Improved Hand Hygiene to Prevent Health Care-Associated Infections

by Adriana Arcia, Johis Ortega, & Susana Barroso

School of Nursing and Health Studies, University of Miami

In this module, you will learn about how you can reduce the risk of health-care associated infections by employing optimal hand hygiene practices. Let’s begin!

According to the World Health Organization (WHO), health care-associated infections are a serious but preventable problem affecting an estimated 1.4 million people around the world at any given time. Rates of health care-associated infection range from 5% to over 40%, depending upon the setting. Correct hand hygiene is a very effective strategy for lowering the incidence of such infections. Unfortunately, health care workers’ compliance with hand hygiene recommendations remains unacceptably low and the resulting infections are a serious threat to patient safety.

Fortunately, you can promote the safety of your patients by practicing good hand hygiene. As nurses, we take pride in making sure our hands are clean, but we could all use reminders of proper technique now and then. This module is designed to help you make sure that your knowledge about hand hygiene is complete and up-to-date.

Upon completion of this module, you should be able to:

  • Describe the five moments of hand hygiene
  • Match the correct hand hygiene method to the clinical situation
  • Apply correct hand hygiene techniques to your nursing practice

Thinking Question

Think about the number of times and places you perform hand hygiene during a typical workday. Are the supplies you need for correct hand hygiene available where and when you need them?

Core Concepts

Read the following Patient Safety Solution to learn about optimal hand hygiene practices:

Improved Hand Hygiene to Prevent Health Care-Associated Infections

  • Hand hygiene is a high priority. Know and implement your 5 moments for hand hygiene and use correct technique.
  • Adequate supplies for hand hygiene (water and soap; alcohol-based handrubs) should be readily available for your use.
  • Encourage the proper hand hygiene practices of the people to whom you delegate patient care activities.
  • Educate patients and their families about proper hand hygiene. Reinforce your teaching by performing your hand hygiene in their presence.

Adapted from: World Health Organization. (2007). Patient Safety Solutions-Improved Hand Hygiene to Prevent Health Care-Associated Infections. Aide Memoire, Volume 1 (Solution 9). Retrieved from

Do you know your 5 moments for hand hygiene? Do you know when to use an alcohol-based handrub and when to use soap and water? Make sure your knowledge is current. Review these WHO hand hygiene materials. Return to the module when you have finished.

Watch this video to see correct hand hygiene in action!

Case Study 1

Mr. Weiss spent several days in room 303 on contact isolation because of infection with Clostridium difficile. When he was discharged, the housekeeping staff cleaned the room thoroughly but left behind the blood pressure cuff that had been assigned to him. A nurse was preparing the newly cleaned room for a patient that was to be admitted within the next hour. The nurse noticed that the contaminated blood pressure cuff had been left behind and took it to the dirty utility room for pickup and cleaning. Before seeing Ms. Rhodes in room 304, the nurse performed hand hygiene with an alcohol-based handrub. Ms. Rhodes eventually developed frequent loose stools and tested positive for C. diff.

Case Study Questions

Which hand hygiene moment applied to this case?

Why was the nurse’s choice of hand hygiene method inappropriate in this case?

Integrating Your New Knowledge

Reflect again on the thinking question from the beginning of this module and incorporate what you have learned. What changes in your workplace would make it easier for you to perform hand hygiene correctly? How can you encourage your colleagues to comply fully with hand hygiene guidelines?

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