Proper Hand Washing Technique in Healthcare

Hand washing is the number one way to prevent infection. While sanitizing hand lotions have become increasingly popular, studies show that a good hand washing with soap and water is still more effective if you have visibly soiled hands. Hand washing can even prevent you from catching the common cold.

For surgery patients, a thorough hand washing prior to performing a dressing change can mean the difference between a speedy recovery and an infected incision. Hand washing is critical to the prevention of infection and should be done frequently. Your hands should be washed immediately before your touch your healing incision.

A doctor watching his hands before surgery
Andersen Ross / Photographer's Choice / Getty Images

Hand Washing 101

  • Using warm or lukewarm running water, wet your hands and apply soap—antibacterial is not required to have clean hands. Warm or lukewarm is preferred. This is because cold water is not as effective and hot water should be avoided because it is drying to the skin. Dry skin is more likely to have tiny cracks, which can lead to infection.
  • Rub your hands together to make a lather. If you have dirt under your nails, use this opportunity to clean under them. Rub your palms together and intertwine your fingers to make sure you get between them. Don't forget the back of your hands!
  • Keep rubbing your hands together! For a proper hand washing, this step should take no less than 20 seconds. Not sure when you're done? Try singing your ABC's twice, and you should be fine. 
  • Rinse your hands well. Ideally, start by rinsing your wrists and letting the water run off of your fingertips. Then rinse the rest of your hands as necessary to remove all lather.
  • Dry your hands well, using a clean paper towel or allowing your hands to air dry. Nurses and doctors are trained to turn the faucet off with a paper towel or with an elbow. Why? The faucet was turned on with dirty hands, so you may not want to touch it with your freshly cleaned hands. In fact, some sinks in hospitals use foot pedals to make this process easier.

When To Wash Your Hands

  • When your hands are visibly dirty or soiled
  • After using the restroom or anytime you are in contact with bodily fluids (sneezing, changing diapers)
  • Before and after touching a surgical incision
  • Before eating and food preparation

What If I Can't Wash My Hands?

If you don't have access to a sink, use antibacterial hand sanitizer. Make sure it is at least 60% alcohol and use plenty of it. It won't remove obvious dirt, but it will help to prevent spreading germs. 

It is important to remember that hand sanitizer works best when enough to lightly coat the entirety of both hands is used and has to dry completely to be effective. To make sure both hands are completely covered, rubbing the hands together while wet and interlacing the fingers to coat the inside each individual finger is best.

When Hand Sanitizer Will Not Work

Hand sanitizer is not effective for hands that are visibly soiled. If you look and your hands and are able to see that they are dirty, you will need to wash your hands with soap and water.

If you are interacting with an individual who has Clostridioides difficile, commonly known as C. diff, you will need to wash your hands with soap and water, as hand sanitizer does not remove the bacteria from hands effectively. The same is true of cryptosporidium and norovirus.

After exposure to all three of these infections, hand washing is the best practice and should be done as soon as possible.

A Word From Verywell

Handwashing is one of the easiest and least expensive ways to protect yourself and others from illness. Good hand washing is the best defense against the common cold and other illnesses that spread easily from person to person. After surgery, hand washing is the best defense against an infected incision, which can often be prevented by washing your hands before and after wound care.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. When and How to Wash Your Hands.

  2. Jabbar U, Leischner J, Kasper D, et al. Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile spores from hands. Infect Control Hosp Epidemiol. 2010;31(6):565-70. doi: 10.1086/652772

Additional Reading

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.