Soap and water versus hand rub

Question

After helping a resident clean up from an episode of diarrhea, a nursing assistant removes her gloves and sees stool on the skin of her wrist. A wall dispenser of alcohol-based hand rub is within reach and a sink is nearby. How should she clean her hands?

1. AWash with soap and water, because her hands are visibly soiled✓ Correct

   Correct. Soil that can be seen must be washed off with soap, friction and rinsing; hand rub is not the right choice here.

2. BUse the alcohol-based hand rub and let it dry, because it is faster✗ Incorrect

   Hand rub is not used on visibly soiled hands or hands exposed to body fluids, however convenient it is.

3. CRinse her hands under running water without soap, then dry them✗ Incorrect

   Water alone does not clean soiled hands; soap is needed to loosen and carry away the material.

4. DApply the hand rub twice in a row to cover the soiled area✗ Incorrect

   A second application does not fix the problem, because hand rub should not be relied on when soil is visible.

Answer

A. Wash with soap and water, because her hands are visibly soiled

Rationale

Hand rub is the usual choice for routine cleaning, but once hands show soil or have touched body fluids the aide has to wash. Soap loosens the material and the friction and rinsing carry it off, which plain water cannot do. This is why a convenient dispenser does not change the right answer.