Hand Hygiene

Clinical Objective

Reduce transient and resident microbial flora on the hands and forearms of all surgical personnel before donning sterile attire and at every transition that exposes hands to potential contamination.

Why This Matters

Hands are the most frequent vector of contamination in any surgical environment. Surgical hand antisepsis is the single most validated infection-control intervention performed by every team member.

Critical Control Points

• Surgical hand antisepsis performed before initial gowning

• Hand hygiene re-performed at any contamination event

• Alcohol-based surgical hand rub applied to fully dry hands

1. 1

   Before any patient contact: apply alcohol-based hand rub using the WHO 6-step technique for 20–30 seconds.

2. 2

   Before handling IV catheters, infusion lines, or injectable medications: perform hand rub or soap-and-water wash.

3. 3

   Before administering sedation or any induction agent: perform hand rub.

4. 4

   After removing gloves: perform hand rub immediately — gloves do not replace hand hygiene.

5. 5

   After patient contact, environmental surface contact, or handling contaminated material: hand rub.

6. 6

   Before leaving and on re-entry to the OR: perform hand rub at the door.

Key Pitfalls

• Skipping hand hygiene because gloves are being worn — gloves are a barrier, not a substitute for clean hands.

• Using alcohol rub on visibly soiled hands — wash with soap and water first.

• Not performing hand hygiene after removing contaminated gloves from clipping or patient prep.

• Skipping re-hygiene when moving between tasks (e.g., from anesthesia setup to catheter handling).