Editing Infection Control and Safety (section)

== Hand Hygiene ==

Hand hygiene is the single most effective measure to prevent the spread of infection and is the most common correct answer on licensure exams.

=== When to perform hand hygiene ===

The World Health Organization describes five moments: before touching a patient, before a clean or aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching the patient's surroundings. Also perform hand hygiene before donning gloves and immediately after removing gloves, before handling medications or food, after using the restroom, and when moving from a contaminated body site to a clean body site on the same patient.

=== Choosing the product ===

; Alcohol-based hand rub (60 to 95 percent alcohol)
: Preferred for most clinical situations when hands are not visibly soiled. Apply enough product to cover all surfaces and rub until the hands are completely dry, roughly 20 to 30 seconds. Do not wipe or fan the hands dry.
; Soap and water
: Required when hands are '''visibly soiled''' or contaminated with blood or other body fluids, after caring for a patient with known or suspected ''Clostridioides difficile'', norovirus, or ''Bacillus anthracis'', after using the restroom, and before eating. Wet hands, apply soap, lather all surfaces including thumbs, fingertips, and between fingers for at least 20 seconds (WHO describes a 40 to 60 second whole procedure), rinse with the fingertips pointed down, dry with a paper towel, and use the towel to turn off the faucet.

'''Why the distinction matters.''' Alcohol does not kill bacterial spores. ''C. difficile'' spores must be physically removed by the friction of handwashing and killed on surfaces by an Environmental Protection Agency registered sporicidal agent such as a bleach product. Norovirus is likewise poorly inactivated by alcohol.

=== Supporting measures ===

Keep natural nail tips shorter than one-quarter inch. Artificial nails and extenders are not permitted for staff who have direct contact with high-risk patients because they harbor gram-negative organisms and fungi. Do not wear rings or wear them minimally in high-risk settings. Use lotion supplied by the facility, because petroleum-based lotions degrade latex gloves. Report skin breakdown on your own hands, since dermatitis increases carriage of pathogens.