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Skip Navigation LinksPennsylvania Department of Health > My Health > A-Z Health Topics > E-H > Hand Hygiene Fact Sheet


Hand hygiene means cleaning your hands by washing with soap and water or by using an alcohol-based hand rub (these include alcohol-based gels or foams and are sometimes called hand sanitizer).
Handwashing is like a "do-it-yourself" vaccine – it involves five simple and effective steps (Wet, Lather, Scrub, Rinse, Dry) to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick and prevent the spread of germs to others. If you don’t have access to soap and water, using alcohol-based hand rubs is a good alternative.
Health care providers perform hand hygiene to avoid spreading germs to patients. Since they must perform hand hygiene so often, alcohol-based hand rubs are the most effective products for health care providers.
When to wash your hands:  
  • before, during and after preparing food
  • before eating food
  • before and after caring for someone who is sick
  • before and after treating a cut or wound
  • after using the toilet
  • after changing diapers or cleaning up a child who has used the toilet
  • after blowing your nose, coughing or sneezing
  • after touching an animal, animal feed or animal waste
  • after handling pet food or pet treats
  • after touching garbage
When a health care provider should wash his/her hands: 
  • before eating
  • before and after having direct contact with a patient's intact skin (for example, taking a pulse or blood pressure, performing physical examinations, or lifting the patient in bed)
  • after contact with blood, body fluids or excretions, mucous membranes, non-intact skin, or wound dressings
  • after contact with inanimate objects near the patient
  • if hands will be moving from a contaminated body site to a clean body site during patient care
  • after glove removal
  • after using a restroom
How to wash your hands with soap and water: 
  • Wet your hands with clean, running water (warm or cold), turn off the tap and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them.
How to clean your hands with alcohol-based hand rub: 
  • Apply to the palm of one hand (read the label to learn the correct amount).
  • Rub your hands together.
  • Rub the product over all surfaces of your hands and fingers until your hands are dry.
What’s better: handwashing or alcohol-based hand rub?
There are important differences between washing hands with soap and water and cleaning them with hand rub. For example, alcohol-based hand rubs don’t kill ALL types of germs, such as a stomach bug called norovirus, some parasites and Clostridium difficile, which causes severe diarrhea. Hand rubs also may not remove harmful chemicals, such as pesticides and heavy metals like lead. Handwashing reduces the amounts of all types of germs, pesticides and metals on hands.
How to protect yourself when you are a health care patient:
As a patient in a health care setting, you are at risk of getting an infection while you are being treated for something else. Patients and their loved ones can play a role in asking and reminding health care providers to clean their hands. Your hands can spread germs too, so protect yourself by cleaning your hands often.
Protect yourself by asking questions: 
  • Clean your own hands and ask those around you to do the same.
  • Don’t be afraid to use your voice: it’s OK to ask your health care provider questions, such as:
    • “I didn’t see you clean your hands when you came in, would you mind cleaning them again before you examine me?”
    • “I’m worried about germs spreading in the hospital. Will you please clean your hands once more before you start my treatment?”
  • Ask your loved ones to clean their hands too:
    • “I saw you clean your hands when you arrived some time ago, but would you mind cleaning them again?”
Additional Information
Centers for Disease Control and Prevention: 
Handwashing and Hand Sanitizer Fact Sheet: 
This fact sheet provides general information. Please contact your physician for specific clinical information. 

Last reviewed/updated: June 13, 2017