• Immediately before touching a patient
• Before performing an aseptic task (e.g., placing an indwelling device) or handling invasive medical devices
• Before moving from work on a soiled body site to a clean body site on the same patient
• After touching a patient or the patient’s immediate environment
• After contact with blood, body fluids or contaminated surfaces
• Immediately after glove removal

Wash with Soap and Water

• Lotions and creams can prevent and decrease skin dryness that happens from cleaning your hands
• Use only hand lotions approved by your healthcare facility because they won’t interfere with hand sanitizing products

Fingernail Care and Jewelry

• Germs can live under artificial fingernails both before and after using an alcohol-based hand sanitizer and handwashing
• It is recommended that healthcare providers do not wear artificial fingernails or extensions when having direct contact with patients at high risk (e.g., those in intensive-care units or operating rooms)
• Keep natural nail tips less than ¼ inch long
• Some studies have shown that skin underneath rings contains more germs than comparable areas of skin on fingers without rings
• Further studies are needed to determine if wearing rings results in an increased spread of potentially deadly germs