steps of hand hygiene according to nabh

"Steps to Hand Hygiene: NABH Guidelines"

By Mark DavisMarch 1, 2026

Hand hygiene is a critical aspect of infection prevention and control, especially in healthcare settings. The National Association of Boards of Health (NABH) has outlined clear steps for effective hand hygiene. Let's delve into these steps, ensuring your understanding and application of this vital practice.

Why Hand Hygiene Matters

Hand hygiene is the single most important measure to prevent healthcare-associated infections. It reduces the risk of transmitting pathogens to patients, visitors, and healthcare workers. According to the World Health Organization (WHO), hand hygiene can reduce the risk of healthcare-associated infections by up to 30%.

NABH's Five Moments for Hand Hygiene

The NABH, in line with the WHO, recommends performing hand hygiene at five critical moments:

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Before touching a patient
Before performing an aseptic task (e.g., handling invasive devices)
After touching a patient
After touching a patient's surroundings (e.g., bed, equipment)
After exposure to body fluids

When to Use Alcohol-Based Hand Rubs vs. Soap and Water

Alcohol-based hand rubs are preferred in most situations as they are faster, more effective against a broader range of pathogens, and less likely to cause skin irritation. However, soap and water should be used in the following situations:

Visible soiling of hands
Contamination with potential spore-forming organisms (e.g., Clostridium difficile)
After using the toilet

Steps of Hand Hygiene According to NABH

The NABH recommends the following steps for hand hygiene:

instructions on how to do hand gestures for beginners

Step	Action
1	Remove any jewelry that could interfere with hand hygiene or become contaminated.
2	Apply an alcohol-based hand rub or turn on the tap and apply soap to your hands.
3	Rub your hands palm to palm.
4	Rub your left palm over the back of your right hand and vice versa.
5	Interlace your fingers and rub your hands palm to palm.
6	Rub your thumbs individually by rotating them in a circular motion over the palms of your hands.
7	Rub your fingertips into the palm of your opposite hand and vice versa.
8	Rub your fingertips into the palm of your opposite hand and vice versa.
9	Rinse your hands with water.
10	Dry your hands using a clean towel or air dry them.

Remember, hand hygiene is not just about following the steps; it's also about doing it consistently and correctly. It's a simple yet powerful tool that can significantly impact patient safety and healthcare outcomes.

In the spirit of continuous learning and improvement, it's essential to stay updated with the latest guidelines and best practices in hand hygiene. The NABH and WHO provide excellent resources for this purpose.