If hands are visibly dirty, what hand hygiene method is appropriate before resident care?

• A. Use soap and water for at least 20 seconds.
• B. Use an alcohol-based hand sanitizer only.
• C. Rinse hands with cold water only.
• D. Apply hand lotion and rewash later.

Answer: (A)

When hands are visibly dirty, washing with soap and water is necessary because mechanical cleaning with soap lifts soil and microbes from the skin and running water flushes them away. Do this for at least 20 seconds, scrubbing all surfaces—palms, backs of hands, between fingers, under nails, and wrists—then rinse thoroughly. Dry with a clean disposable towel and use it to turn off the faucet to avoid recontamination. Alcohol-based sanitizers don’t remove visible dirt, so they aren’t appropriate here. Rinsing with cold water alone won’t remove the soil, and delaying washing or just reapplying lotion and washing later won’t adequately clean the hands before resident care.