Lessons · Nursing · hand hygiene, in order

Hand hygiene: the order, and the twenty seconds

Wet, soap, rub every surface for at least twenty seconds, rinse with the fingers pointing down, dry with a paper towel, and turn the tap off with that towel.

Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.

What it is for

It is the first thing taught and the first thing hurried when a shift gets busy, and it is the single measure that stops most of what travels between rooms. The step people skip is the last one: clean hands on a tap that dirty hands turned on.

How to think about it

Do it in the same order every time, so a busy shift cannot rearrange it. Water first, soap second, twenty seconds of rubbing that includes the backs of the hands, between the fingers, the thumbs and the nails, then rinse downward so the water runs off the fingertips, then dry, then the tap through the towel.

Worked example

1. Wet the hands with running water

Before the soap, so it lathers instead of sitting on dry skin.

2. Apply soap

Enough to cover every surface.

3. Rub all surfaces for at least 20 seconds

Palms, backs, between the fingers, thumbs, fingertips and nails.

4. Rinse with the fingers pointing down

So what came off the hands runs away from the clean wrists.

5. Dry with a paper towel

Wet hands pick up and pass on far more than dry ones.

6. Turn the tap off with the towel

The tap was touched with dirty hands and nothing has cleaned it since.

Your turn

Write what the tap is turned off with at the end.

6. Turn the tap off with the

The trap

Turning the tap off with a bare clean hand. The handle is exactly as contaminated as it was when you turned it on, so the last second of the procedure undoes the twenty before it.

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