Editing Infection Control and Safety (section)

=== 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.