What You Should Know about Hand Hygiene

Author: L. Clifford McDonald
Associate Director for Science, CDC Division of Healthcare Quality Promotion

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.