What You Should Know about Hand Hygiene

The science is clear: clean hands can protect patients and healthcare providers from dangerous and deadly infections. Yet, studies show that on average, healthcare providers clean their hands less than half of the times they should. 1

CDC’s Division of Healthcare Quality Promotion often receives inquiries from healthcare providers and staff asking for clarification on CDC recommendations and guidelines, including hand hygiene in healthcare facilities. The following are a few of the most commonly asked questions on hand hygiene.

1. What is the preferred method for healthcare providers to clean their hands – soap and water or alcohol-based hand sanitizer?
   Alcohol-based hand sanitizer is the preferred method (see exceptions for C. difficile in next question). Compared to soap and water, alcohol-based sanitizers are more effective and less drying to the hands than frequent use of soap and water. To learn more, check out CDC’s Show Me the Science webpage.
2. Alcohol-based hand sanitizer doesn’t kill C. difficile, so how should healthcare providers manage hand hygiene when caring for patients with C. difficile?
   Healthcare providers should always use gloves when caring for patients with C. difficile. In addition, when there’s an outbreak of C. difficile in your facility, wash your hands with soap and water after removing gloves.
3. Is there a technique to cleaning hands with alcohol-based hand sanitizer?
   When using alcohol-based hand sanitizer, put product on your hands and rub hands together. Cover all surfaces until hands feel dry. This should take around 20 seconds, a good indicator that the right amount has been used. Remember to clean your thumbs, finger tips, and in between the fingers – these areas are commonly missed when cleaning hands with alcohol-based hand sanitizer.
4. How long should it take to wash my hands with soap and water – 15 or 20 seconds?
   When washing hands with soap and water, wet hands first with water, apply an amount of product recommended by the manufacturer to hands, and rub hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fingers. Rinse hands with water and dry thoroughly with a disposable towel. Use a towel to turn off the faucet. In healthcare, CDC’s guidelines state that hands should be washed for at least 15 seconds, not specifically 15 seconds. Some CDC documents for handwashing outside of healthcare settings say to wash for 20 seconds and recommend singing happy birthday twice, which takes around 20 seconds. Either time is acceptable.
5. Why do I have to clean my hands if I will wear gloves?
   Glove use is not a substitute for cleaning hands. Dirty gloves can soil hands. Healthcare providers should clean their hands after removing gloves to help prevent the spread of potentially deadly germs.

The bottom line: Clean hands can protect patients and healthcare providers from dangerous and deadly infections, so clean your hands before and after every patient contact!

On May 5th, in celebration of World Hand Hygiene Day, CDC rolled out a new campaign called Clean Hands Count that answers these questions and more. Learn more about CDC’s Clean Hands Count Campaign: http://www.cdc.gov/handhygiene/campaign/index.html.

1. L. Kingston et al. Hand hygiene-related clinical trials reported since 2010: a systematic review. Journal of Hospital Infection: 92 (2016) 309-320.

10 comments on “What You Should Know about Hand Hygiene”

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Can you hand sanitize your gloved hand with an alcohol based hand sanitizer? Is this practice OK to do occasionally/never? Thanks

Can I effectively re-use disposable nitrile gloves if I clean them with hand sanitizer? Does the hand sanitizer break the gloves down?

Sir, you have given the best advice. As, I have seen many of nurse in hospital don’t care to wash their hand again and again. If Alcohol based hand sanitizer & hand glove use in hospitality, many people can get protected from any other diseases.

Very helpful and will utilize with Staff Huddles starting today!
Thank you…

We as health professionals preach “Good Hand Hygiene” until we are blue in the face and HCWs are compliant while they are being observed, but does just the opposite when we are not looking. How do we get HCW to understand that this is a serious, and potential life-threating matter, so that the correct and proper hand hygiene is performed as it should be?

Restrooms at restaurants generally have a sign proclaiming, “Employees MUST wash hands before returning to work.” By implication, management considers it is OK for non-employees not to wash their hands.
Casual observations have revealed that about one-third to one-half of all persons leaving a public restroom do not wash their hands. Why not advocate and post a sign in every public restroom, that applies to all persons, in all locations, stating, “WASH HANDS AND DRY THEM BEFORE LEAVING RESTROOM” ? That might promote better hand-hygioene and thereby lessen a preventable, transmissible public health problem.

Thank you for the advice . Sometime with daily work we forget about simple thinks like protect are self like cleaning are hands small think made the different. Thank you please keep me informed

hi, thanks for the touching text on hand hygiene. i am looking forward to launch a sensitization campaign on the same in Kenya health facilities.

I think you should reword the point about C. difficile. Saying wear gloves makes it seem like that’s all that is needed when working with infected patients and/or their environments and hands are to only be washed when there is a c. diff outbreak. Hands should be washed with soap and water always with c. diff patients in addition to gloves being worn.

Before losing my career in Nursing due to Complex Regional Pain Syndrome, due to recurring right hand infections due to MRSA which reared its ugly head in 2002-2005, Staph or Cellulitis, knowing I have a bug inbetween my right middle and ring finbers, remembering my clean hands requirements as an ICU Nurse Tech, the hospital had strict hand guidelines. Now that I still battle whatever bug is between the webbing and has spread partially up my hand, I use both soap and water, then hand sanitizer. When going into a doctors office I use my own pen as whatever bug is in there, I don’t want anyone else to get whatever is hiding. I wash my hands before handling dishes or food. It may be overkill, but bacteria can be spread by touching anything someone following me could pick up. Recently, I had what looked like dry skin when food shopping and when I picked up something heavy, I noticed a small amount of puss pop up. I bought a dressing kit and put it between my fingers. When I got home, the case of water someone helped me with I use my left hand. As I brought it into my home, it dropped and being r. hand dominant, when the case dropped onto my feet, I automatically grabbed it without thinking and it was like a volcano erupted with pus and blood. I haven’t seen my new PCP yet and knowing my closest hospital is only three miles from me, I didn’t take a taxi because their care is poor at best so I would put gloves on after washing my hand which is impossible since my r. middle finger now lies in my palm three years post op hand surgeon who was the Director of a large University Hospital. We did not discuss him placing three, three inch pins in three of my fingers for six weeks. He didn’t read you never immobilize a CRPS patients extremity. or I would never agreed to the surgery. At any rate I cleaned out the area with Peroxide and sterile saline. I was washing my hands before’ and after using the bathroom. The only antibiotic I can take is Cubicin. I am now allergic to almost every antibiotic, finally including Vancomycin after being on it after 17 years. The only fast food restaurant I ever use is Subway because their employees have to wash their hands before putting gloves on. I think all fast food restaurants were required to use the same guidelines. I think if the CDC were to do a surprise visit to any place serving food and do hand and nail checks, most would lose their business when the tests came back. They handle food, then take a customer’s money and handle food again without washing their hands.