when are staff expected to perform a hand hygiene

"Hand Hygiene: When & Why Staff Must Perform It"

By Brian AndersonNovember 22, 2025

Hand hygiene is a critical aspect of infection prevention and control in healthcare settings. It's one of the most important measures to prevent healthcare-associated infections (HAIs), which are a significant global health concern. But when are staff expected to perform hand hygiene? Let's delve into the guidelines and best practices.

Understanding the "Five Moments" of Hand Hygiene

The World Health Organization (WHO) has outlined the "Five Moments" of hand hygiene, which are universally recognized and widely adopted. These moments are:

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

When to Perform Hand Hygiene: Detailed Guidelines

Before Patient Contact

Hand hygiene should be performed before touching a patient or their immediate surroundings. This is because healthcare workers (HCWs) can carry microorganisms on their hands, which can be transferred to patients and cause infections.

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Before Clean/Aseptic Procedures

Hand hygiene is crucial before performing any clean or aseptic procedures, such as preparing an injection or handling sterile equipment. This is to minimize the risk of contaminating the sterile field and causing an infection.

After Exposure to Body Fluids

Hand hygiene should be performed immediately after exposure to a patient's blood, body fluids, secretions, or excretions. This is to prevent the transmission of microorganisms from the HCW's hands to other patients or surfaces.

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After Patient Contact

Hand hygiene should be performed after touching a patient, even if gloves were worn. This is because gloves can become contaminated and touching them can lead to self-contamination.

After Touching Patient Surroundings

Hand hygiene should be performed after touching surfaces or equipment in the patient's environment that could be contaminated, such as bedrails, overbed tables, or stethoscopes. This is to prevent the spread of microorganisms to other patients or surfaces.

Hand Hygiene Techniques

Knowing when to perform hand hygiene is only half the battle. It's equally important to know how to perform it effectively. The WHO recommends the use of alcohol-based hand sanitizers or soap and water, depending on the situation.

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The Five Essential Moments for Clinical Hand Hygiene

Situation	Recommended Hand Hygiene Method
Routine hand hygiene (no visible soil)	Alcohol-based hand sanitizer
Visible soil or contamination	Soap and water
After using the toilet	Soap and water

Regardless of the method used, it's essential to follow the recommended steps for thorough hand hygiene. This includes washing hands with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer until hands are dry.

Promoting a Culture of Hand Hygiene

While knowing when and how to perform hand hygiene is crucial, it's equally important to promote a culture of hand hygiene in healthcare settings. This involves leading by example, providing adequate resources, educating staff, and monitoring compliance.

In conclusion, hand hygiene is a cornerstone of infection prevention and control. Understanding the "Five Moments" of hand hygiene and adhering to the recommended techniques can significantly reduce the risk of healthcare-associated infections. It's not just about knowing when to perform hand hygiene; it's about making it a habit, a culture, and a priority in healthcare settings.