The CDC makes the following 13 recommendations for indications for handwashing and hand antisepsis in its "Guideline for Hand Hygiene in Health-Care Settings."
1. When hands are visibly dirty or contaminated with proteinaceous material or are visibly soiled with blood or other body fluids, wash hands with either a non-antimicrobial soap and water or an antimicrobial soap and water.
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2. If hands are not visibly soiled, use an alcohol-based hand rub for routinely decontaminating hands in all other clinical situations described in items 2-10. Alternatively, wash hands with an antimicrobial soap and water in all clinical situations described in items 2-10.
3. Decontaminate hands before having direct contact with patients.
4. Decontaminate hands before donning sterile gloves when inserting a central intravascular catheter.
5. Decontaminate hands before inserting indwelling urinary catheters, peripheral vascular catheters, or other invasive devices that do not require a surgical procedure.
6. Decontaminate hands after contact with a patient's intact skin (e.g., when taking a pulse or blood pressure, and lifting a patient).
7. Decontaminate hands after contact with body fluids or excretions, mucous membranes, nonintact skin, and wound dressings if hands are not visibly soiled.
8. Decontaminate hands if moving from a contaminated-body site to a clean-body site during patient care.
9. Decontaminate hands after contact with inanimate objects (including medical equipment) in the immediate vicinity of the patient.
10. Decontaminate hands after removing gloves.
11. Before eating and after using a restroom, wash hands with a non-antimicrobial soap and water or with an antimicrobial soap and water.
12. Antimicrobial-impregnated wipes (i.e., towelettes) may be considered as an alternative to washing hands with non-antimicrobial soap and water. Because they are not as effective as alcohol-based hand rubs or washing hands with an antimicrobial soap and water for reducing bacterial counts on the hands of HCWs, they are not a substitute for using an alcohol-based hand rub or antimicrobial soap.
13. Wash hands with non-antimicrobial soap and water or with antimicrobial soap and water if exposure to Bacillus anthracis is suspected or proven. The physical action of washing and rinsing hands under such circumstances is recommended because alcohols, chlorhexidine, iodophors, and other antiseptic agents have poor activity against spores.
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