fingers — commonly missed areas.
  • Never rinse or wipe off alcohol-based sanitizer before it dries.
  • Maintain healthy skin; report cracks or irritation that interfere with hand hygiene.

Practice

  • Studied
  • Observed
  • Practiced
  • Passed checkoff

Sources

Flashcards

When is hand hygiene required during routine resident care?03-application / clinical-skills
Answer

Before and after contact, before clean procedures, after bodily-fluid exposure, after gloves, and between dirty and clean tasks.

Which method is generally preferred when hands are not visibly soiled?01-foundations / clinical-skills
Answer

Alcohol-based hand rub.

When should soap and water be used instead of alcohol-based hand rub?03-application / clinical-skills
Answer

When hands are visibly dirty, after restroom use, before eating, and when required by infection-control protocols.

What is the minimum soap-and-water scrubbing time?01-foundations / clinical-skills
Answer

At least 20 seconds.

Which areas are commonly missed during hand hygiene?01-foundations / clinical-skills
Answer

Thumbs, fingertips, between fingers, and around nails.

Why must you perform hand hygiene after removing gloves?03-application / clinical-skills
Answer

Gloves can become contaminated, and hands may be contaminated during removal.

flashcards/03-application/clinical-skills What is the correct sequence for washing hands with soap and water?
?

  1. Wet hands.
  2. Apply soap.
  3. Scrub all surfaces for at least 20 seconds.
  4. Rinse thoroughly.
  5. Dry with a disposable towel.
  6. Turn off the faucet using a clean towel.
How should alcohol-based hand rub be applied?03-application / clinical-skills
Answer

Use the recommended amount, cover all hand surfaces, and rub until dry.

Should alcohol-based hand rub be rinsed or wiped off?03-application / clinical-skills
Answer

No. Allow it to dry completely.

What should you do during a C. difficile or norovirus outbreak?03-application / clinical-skills
Answer

Follow facility-specific hand hygiene requirements, including when soap and water is indicated.

Does wearing gloves eliminate the need for hand hygiene?03-application / clinical-skills
Answer

No. Gloves never replace hand hygiene.

What should you do if your hands develop cracks or irritation that interfere with hand hygiene?03-application / clinical-skills
Answer

Report the issue and follow approved skin-care or occupational-health guidance.

When is alcohol-based hand rub generally preferred?03-application / clinical-skills
Answer

Most routine care when hands are not visibly soiled.

How long should hands be scrubbed with soap and water?03-application / clinical-skills
Answer

At least 20 seconds.

Do gloves replace hand hygiene?03-application / clinical-skills
Answer

No; clean hands at indicated times including after glove removal.

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