When do hand hygiene recommendations necessitate the use of soap and water over ABHRs?

The need for soap and water over alcohol-based hand rubs (ABHRs) is particularly emphasized when hands are visibly soiled. This recommendation is grounded in the fact that ABHRs may not effectively remove dirt, organic material, and certain pathogens that are found on visibly soiled hands. Soap and water are more effective in achieving complete cleanliness and ensuring that any contaminants are thoroughly removed from the skin.

Using soap and water helps to physically remove dirt and grime through the action of scrubbing, which cannot be achieved with an alcohol-based rub. This practice is especially important in healthcare settings where the risk of infection is high, as it contributes to maintaining a safe environment for patients and healthcare workers alike.

In situations where the hands appear clean or only have minimal contamination, ABHRs would typically suffice. However, when there is visible soiling, it is vital to prioritize hand hygiene practices that fully address the potential for pathogens to remain on the skin.