Hand Hygiene and the WHO Steps
Hand hygiene is the cornerstone of infection prevention. The WHO defines Five Moments and a step-by-step handwashing technique.
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What you must know about Hand Hygiene
The WHO "Five Moments for Hand Hygiene" guide when to clean hands.
The Five Moments: before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings.
Handwashing with soap and water should take about 40–60 seconds.
Alcohol-based hand rub is used when hands are not visibly soiled (about 20–30 seconds).
Wash hands with soap and water when they are visibly dirty or after contact with spores (e.g., C. difficile).
Cover all surfaces of the hands, including between fingers, thumbs, and fingertips.
NMCN Exam Tips
How this topic appears in the NMCN exam
Know the WHO Five Moments for Hand Hygiene.
Use soap and water when hands are visibly soiled.
Alcohol rub takes ~20–30 seconds; handwashing ~40–60 seconds.
Hand hygiene is the top measure to prevent cross-infection.
Practice Question
Test yourself
According to WHO guidelines, when should a nurse perform hand hygiene in relation to patient care?
Explanation
The WHO 'Five Moments for Hand Hygiene' require cleaning hands before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings — not only when hands appear dirty.
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