Basic Practices for Hand Hygiene: Recommended for All
Acute Care Hospitals
Î Select appropriate products (II).
• For routine hand hygiene, choose an alcohol-based hand rub (ABHR) with at
least 62% alcohol.
• Antimicrobial or nonantimicrobial soap should be available and accessible for
routine hand hygiene in all patient care areas.
• For surgical antisepsis, use an ABHR that is specially formulated for surgical
use, containing alcohol for rapid action against microorganisms and another
antimicrobial for persistence, or use an antimicrobial soap and water. Scrub
brushes should be avoided because they damage skin.
Î Provide convenient access to hand hygiene equipment and products by
placing them strategically and assuring that they are refilled routinely
as often as required (III).
• Sinks should be located conveniently and in accordance with the local
applicable guidelines.
• Dispenser location may be determined by assessing staff workflow patterns or
use of a more formal framework, such as Toyota Production Systems shop floor
management. Counters in product dispensers can show which dispensers are
frequently used and which are rarely used.
▶ It is important to place hand hygiene products in the flow of work to promote
adherence.
▶ Location of dispensers and storage of ABHR should be in compliance with
fire codes.
Î Involve HCPs in choosing products (III).
• Various components of hand hygiene products can cause irritation, and products
that are not well accepted by HCPs can negatively affect hand hygiene adherence.
Î Perform hand hygiene with an ABHR or, alternatively, an antimicrobial
or nonantimicrobial soap for the following indications (II).
• Before direct patient contact.
• Before preparing or handling medication in anticipation of patient care (eg, in
medication room or at medication cart before patient encounter).
• Before inserting an invasive device.
• Before and after handling an invasive device, including before accessing
intravenous devices for medication administration.
• Before moving from a contaminated body site to a clean body site on the
same patient.
• After direct patient contact.
• After removing gloves.
• After contact with blood or bodily fluids.
• After contact with the patient environment.
Hand Hygiene
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