Before patient contact, the nurse disinfects equipment and performs hand hygiene. Which action demonstrates compliance with hand hygiene?

• A. Wearing gloves without washing hands.
• B. Wiping hands on the gown.
• C. Performing hand hygiene with soap and water for at least 20 seconds or using an alcohol-based sanitizer when hands are not visibly soiled.
• D. Washing for 5 seconds.

Answer: (C)

Hand hygiene before patient contact is the key to preventing transmission of infections in the care setting. The best demonstration is performing hand hygiene with soap and water for at least 20 seconds, or using an alcohol-based sanitizer when hands are not visibly soiled. This should be done before donning gloves, because gloves are not a substitute for clean hands and can transfer organisms if hands aren’t properly cleaned. Wiping hands on the gown doesn’t remove contaminants, and a 5-second wash is far too short to adequately reduce microbial burden. If hands are visibly dirty or contaminated, wash with soap and water; otherwise, sanitizer is quick and effective for routine decontamination.