hand hygiene ebp nursing

"Hand Hygiene EBP for Nurses: Best Practices & Guidelines"

By Rachel WalkerJanuary 31, 2026

Hand hygiene is a cornerstone of infection prevention and control in nursing practice. It is the most effective way to prevent healthcare-associated infections (HAIs), which are a significant global health issue. According to the World Health Organization (WHO), hand hygiene is the most important measure to prevent the spread of infection in healthcare settings. This article will delve into the evidence-based practice (EBP) of hand hygiene in nursing, its importance, methods, and best practices.

Understanding Hand Hygiene in Nursing

Hand hygiene in nursing refers to the process of cleaning hands to remove or kill transient microorganisms. It is a critical component of infection prevention and control, as healthcare workers' hands are the most common route of transmission for healthcare-associated infections. The Centers for Disease Control and Prevention (CDC) estimates that up to 50% of HAIs could be prevented with improved hand hygiene compliance.

Evidence-Based Practice Guidelines for Hand Hygiene

Several organizations have developed evidence-based practice guidelines for hand hygiene in healthcare settings. These include:

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World Health Organization (WHO): The WHO "Five Moments for Hand Hygiene" approach emphasizes the importance of hand hygiene at specific times during patient care.
Centers for Disease Control and Prevention (CDC): The CDC provides detailed guidelines on when and how to perform hand hygiene, as well as the appropriate use of gloves.
Institute for Healthcare Improvement (IHI): The IHI's "5 Million Lives Campaign" includes hand hygiene as one of the key interventions to prevent HAIs.

Five Moments for Hand Hygiene (WHO)

The WHO's "Five Moments for Hand Hygiene" approach is based on the most common modes of transmission of microorganisms in healthcare settings. The five moments are:

Before touching a patient
Before performing a clean/aseptic procedure
After exposure to body fluids
After touching a patient
After touching a patient's surroundings

Methods of Hand Hygiene

There are two primary methods of hand hygiene in nursing:

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How Hand Hygiene Reduces Infections in Nursing Homes

Handwashing: The use of soap and water to physically remove microorganisms from the hands.
Hand rubbing (alcohol-based hand rub): The use of an alcohol-based hand rub to kill microorganisms on the hands.

Hand rubbing is generally preferred over handwashing when hands are not visibly soiled. However, handwashing is required when hands are visibly soiled or contaminated with potential infectious materials.

Best Practices for Hand Hygiene in Nursing

To ensure optimal hand hygiene practice, nurses should follow these best practices:

Best Practice	Rationale
Wear a wristwatch with a covered face or remove it before performing hand hygiene.	Watches can harbor microorganisms and may contaminate hands during hand hygiene.
Use a nailbrush to clean nails during handwashing.	Nails can harbor microorganisms and are difficult to clean with soap and water alone.
Avoid using rings, bracelets, and other jewelry that can harbor microorganisms.	Jewelry can harbor microorganisms and may contaminate hands during hand hygiene.
Dry hands thoroughly after handwashing to remove residual microorganisms.	Moist hands can harbor more microorganisms than dry hands.
Perform hand hygiene before and after using personal protective equipment (PPE).	PPE can become contaminated and may contaminate hands during use.

Hand hygiene is a critical component of infection prevention and control in nursing. By understanding and adhering to evidence-based practice guidelines, nurses can significantly reduce the risk of healthcare-associated infections and improve patient outcomes. Regular education, monitoring, and feedback on hand hygiene compliance are essential to maintain high standards of hand hygiene practice.