Hand Hygiene

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The best way to prevent the spread of germs (bacteria and viruses) and infections is by a process called hand hygiene. Good hand hygiene means either washing hands with soap and water or killing germs on the hands with an at least 60% alcohol-based hand sanitizer or rub. When you clean your hands, you remove many germs. Germs are very small and are everywhere. You cannot see them, but they spread disease. They are on door handles, tables, phones, pencils, and most things that people touch. Our hands are always touching germs. Clean hands will help keep you healthy. 

Wash your and your child’s hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer until dry, every time you enter and leave the hospital room.

How to Wash Your Hands

  1. Wet your hands with warm, running water. Running water is an important part of washing away germs. Special towelettes or hand wipes should only be used when running water is not nearby. Water basins should not be used instead of running water. Illnesses have been linked with sharing wash water and wash basins or sinks.
  2. Apply soap. Antibacterial bars or liquid soap kills more germs than regular soap and is the best. Mild liquid soap should be okay if you do not have antibacterial soap.
  3. Rub your hands together well for at least 20 seconds, making sure to clean between your fingers, under your nails, and on the backs of your hands (Picture 1). Count to 20 slowly before you finish rubbing your hands. If children are old enough, teach them to sing the “ABC” song while washing.
  4. Rinse your hands well under clean, running water (Picture 2). Soap left on your hands may cause dry, chapped skin.
  5. Dry your hands with a paper towel or a clean washcloth (Picture 3).
  6. Use the towel or washcloth to turn off the water (Picture 4). If you touch the water faucet after you wash your hands, you may get germs on your hands again.

Hand Hygiene

How to Use an Alcohol-Based Hand Sanitizer

  1. Apply the sanitizer to the palm of your hand.
  2. Rub your hands together. Make sure to rub between fingers, under your nails, and the backs of your hands.
  3. Rub until your hands are dry.

When to Perform Hand Hygiene

Washing your hands with soap and water is always best. 

It is best to wash with soap and water at these times:

  • Before you eat
  • After you use the bathroom
  • After blowing your nose, coughing, or sneezing
  • Any time your hands are dirty
  • After changing diapers or helping a child use the potty
  • After contact with body fluids like blood, urine, or vomit (throw-up) 

If you cannot wash your hands, it is okay to use an alcohol-based hand sanitizer at these times:

  • At school
  • After petting animals
  • After being in contact with a sick person 


Artificial (fake) nails can hide dangerous bacteria. Do not wear them, especially if you are doing dressing changes or caring for a child who has lowered immunity, a central IV (CVC) line, or a feeding tube.

Artificial nails include gel nails, shellac, acrylics, bonding, tips, wraps, tapes, inlays, overlays, appliques, or powders. It is best to use clear polish on natural nails or leave nails unpolished.

Hand Hygiene (PDF), Arabic (PDF), Nepali (PDF), Somali (PDF)Spanish (PDF)

HH-IV-80 6/01, Revised 2/22 Copyright 2001, Nationwide Children’s Hospital