1.2 Hand Hygiene

Image of hand for practise good hand hygieneHand hygiene is considered an important practice in reducing the transmission of infectious agents which cause HAIs.

Hand washing sinks must only be used for hand hygiene and must not be used for the disposal of other liquids.  (See Appendix 3 of Pseudomonas Guidance)

Before performing hand hygiene:

Hand washing should be extended to the forearms if there has been exposure of forearms to blood and/or body fluids.

 *For health and safety reasons, Scottish Ambulance Service Special Operations Response Teams (SORT) in high risk situations require to wear a wristwatch.

To perform hand hygiene:

Alcohol Based Hand Rubs (ABHRs) must be available for staff as near to point of care as possible. Where this is not practical, personal ABHR dispensers should be used.

Perform hand hygiene:poster showing who 5 moments for hand hygiene

  1. before touching a patient;
  2. before clean/aseptic procedures. If ABHR cannot be used then antimicrobial liquid soap should be used;
  3. after body fluid exposure risk;
  4. after touching a patient; and
  5. after touching a patient’s immediate surroundings


Some additional examples of hand hygiene moments include:

Download and print the 5 moments of hand hygiene poster.

Wash hands with non-antimicrobial liquid soap and water if:

In all other circumstances use ABHRs for routine hand hygiene during care.

Staff working in the community should carry a supply of Alcohol Based Hand Rub (ABHR) to enable them to perform hand hygiene at the appropriate times. 

Where staff are required to wash their hands in the service user’s own home they should do so for at least 20 seconds using any hand soap available. 

Staff should carry a supply of disposable paper towels for hand drying rather than using hand towels in the individual’s own home.  Once hands have been thoroughly dried, ABHR should be used.

The use of antimicrobial hand wipes is only permitted where there is no access to running water.  Staff must perform hand hygiene using ABHR immediately after using the hand wipes and perform hand hygiene with soap and water at the first available opportunity.

(The video above demonstrating Hand Washing and Drying Technique was produced by NHS Ayrshire and Arran)

For how to:

Skin care:

Surgical Hand Antisepsis

Surgical scrubbing/rubbing: (applies to persons undertaking surgical and some invasive procedures)

Perform surgical scrubbing/rubbing before donning sterile theatre garments or at other times e.g. prior to insertion of central vascular access devices.

Hand Hygiene posters/leaflets can be found at Wash Your Hands of Them Resources.

Information on the WHO World Hand Hygiene Day 2021 with the theme 'Achieving hand hygiene at the point of care' is available.

Further information can be found in the Hand Hygiene literature reviews:

  (The video above demonstrating Surgical Scrubbing using ABHR was produced by Golden Jubilee National Hospital)